I do not know if it is by mere coincidence, or whether it is due to something slightly more cosmic, but, many of the most important, and in fact traumatic events in my life have happened in August . It was in August at the start of my senior year in high school when my parents decided to up and move yet again, ending the Beverly to Salem to Beverly loop by moving to Ipswich. It was in August, 1990 when I received my first diploma. It was in August when my wife and I bought our first home. It was in August when we bought our second home. It was in August when we later sold the first. More recently in August I received my biopsy results. Ten years ago , on the third of August I became a father. Sixteen days later, a stretch of eight days began that would bring me as close to the title of "single dad" or "widower" than I hope I ever experience again.
Our son ,who I am convinced did not want to be born ( he had to be induced twice) finally joined the outside world at 9:45 pm on August 3rd, 2000. Two days later our discharge to go home was delayed as our baby boy came down with jaundice, so we had to wait for a blood test result on him to see if we could go home. Finally about 9 pm they sent us packing , more or less. That is what it felt like. They are just throwing us out? When you are new parents, you feel like every time you pick your baby up you may break him. At least in the hospital, if you do in fact break the baby, they can fix him right there. They have a baby-fixin' toolbox right there. I have seen it. No worries.
Eventually, though,the legally mandated forty-eight hours expires, and suddenly you find yourself escorted to the curb, thrust out into the cold cruel world( well it was August so it wasn't all that cold) entrusted with caring for this really tiny human. Really tiny. Hamster sized. Made out of Christmas Ornament glass. Well not really . But that is what it felt like. And they were keeping the toolbox. Sure they sent us home with a six- pack of Pampers,"just to getcha started", but that is like sending an Astronaut on a space walk with nothing more than a a scuba mask. But it would only be for sixteen days.
Ten years ago, for the most part August 19th was like any other hectic, sleep-deprived day in the life of new parents. At that point, after sixteen consecutive days of sleeping in ninety-minute shifts, Michelle and I were pretty much shells of our former selves. Our son was not what you call a "napper". He would so unwillingly submit to the sandman that I used to think we should have named him Dylan. So the fact that Michelle was not quite feeling herself that afternoon, at first did not seem that odd. Giving birth after a long labor, then a subsequent mild infection, and a baby that refused to sleep would do that to a person. But her unease quickly escalated to the point of horrific pain,so severe that when they asked her later at the E.R. to quantify the pain, had she not just given birth, she told them it would have ranked as the worst in her life.
They admitted her for tests, that would later reveal a massive gall stone attack. She needed surgery. Quickly. The doctors put her on morphine for the pain, then proceeded to explain to us how they would do the surgery. Many words flowed from their mouths. Large words like laparoscopic, hepatic, pancreatitis and not so large words like camera, gas, bile, risks, and death.
After approving the procedure, she was wheeled away a short while later for her surgery. For the first time in my life I was faced with the prospect that were something to go tragically wrong, my newly born son could be left without a mother. A mother he would never know. Comforting thoughts to a new dad. Good book title.
I spent the next few hours waiting, worrying, pacing, processing , and learning how to feed my child formula . Up to that point the plan was that he was going to be nursed. Morphine drips tend to change plans.
After her surgery they wheeled her back into the room, and declared that the surgery went well. Some relief seemed to float into the room alongside her gurney. But it would not last.
Over the next several hours it became harder for her to breathe. Out she went for more tests. X-Rays. CT-Scans. The doctor came back to speak with us. His earlier upbeat face had been replaced. This one was not smiling. This time he used a word whose gravity I didn't fully grasp at the time : embolism.
Up to that point she had been allowed to return to the maternity ward, to be close with the baby. With this new news, she was to be moved into the telemetry unit. More nurses there, he explained. More training to deal with this sort of thing, he said.
So we were taken to the new room. We left the carpeted, wood paneled , almost hotel-like amenities of the maternity ward and soon found ourselves immersed in more traditional hospital decor. It was at this point I began to fully realize what was happening. Then it was made crystal clear, when the nurse in charge at the new unit, informed me that Michelle could no longer breastfeed due to the "clotbusting drugs they are starting her on. So you need to go get yourself some formula for the baby".
Practically in a state of shock, I took my newly born son, left my wife to be tended to by what I hoped and prayed were capable doctors , and headed to the grocery store. I had no idea what was going to happen. At the hospital. Or at the store.
After a few false starts up and down the aisles, I soon located the formula . During my quest , my son began crying. He was hungry. I was lost. Not a good combination. As his screams grew louder I found myself confronted with literally hundreds of brightly colored boxes, each claiming to be the "best choice for your child's nutrition". Yet each named with such unappetizing words like Enfamil. Or Simmilac. Is there an Ipecac too, I wondered. I had no idea what to choose. It was so frustrating. I started to sweat. The baby's cries grew louder. People around us in the store started to look. What is that guy doing to that baby. He has no idea what he is doing. Well, this is not the plan . I would explain to them. The plan was for the baby to be born on time. The plan was that the baby would be nursed. I am not supposed to be doing this. I found myself suddenly feeling angry. Then guilty. The plan was not to be on this roller-coaster ride;one minute taking you up, up up, filled with the incredible awe, joy and wonder of birth, then down, down down , the next turn into emergency surgery, morphine, heparin, medical proxy decisions and last minute formula purchases .
But then again it is August.
Thursday, August 19, 2010
Monday, August 16, 2010
How Elvis Saved My Summer
Thirty-three years ago, on this date, the sixteenth day of August, nineteen hundred and seventy-seven, I remember exactly where I was. I also remember what I did pretty much the entire day.
That summer I was ten years old and my family had just moved from the city of my birthplace , Beverly, across the bridge to Salem. We went from living in a classic "leave it to beaver" kind of neighborhood, unified around a quaint, old-fashioned elementary school at it's center, to one split in half, divided as much by the physical location of the school, if not the socioeconomics of the inhabitants . One half of the neighborhood, the side we were now living, was filled with older Victorian-era homes that had seen better days, with mostly french-canadian names on the mailboxes. The other half was a more urban neighborhood than my young eyes had ever seen. Narrow,litter-strewn, congested streets filled with run down triple deckers, inhabited mostly by recent immigrants from Latin America and Puerto Rico.
It was a far cry from the neighborhood we left . At that time, Beverly was mainly populated by families with either Irish or Italian surnames. Names like O'Brien, Flaherty, McDonald, Giacomo ,Vitale were the ones that filled the phone books of the first ten years of my life.
We moved literally the day after school ended. I was still finishing my Little League season , in fact, and had to arrange rides to finish out the schedule. My parents had found what they thought was a way out of their five years of post-bankruptcy tenancy by pursuing a "rent with the option to buy" arrangement they saw in the local paper. "It's too good to pass up" my dad naively explained to his five kids, three of whom would be forced to change schools, friends, and last but not least ,baseball. Baseball!
Due to his previous financial misfortunes and having five children before he was thirty, my father could not pay the movers any more than he had to. This was to be the third move for me, so I knew the drill. About a month before the move date, he would begin secretly bringing home his truck from his job at the newspaper, so we could spend the last weekends of the school year packing, (which involved a lot of fighting between my parents over what to keep and what not to keep) and loading box after box into the van, driving it over the bridge into Salem, and unloading it into our "new" house. Not since the Berlin airlift had American's been involved in something so logistically complicated. There was also the added air of secrecy to our operation, as dad "would catch hell" from his boss if he was caught using the truck that way, burning company gas. Like the moonshine runners of the thirties, we loaded by daylight and unloaded by twilight.
The house up to this point had been serving as a defacto frat house for the nearby Salem State College. We knew this because evidence of its previous life was everywhere.The first thing I remember seeing when I walked in was the Christmas tree hanging from the antique chandelier in the living room, so dry it was practically mummified. In June. There was also the nice, collegiate-themed decorating touches in each room: "A friend with weed is a friend indeed" posters, along with matching exotic tubular "ashtrays" which my mother quickly gathered up with a gasp. Also hanging on the walls were the requisite velvet black light posters of the 1970's. They contained the usual suspects: Led Zeppelin, Hendrix, and some kind of a unicorn/water buffalo themed Dali-esque lovefest. You know, the usual stuff. This once proud Victorian, probably originally commissioned for one of Salem's early movers and shakers, had been carved in two, christened with the haze of post-Vietnam celebratory pot smoke, and rented out to students who, when the acid kicked in, must have thought they had died and gone to Hell .
Somehow during all the chaos and nashing of teeth that came to be known as the"Linden Street" move, my siblings and I "discovered" my mother's collection of vinyl, that somehow she had manged protect from her now brood of five. And we also realized that we had a turntable that unlike most of the household devices of my childhood,actually worked.
On top of being the "new kids" in a strange , tough neighborhood, the summer of '77 was extremely hot. So we mostly stayed inside. At first helping my mom unpack. Then driving her crazy. When it looked like we were about to become a murder stastistic: "five children found hanging by a Christmas Tree. In July" we found the vinyl. We then spent the rest of that summer listening to many, many old 45's. She seemed to have everything, from the Beatles to the Searchers' to Johnny Cash to Robert Mitchum. Yes that Robert Mitchum. Seems ol' Bob himself cut the theme song for his moonshine-running crime flick "Thunder Road" back in 1958.
But to us, the true piece of eight in this newly discovered treasure chest ,was the LP entitled Elvis' Golden Records. From the moment the needle hit the vinyl on the opening track "Hound Dog", once we placed that platter on the turntable, it never left. We loved it so much we began performing the songs , grabbing whatever was nearby to assume the roles of our instruments in our newly formed band. As the oldest, I naturally felt I should be Elvis, and my sister took on the part of the drums, and the older of my two brothers completed the rest of the ensemble.The other two kids were toddlers, so they were our "audience". My sisters "drum set" consisted of the arm of our beat-to-hell brown Naugahyde-cloaked recliner , which she would straddle and play, looking more like it was some bizarre headless animal , than a drum set. My part was to "sing" into my "mike":the hollow metal tube for the "power nozzle" attachment for our ancient Electrolux vacuum cleaner.
The racket we made singing along with the King probably made my mother wish she could actually put us in a vacuum.
There was a boy living on the other side of the duplex we met during one of our many "moonshine runs". He was about my age and introduced himself to us soon after our first visit. I remember thinking he must have just come back from the beach because he was so tan. His name was Jimmy, and his family was Greek he told us, not beachcombers, and his dad left his mom a along time ago so it was just him , his two sisters and his mom next door. He would be my friend if I wanted, he told me. I could also be his older sister's boyfriend if I wanted. She's twelve. He seemed like a nice kid. I remember just being relieved to know one person in this new place, but as things often go in families like his, he was gone just a year later, shipped off to live with his dad and I never saw him after that.
That summer after we were more or less settled in , my best friend from Beverly would sleep over on the weekends. Kind of helped ease the transition I guess. It was during one of these weekends when Jimmy burst through our back screen door , yelling "hey did you hear ? did you hear? Elvis is dead! The King is dead!"
He told us he had just got back from a plane trip to see his dad, and apparently the pilot announced the news over the loudspeaker to all the passengers. Women broke down and cried, he said. It was really weird. As suddenly as he had arrived, he left. Probably to tell Mrs.Hood next door, my mom said. We immediately went back to our 'tween Elvis Tribute Band performance. Appropriately, "Heartbreak Hotel" came up next.
Despite the traumatic start to that summer, when I left the only school I had ever known, and the looming uncertainty of it's end ,when I would find myself thrust into a sea of children as diverse
as the General Session of the U.N., the few weeks before and after Elvis' death remain a bright spot in my memories of that part of my childhood. So much so, that whenever I hear one of the tracks that was on the Golden Records LP, it instantly transports me back to that strange old house, surrounded by old vinyl, an electrolux, and the songs of a dead king .
That summer I was ten years old and my family had just moved from the city of my birthplace , Beverly, across the bridge to Salem. We went from living in a classic "leave it to beaver" kind of neighborhood, unified around a quaint, old-fashioned elementary school at it's center, to one split in half, divided as much by the physical location of the school, if not the socioeconomics of the inhabitants . One half of the neighborhood, the side we were now living, was filled with older Victorian-era homes that had seen better days, with mostly french-canadian names on the mailboxes. The other half was a more urban neighborhood than my young eyes had ever seen. Narrow,litter-strewn, congested streets filled with run down triple deckers, inhabited mostly by recent immigrants from Latin America and Puerto Rico.
It was a far cry from the neighborhood we left . At that time, Beverly was mainly populated by families with either Irish or Italian surnames. Names like O'Brien, Flaherty, McDonald, Giacomo ,Vitale were the ones that filled the phone books of the first ten years of my life.
We moved literally the day after school ended. I was still finishing my Little League season , in fact, and had to arrange rides to finish out the schedule. My parents had found what they thought was a way out of their five years of post-bankruptcy tenancy by pursuing a "rent with the option to buy" arrangement they saw in the local paper. "It's too good to pass up" my dad naively explained to his five kids, three of whom would be forced to change schools, friends, and last but not least ,baseball. Baseball!
Due to his previous financial misfortunes and having five children before he was thirty, my father could not pay the movers any more than he had to. This was to be the third move for me, so I knew the drill. About a month before the move date, he would begin secretly bringing home his truck from his job at the newspaper, so we could spend the last weekends of the school year packing, (which involved a lot of fighting between my parents over what to keep and what not to keep) and loading box after box into the van, driving it over the bridge into Salem, and unloading it into our "new" house. Not since the Berlin airlift had American's been involved in something so logistically complicated. There was also the added air of secrecy to our operation, as dad "would catch hell" from his boss if he was caught using the truck that way, burning company gas. Like the moonshine runners of the thirties, we loaded by daylight and unloaded by twilight.
The house up to this point had been serving as a defacto frat house for the nearby Salem State College. We knew this because evidence of its previous life was everywhere.The first thing I remember seeing when I walked in was the Christmas tree hanging from the antique chandelier in the living room, so dry it was practically mummified. In June. There was also the nice, collegiate-themed decorating touches in each room: "A friend with weed is a friend indeed" posters, along with matching exotic tubular "ashtrays" which my mother quickly gathered up with a gasp. Also hanging on the walls were the requisite velvet black light posters of the 1970's. They contained the usual suspects: Led Zeppelin, Hendrix, and some kind of a unicorn/water buffalo themed Dali-esque lovefest. You know, the usual stuff. This once proud Victorian, probably originally commissioned for one of Salem's early movers and shakers, had been carved in two, christened with the haze of post-Vietnam celebratory pot smoke, and rented out to students who, when the acid kicked in, must have thought they had died and gone to Hell .
Somehow during all the chaos and nashing of teeth that came to be known as the"Linden Street" move, my siblings and I "discovered" my mother's collection of vinyl, that somehow she had manged protect from her now brood of five. And we also realized that we had a turntable that unlike most of the household devices of my childhood,actually worked.
On top of being the "new kids" in a strange , tough neighborhood, the summer of '77 was extremely hot. So we mostly stayed inside. At first helping my mom unpack. Then driving her crazy. When it looked like we were about to become a murder stastistic: "five children found hanging by a Christmas Tree. In July" we found the vinyl. We then spent the rest of that summer listening to many, many old 45's. She seemed to have everything, from the Beatles to the Searchers' to Johnny Cash to Robert Mitchum. Yes that Robert Mitchum. Seems ol' Bob himself cut the theme song for his moonshine-running crime flick "Thunder Road" back in 1958.
But to us, the true piece of eight in this newly discovered treasure chest ,was the LP entitled Elvis' Golden Records. From the moment the needle hit the vinyl on the opening track "Hound Dog", once we placed that platter on the turntable, it never left. We loved it so much we began performing the songs , grabbing whatever was nearby to assume the roles of our instruments in our newly formed band. As the oldest, I naturally felt I should be Elvis, and my sister took on the part of the drums, and the older of my two brothers completed the rest of the ensemble.The other two kids were toddlers, so they were our "audience". My sisters "drum set" consisted of the arm of our beat-to-hell brown Naugahyde-cloaked recliner , which she would straddle and play, looking more like it was some bizarre headless animal , than a drum set. My part was to "sing" into my "mike":the hollow metal tube for the "power nozzle" attachment for our ancient Electrolux vacuum cleaner.
The racket we made singing along with the King probably made my mother wish she could actually put us in a vacuum.
There was a boy living on the other side of the duplex we met during one of our many "moonshine runs". He was about my age and introduced himself to us soon after our first visit. I remember thinking he must have just come back from the beach because he was so tan. His name was Jimmy, and his family was Greek he told us, not beachcombers, and his dad left his mom a along time ago so it was just him , his two sisters and his mom next door. He would be my friend if I wanted, he told me. I could also be his older sister's boyfriend if I wanted. She's twelve. He seemed like a nice kid. I remember just being relieved to know one person in this new place, but as things often go in families like his, he was gone just a year later, shipped off to live with his dad and I never saw him after that.
That summer after we were more or less settled in , my best friend from Beverly would sleep over on the weekends. Kind of helped ease the transition I guess. It was during one of these weekends when Jimmy burst through our back screen door , yelling "hey did you hear ? did you hear? Elvis is dead! The King is dead!"
He told us he had just got back from a plane trip to see his dad, and apparently the pilot announced the news over the loudspeaker to all the passengers. Women broke down and cried, he said. It was really weird. As suddenly as he had arrived, he left. Probably to tell Mrs.Hood next door, my mom said. We immediately went back to our 'tween Elvis Tribute Band performance. Appropriately, "Heartbreak Hotel" came up next.
Despite the traumatic start to that summer, when I left the only school I had ever known, and the looming uncertainty of it's end ,when I would find myself thrust into a sea of children as diverse
as the General Session of the U.N., the few weeks before and after Elvis' death remain a bright spot in my memories of that part of my childhood. So much so, that whenever I hear one of the tracks that was on the Golden Records LP, it instantly transports me back to that strange old house, surrounded by old vinyl, an electrolux, and the songs of a dead king .
Wednesday, August 11, 2010
Can You Hear Me Now?
Seems I am finally getting my voice back to normal after almost 4 weeks. Sunday marked the first day without any real throat pain. Still feels as if I tied my tie too tight, but the main soreness has dissipated. Seemed to take a lot longer than they said it would. Needless to say, once you find yourself with an altered voice box, you tend to put off verbal communication as much as possible. The less I spoke the better. A week or so ago, I went into Dunkin Donuts for an iced coffee and it took three takes to get my order right. Not terribly enjoyable, but I would be lying if I didn't say it bothered me more that I repeatedly caught the clerk's eyes alternating her glances between my eyes and the bandage on my neck. In this period my main communication has been with my family , and aside from writing, not so much the rest of the world. Time to start getting back to "normal".
I realized I was regaining my voice during Donovan's birthday party, which we hosted this past Sunday. I was able to, for the most part, hold a tune when we sang "Happy Birthday" to the lad. Having some strength in the vocal chords also came in handy earlier in the afternoon, while I was simultaneously grilling and keeping his cousins from burning themselves on the deck-side inferno, aka our Smokey Joe Weber grill. While I grilled , there were gusts of wind that kept the flames a good 8 to 12 inches high throughout most of the cooking process. Good for the burgers and 'dogs. Not so good for children.
I spent most of my "fire safety" time on one cousin, who stared wide-eyed with pyro-maniacal desire at the billowing flames and smoke. I was tipped off to his infatuation earlier in the day, when he repeatedly peppered with me "Uncle Roger , let me try " while lighting the old newspaper we use to start the lump charcoal. The other children at the party could care less about the guy at the grill. Not this one. Had I left the grill for a moment, I am sure anything flammable nearby would have been thrust into the flames, and carried about devolving a late-summer birthday bbq into a suburban variation of "lord of the flies".
I realized I was regaining my voice during Donovan's birthday party, which we hosted this past Sunday. I was able to, for the most part, hold a tune when we sang "Happy Birthday" to the lad. Having some strength in the vocal chords also came in handy earlier in the afternoon, while I was simultaneously grilling and keeping his cousins from burning themselves on the deck-side inferno, aka our Smokey Joe Weber grill. While I grilled , there were gusts of wind that kept the flames a good 8 to 12 inches high throughout most of the cooking process. Good for the burgers and 'dogs. Not so good for children.
I spent most of my "fire safety" time on one cousin, who stared wide-eyed with pyro-maniacal desire at the billowing flames and smoke. I was tipped off to his infatuation earlier in the day, when he repeatedly peppered with me "Uncle Roger , let me try " while lighting the old newspaper we use to start the lump charcoal. The other children at the party could care less about the guy at the grill. Not this one. Had I left the grill for a moment, I am sure anything flammable nearby would have been thrust into the flames, and carried about devolving a late-summer birthday bbq into a suburban variation of "lord of the flies".
Thursday, August 05, 2010
Letting It Sink In
Today I had my first-ever, post-op, follow-up. (that has to rank as one of the most hyphenated sentences I have ever written.)
Throughout this process ,all the appointments were made for me by the doctor's office month's in advance, completely wrestling from me the ability to delay something I very much wanted to delay, if not avoid completely. These dates seemed so far off that they may as well not even have existed. I received my "packet" three months ago that laid out the pre-op consult , the pre-op physical exam, and the post-op follow-up, along with lots of documentation, needing lots of my closely guarded personal information. It was then I began to realize how much control over "self" you give up as soon as you decide to enter the mechanism known as the "Finest Medical Care In The World". I had just seen Gran Torino when the package arrived and unlike Mr. Kowalski(or is that kwaski?) I filled out all my forms, and kept all my appointments.
It has been a bit longer than two weeks since my surgery, and I am still adhering to the restrictions imposed on me as best I can. One such item was 'no driving'. I probably can drive now, but I figured rush hour in Boston was not the time to get behind the wheel for the first time in weeks. So Michelle drove me in to Mass Eye and Ear. My appointment was for 10:45, and we made it in with enough time to spare to hit the cafeteria on the seventh floor for some of their pancakes . For some reason they did not seem as good as they were two weeks ago when they were my first breakfast in forty-eight hours. Go figure.
When we got to the office , it became apparent that today the doctor was on a tight schedule. "He wants to keep things moving" one of his assistants explained to me as she escorted me back as soon as I walked in the door.
After showing us to the exam room, she immediately began her role in this process: removal of the steri-strips. She bustled about the cramped exam room, her extremely generous physical attributes only adding to the claustrophobic feeling I had as my personal space was invaded yet again, and began draping me with a gauze bib.
" I'm a-gonna put some unsticker lotion on you, and this will keep you dry"
Did she say 'a-gonna?'What the hell is 'unsticker' " I thought to myself as she started to squirt a cold fragrant gel all over my neck.
"Apparently the gel is mainly witch hazel," she informed us. By the smell of it, I had no reason to doubt her. After I was good and saturated with it, from Adam's apple to navel, and the room full of its aroma,she began pulling off the last surgical remnants of my summer ordeal. "Ohh look at that! He sure does good work" she crowed as she got the first looks at my nineteen day old incision. "Here come see for yourself" she prompted , showing me where the mirror was. "Oh. Yeah." I concurred, not so much agreeing as placating. I still had a six inch long scar on my neck. I still had the disturbing "path" report. I still had to "have a conversation" with the surgeon, and the endocrinologist. The only things I didn't have anymore were the nasty,yellowed, curling steri-strips, and half of my thyroid.
"The doctor will be with you shortly" she said abruptly exiting the room.
Michelle and I barely had time to make the usual, sarcastic wise-ass comments about the medieval-looking instruments laying about the room, before there was a light rap on the door and one of the "fellows" entered the room and introduced himself. I remembered seeing him several times when I was in the hospital, but Michelle was meeting him for the first time.
"Hello, I am Dr. P. Nice to see you again."
He took a deep breath before speaking. " So, I am going to talk with you first and then Dr. R will be in . I see he called you last week with your report, and informed you that the large lesion was benign..." he began with thickly accented English. My years spent in food service told me when I first met him, even in my narcotic-induced post-op haze, " he's Brazilian" . I wanted to say "Fala !" but restrained myself .
"...but we also found a small papillary carcinoma. This happens all the time and you have nothing to worry about" Now do you mind if I feel your neck..."
While he was speaking, I had become aware of a presence hovering outside the half-opened door to the exam room. Dr. R suddenly opened the door fully, said "hello" to both Michelle and I, then curtly asked the fellow, "Dr. P, Can I speak with you for a moment in the other room."
Michelle and I just looked at each other with a "wtf is going on?" expression as we awaited the fellow's return.
It never came.
Instead it was Dr. R who returned to the room. We exchanged pleasantries, and he flipped open the red folder with my name on it, and took a moment to look at the papers therein.
"As I discussed with you over the phone last week the path report showed the lesion we were concerned with, the large 16 mm one, was benign. So that is good news. But it also did show a small follicular carcinoma, of about 4 mm in size..."
I did not really hear the remainder of that sentence .
I heard the word "follicular" and my mind was off to the races.
The fellow had used the word "papillary" to describe the cancer. Papillary is the most common , and most indolent form of thryoid cancer. If it spreads at all, it mainly is confined to the lymph nodes of the neck. Very easy to keep an eye on. Follicular on the other hand spreads through the blood , bypassing the lymph system altogether. Immediately my mind began to think of the worst case possibilities. That my body was at that very moment being seeded with microscopic cancerous cells floating throughout my bloodstream, like bits of garbage swept away in a mid-summer's flash flood. That the garbage contained cancer-like maggots that would then infiltrate the organs of my body, devouring from the inside out. That what he was going to say next would include the words "six weeks" or " six months" or "to live". And "radiation." And "chemotherapy".
But it didn't. Instead the conversation contained phrases like " "minimally invasive", and "near zero","discussions" , "conversations" and "we will make sure we follow you".
But I couldn't let the slip-up by the fellow go.
"Dr. P told me it was 'papillary'. Follicular can spread through the blood" I blurted out, interrupting the doctor in mid-sentence.
"yes, Dr. P made a mistake. He is still very new, and does not always get the language right."
No shit ,he is new, I thought. Would it totally blow this guys mind if he knew with my advanced research tool , "The Google" , I found out on "the Google" that Dr. P was so new that his medical license, a "limited " one in fact, had only been issued to him on July 7th. Exactly one week before he was in the O.R. assisting you as you sliced open my neck? But I refrained.
" Yes, about that. I will be addressing that with him shortly. Forget what he said. You need to listen to what I am saying", Dr. R replied. I began picturing what will happen later, after we leave. I imagined this intern, fellow, whatever he is called being beat about the head by my enraged surgeon with tubes of witchhazel,clipboards, his "Limited License", and whatever else he could grab,amid screams of " Papillary? Papillary?!! I'll show you Papillary!!!!" Then, summarily being dragged by his ear to the cabinet where the wax for the Maserati is kept," I want two coats this time , dammit, you hear me? TWO COATS!"
Needless to say,henceforth our verbally challenged fellow has now become known as "Dr. Maserati" between Michelle and I.
Basically the long and short of my follow-up is my doc feels they got all of the cancer during the surgery. Yes it was follicular , a more aggressive variant, but the fact that it was minimally invasive in pathology means he feels ,aside from more frequent check-ups on the remaining part of my thyroid, "we can put this to bed at this time". The likelihood that it metastasized is in his words "close to zero". But that also means that the ability to have the certainty I need for my own peace of mind will be "close to zero" as well. I realize the chances at getting a doctor to speak in absolutes, or guarantees is also "close to zero".
So I surrender to my new reality. That of "lucky bastard post-op cancer patient" . I will be followed more closely. That means more frequent blood tests, checkups, ultrasounds, more invasion of my personal space, and whatever else they deem necessary, for the rest of my life. As a sufferer of "white coat syndrome" I am not thrilled at the prospect, but it certainly is much better than what the alternative could have been. As cancer diagnoses go, this is about as good as it gets.
The doctor began the visit "wrap-up" by summarizing what he had said previously, and telling me he understood "this was a lot to process " and I need to "let it all sink in." No kidding.
So I have begun the sinking-in process. If this is my only brush with the Big C , I will take it, but this year so far has been enough to make me old.
I sure as hell hope so.
Throughout this process ,all the appointments were made for me by the doctor's office month's in advance, completely wrestling from me the ability to delay something I very much wanted to delay, if not avoid completely. These dates seemed so far off that they may as well not even have existed. I received my "packet" three months ago that laid out the pre-op consult , the pre-op physical exam, and the post-op follow-up, along with lots of documentation, needing lots of my closely guarded personal information. It was then I began to realize how much control over "self" you give up as soon as you decide to enter the mechanism known as the "Finest Medical Care In The World". I had just seen Gran Torino when the package arrived and unlike Mr. Kowalski(or is that kwaski?) I filled out all my forms, and kept all my appointments.
It has been a bit longer than two weeks since my surgery, and I am still adhering to the restrictions imposed on me as best I can. One such item was 'no driving'. I probably can drive now, but I figured rush hour in Boston was not the time to get behind the wheel for the first time in weeks. So Michelle drove me in to Mass Eye and Ear. My appointment was for 10:45, and we made it in with enough time to spare to hit the cafeteria on the seventh floor for some of their pancakes . For some reason they did not seem as good as they were two weeks ago when they were my first breakfast in forty-eight hours. Go figure.
When we got to the office , it became apparent that today the doctor was on a tight schedule. "He wants to keep things moving" one of his assistants explained to me as she escorted me back as soon as I walked in the door.
After showing us to the exam room, she immediately began her role in this process: removal of the steri-strips. She bustled about the cramped exam room, her extremely generous physical attributes only adding to the claustrophobic feeling I had as my personal space was invaded yet again, and began draping me with a gauze bib.
" I'm a-gonna put some unsticker lotion on you, and this will keep you dry"
Did she say 'a-gonna?'What the hell is 'unsticker' " I thought to myself as she started to squirt a cold fragrant gel all over my neck.
"Apparently the gel is mainly witch hazel," she informed us. By the smell of it, I had no reason to doubt her. After I was good and saturated with it, from Adam's apple to navel, and the room full of its aroma,she began pulling off the last surgical remnants of my summer ordeal. "Ohh look at that! He sure does good work" she crowed as she got the first looks at my nineteen day old incision. "Here come see for yourself" she prompted , showing me where the mirror was. "Oh. Yeah." I concurred, not so much agreeing as placating. I still had a six inch long scar on my neck. I still had the disturbing "path" report. I still had to "have a conversation" with the surgeon, and the endocrinologist. The only things I didn't have anymore were the nasty,yellowed, curling steri-strips, and half of my thyroid.
"The doctor will be with you shortly" she said abruptly exiting the room.
Michelle and I barely had time to make the usual, sarcastic wise-ass comments about the medieval-looking instruments laying about the room, before there was a light rap on the door and one of the "fellows" entered the room and introduced himself. I remembered seeing him several times when I was in the hospital, but Michelle was meeting him for the first time.
"Hello, I am Dr. P. Nice to see you again."
He took a deep breath before speaking. " So, I am going to talk with you first and then Dr. R will be in . I see he called you last week with your report, and informed you that the large lesion was benign..." he began with thickly accented English. My years spent in food service told me when I first met him, even in my narcotic-induced post-op haze, " he's Brazilian" . I wanted to say "Fala !" but restrained myself .
"...but we also found a small papillary carcinoma. This happens all the time and you have nothing to worry about" Now do you mind if I feel your neck..."
While he was speaking, I had become aware of a presence hovering outside the half-opened door to the exam room. Dr. R suddenly opened the door fully, said "hello" to both Michelle and I, then curtly asked the fellow, "Dr. P, Can I speak with you for a moment in the other room."
Michelle and I just looked at each other with a "wtf is going on?" expression as we awaited the fellow's return.
It never came.
Instead it was Dr. R who returned to the room. We exchanged pleasantries, and he flipped open the red folder with my name on it, and took a moment to look at the papers therein.
"As I discussed with you over the phone last week the path report showed the lesion we were concerned with, the large 16 mm one, was benign. So that is good news. But it also did show a small follicular carcinoma, of about 4 mm in size..."
I did not really hear the remainder of that sentence .
I heard the word "follicular" and my mind was off to the races.
The fellow had used the word "papillary" to describe the cancer. Papillary is the most common , and most indolent form of thryoid cancer. If it spreads at all, it mainly is confined to the lymph nodes of the neck. Very easy to keep an eye on. Follicular on the other hand spreads through the blood , bypassing the lymph system altogether. Immediately my mind began to think of the worst case possibilities. That my body was at that very moment being seeded with microscopic cancerous cells floating throughout my bloodstream, like bits of garbage swept away in a mid-summer's flash flood. That the garbage contained cancer-like maggots that would then infiltrate the organs of my body, devouring from the inside out. That what he was going to say next would include the words "six weeks" or " six months" or "to live". And "radiation." And "chemotherapy".
But it didn't. Instead the conversation contained phrases like " "minimally invasive", and "near zero","discussions" , "conversations" and "we will make sure we follow you".
But I couldn't let the slip-up by the fellow go.
"Dr. P told me it was 'papillary'. Follicular can spread through the blood" I blurted out, interrupting the doctor in mid-sentence.
"yes, Dr. P made a mistake. He is still very new, and does not always get the language right."
No shit ,he is new, I thought. Would it totally blow this guys mind if he knew with my advanced research tool , "The Google" , I found out on "the Google" that Dr. P was so new that his medical license, a "limited " one in fact, had only been issued to him on July 7th. Exactly one week before he was in the O.R. assisting you as you sliced open my neck? But I refrained.
" Yes, about that. I will be addressing that with him shortly. Forget what he said. You need to listen to what I am saying", Dr. R replied. I began picturing what will happen later, after we leave. I imagined this intern, fellow, whatever he is called being beat about the head by my enraged surgeon with tubes of witchhazel,clipboards, his "Limited License", and whatever else he could grab,amid screams of " Papillary? Papillary?!! I'll show you Papillary!!!!" Then, summarily being dragged by his ear to the cabinet where the wax for the Maserati is kept," I want two coats this time , dammit, you hear me? TWO COATS!"
Needless to say,henceforth our verbally challenged fellow has now become known as "Dr. Maserati" between Michelle and I.
Basically the long and short of my follow-up is my doc feels they got all of the cancer during the surgery. Yes it was follicular , a more aggressive variant, but the fact that it was minimally invasive in pathology means he feels ,aside from more frequent check-ups on the remaining part of my thyroid, "we can put this to bed at this time". The likelihood that it metastasized is in his words "close to zero". But that also means that the ability to have the certainty I need for my own peace of mind will be "close to zero" as well. I realize the chances at getting a doctor to speak in absolutes, or guarantees is also "close to zero".
So I surrender to my new reality. That of "lucky bastard post-op cancer patient" . I will be followed more closely. That means more frequent blood tests, checkups, ultrasounds, more invasion of my personal space, and whatever else they deem necessary, for the rest of my life. As a sufferer of "white coat syndrome" I am not thrilled at the prospect, but it certainly is much better than what the alternative could have been. As cancer diagnoses go, this is about as good as it gets.
The doctor began the visit "wrap-up" by summarizing what he had said previously, and telling me he understood "this was a lot to process " and I need to "let it all sink in." No kidding.
So I have begun the sinking-in process. If this is my only brush with the Big C , I will take it, but this year so far has been enough to make me old.
I sure as hell hope so.
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