Tuesday, December 29, 2009

Christmas 2.0

When my son and his family decided to spend Christmas in Micronesia, I realized we would need to have two Christmas celebrations--one early with his family and one when my daughter was home on Christmas Day.  Unfortunately, my body did not cooperate for the latter celebration and I wound up having surgery to remove a large ovarian tumor on December 22.  Because the surgery was more extensive than I had hoped it would be,  I was hospitalized until the 27th and so spent Christmas in Cedars Sinai Medical Center.  I was pretty drugged up from having a difficult Christmas Eve so I only vaguely remember hearing the men's chorus singing Adeste Fideles a cappella in Latin and English in the hall midday.  Luckily since my husband is a true mensch, I had Paul's company all day in a dark and small hospital room while my daughter hang out with her grandmother.

My surgery caused me to lose blood and delayed my recovery a day while I had a blood transfusion on Wednesday.  Then on Thursday after I started drinking clear liquids again, I had another setback when my bowel refused to cooperate and pass the gas through.  Instead I belched and ultimately vomited on Christmas Eve.  I started shaking and asked the nurse for some help in an inartful way --asking if perhaps some of the meds were interacting badly with each other.  The nurse got real huffy and said essentially that I just had surgery that was all that was wrong and to just deal with it.  She stormed off and left me alone, scared and shaking.  The next day the resident took my complaint more seriously and prescribed some wonderful medication that helped with "motility" (great word) and allowed me to sleep soundly.  My sleep had been marred with nightmares the first few nights, touching on every fear I have from being fired (by the CEO himself), to attacks by insects, to violence and mayhem.  So the nightmare free sleep was quite welcome.

With the exception of the nurse on Christmas Eve, I had very nice nurses at the hospital.  Unfortunately the level of competence varied quite a bit and sometimes I got doses of meds too early or too late.  One of the nurse assistants did not know how to take blood pressure properly and thus recorded much lower BP levels for me than other nurses did when they took it properly.  As a result I did not take my BP meds in the hospital even though at the end they were probably warranted.

Even the doctors were not the best communicators.  CSMC is a teaching hospital so I was treated to residents, Grey's Anatomy style.  One of the attendings who was subbing for my doctor, showed up with an entourage of 5 residents on Christmas day to discuss my problems from the night before.  Words of wisdom from the attending: "Once you pass gas, the angels will sing and the heavens will open".   She was, of course, correct if not obvious.

One of the doctors, a young man who was assigned to my doctor and whose status was between resident and attending,  was always referred to as "The Fellow".  Never by name.  "I will discuss this with The Fellow."   "The Fellow will need to approve."  I started thinking of calling him "Jolly Good" or "JG" for short.  On the day after Christmas, I asked him his name and said I only knew him as The Fellow.  He showed me his name card which, of course, I could not see without my glasses.  So I asked again, explaining my vision limitations and he finally said his name out loud and brought his name tag closer.  It turned out he had an Arab surname, which one might speculate you would not want to shout out loud much in a Jewish hospital.  Or perhaps, as one of the residents explained, it was not an easy name to pronounce correctly and no one wanted to give offense.  I of course said thank you to him repeating his name out loud.  He smiled and seemed more human for the first time-- something all of these young doctors need to remember that their patients need and crave as much as the medical skill.

So now I am home and have had a proper turkey dinner.  We have opened presents.  Christmas 2.0 may have been interruptus but still was a pleasure to have at home after being in the hospital.

Saturday, December 19, 2009

Role Reversal

Paul went to see our primary care doctor yesterday morning to get his labs done and checked.  With all of Paul's ailments, he is a regular customer of our doctor.

Interestingly, Paul said that almost all of his conversation yesterday with this doctor concerned me (Paul's wife).  What a role reversal! We decided that whoever has the more serious illness at the time gets to be the focus of this doctor's attention and for a change,  it's me and Monster Mass.  We decided that doctors are most interested in the illnesses and not in the healthy patients (oh, so boring, nothing in your labs).  Illness is their sweet spot.

Friday, December 18, 2009

At a Loss for Words for a Change.

It is true.  I have been told that you must take someone with you when you talk to your doctor about any major illness you might have because you are rendered stupid during the conversation.  I learned first hand today that my analytic abilities, of which I am so proud, evaporated when the word "cancer" was mentioned several times by an oncologist talking about options to deal with my massive growth.  Luckily, this effect did not extend to my husband who remembered all the questions we wanted to ask the doctor.  I, on the other hand, sat  mute, amazed that Paul could even think.

The "C" word.  Automatic IQ dropper.

Thursday, December 17, 2009

Call From My Primary Care Doctor Today

"Hello Paul's wife.  This is Paul's (and your) doctor.  I just got the information from your Gastroenterologist about the massive tumor you have in your abdomen.  I guess it wasn't all in your head after all.  Take care. How is Paul doing by the way?"

Of course, I would never get that call since it admits I am not merely crazy.

In the call I did get, Paul's doctor (and mine) said that it looks like I am under good care. Nothing for him to do.  At least he called . . .

Monday, December 14, 2009

Scanned

As I expected once I got the call Friday from the doctor's office to come in on Monday, the results of the CT scan were not good.  Apparently I have hatched a growth 20 cm in diameter at its widest spot and this growth is pushing on a few organs.  Now I have an explanation for my overwhelming fatigue some days, the trouble I was having breathing when I went upstairs, and of course all the stomach problems I have had since the beginning of our vacation in late September.  And  we have moved to the pain portion of our program as well as my looking like I am about 6 months pregnant.  Unlike a pregnancy, my monster growth is causing me chronic low level pain with spikes of sharp pain from time to time.

Now I have to have surgery but have hit the first roadblock.  The doctors my GI MD recommended would not even schedule an appointment until he sends them the CT scan and a referral.  Then I have to go see someone who will tell me the same thing presumably my GI MD said (you need surgery STAT) and then we will try to get an OR booked at Cedars Sinai.  I had my last surgery at St. Johns in Santa Monica but the practice to which I was referred supposedly specializes in removing these types of growths, which can get tricky depending on where the tentacles of the growth have gone.  So I will succumb to the recommendation of a specialist even if I have to go to the huge hospital farther away from home.  Both my son and husband have recently done time in Cedars and both thought it was a good hospital.  Of course, my friend with cancer has spent some time there too in the last few years.

Odds are the monster is benign.  But until they do the surgery and the biopsy I will not know.  So more anxiety in store for me during this holiday season.

Sunday, December 13, 2009

Christmas 1.0

My goal to simplify was supported yesterday by stomach pains all day.  As a result I did not have to trim the tree, wrap presents or do any last minute shopping.  My mother in law wound up wrapping all of my presents and my son and family, under Mom's direction, helped trimmed the tree even though they did not particularly want to. Mom put up the ornaments and became upset that there was no star for the tree. She also wanted to put on tinsel but we ran out of time. We convinced her that 80% was good enough and it turned out that when my grandchildren saw the tree, it was more than good enough.

My granddaughter was celebrating her first Christmas and was fascinated by the lights and ornaments.  In one of those unfortunate turn of events, we wound up having many more gifts for her than for my grandson.  He noticed and became a bit testy.  As we were still opening Lely's gifts, he said "Oh we should look but I think there are no more gifts for Pauly."  In typical sociopathy of the child (see Onion article ), he rejected the lovely and too advanced skateboard he had received and the overtures from his Dad to try it out when they got back from Micronesia.  He also refused at first to play with the fire truck he had coveted, having convinced himself that it was Legos and thus not what he had wanted. And he observed that he already had one of the Scooby Doo DVDs we got him, even though it is lost.  Eventually he came around and started to play with various toys. Lely, who is crawling and pulling to stand, used many of the gifts as leverage to get on her feet.

At some point, my son got the "New Year's beers" he had been saving to share with his Dad--one each for the guys as we counted down to the hypothetical 2010 three weeks early and shouted "Happy New Year".  So we went through all the holiday celebrations we would miss this year with my son and his family.  It was great, notwithstanding the crabby kid who kept sneaking out to grab another Christmas cookie (He had 6 total).  When my son was that age, he would negotiate how many cookies he would get.  I would offer one and he would ask for 3.  My grandson agrees to eat only one and then sneaks more and more.  His excuse: "I just love cookies!"

So my guys are gone on their way to Hawaii for the first leg of their journey--18 hours total  on planes and a layover in Oahu of about 22 hours.  I hope they enjoy their island Christmas as much as we enjoyed having Christmas 1.0 with them.

Saturday, December 12, 2009

Christmas Lite


Since I am not feeling well and my family is taking my health (or lack thereof) seriously, I have convinced my husband and son to fetch the Christmas decorations from storage this year. We are having Christmas 1.0 tonight for Bill and his family, who are leaving tomorrow for a month in Micronesia.

Typically I do not decorate the house or put up the tree until the weekend before Christmas.  I am a bit neurotic about having a tree with lights in the house for a long time and I try to have the tree as fresh as possible for Christmas and the week after.  Most of the time it works out fine to leave getting the tree until that late.  One year, however, Paul and I drove all over the South Bay because all the trees (including artificial ones) were sold out in the usual haunts.  Other years when my work schedule has been busy, I have left the trimming of the tree until as late as Christmas eve and rushed to get it done at the last minute.  Some years I have had help trimming and others I have done it alone.  There is no question that the holidays increase my work load and stress levels.

My goal every year is to simplify, simplify, simplify.  If I do not have time, holiday cards get dropped from the agenda.  We took pictures of our kids for years and I wrote a one page, sometimes funny, update of what had happened that year.  Our children had challenging teen years so the funny update was not so funny during that time and thus got shelved.  Resurrecting it has been hit and miss.

I now buy most of my gifts online because the stores have become unmanageable.  I did however this week venture out to Target at lunch time to pick up a few last minute gifts for tonight's celebration.  Target did not appear to be all that crowded.  I found a parking spot relatively easily and managed to get into the store without bumping into too many other shoppers.  Inside it was more crowded than the parking lot revealed but I was able to get what I needed relatively quickly and only with a few nudges to other shoppers to move out of the way.  However, as I was trying to get to the checkout stand, a child ran in front of my cart which forced me to stop until his mother grabbed him and then, of course, someone else sprinted in and cut ahead of me.  Grrr.  Out in the parking lot with my cart filled with large items I was well into the crosswalk when a car drove right through the stop sign and just missed me.  Double grrrr.  Shopping at malls brings out the best in us, n'est-ce pas?

So in my quest to simplify I also buy fewer gifts for those with whom I do exchange, and exchange with fewer people.  I typically give books to my colleagues at the office but I might even skip that this year since I am taking the week off before Christmas ostensibly to spend time with my daughter but probably mostly to read unless I need to have a medical procedure which is still up in the air.  (My doctor knows.  He has the results of the CT scan but I won't find out until Monday, which is not helping my stress levels either.)

So it's beginning to look a lot like Christmas and I am trying my best to find some holiday cheer in all of this. My guys have just delivered the decorations and are off to get wrapping paper so my jobs can begin. Once the work is done, perhaps the spirit will come.

Wednesday, December 9, 2009

Health Care Option(al)

I am one of the lucky ones in America.  I have incredible health insurance that has paid for my family and me at very high levels of treatment for the past 16 years.  I do not want to jinx it but I feel blessed.  It saddens me that the Senate Democrat leadership made a deal to do away with the public option. So many tens of millions will still not be insured and those who get subsidized private insurance may still pay up to 17% of their income for that insurance.

Today I went to see a specialist for my ongoing stomach problems.  He is fairly conservative about ordering tests but decided my symptoms warranted a CT scan.  I called to get an appointment and luckily can have the scan done tomorrow (keep your fingers crossed).  The person at the diagnostics center took my insurance information and said she would call back if there were a coverage problem.  I did not hear back from her so I have to believe that the test will be covered.  Indeed I believe my policy even makes special provisions for cancer screening even if I did not have the symptoms to justify the test.  Lucky me.

 Is some form of health care legislation better than nothing?  I hope so because we are not even close to pulling away from the domination of big Insurance and big Pharma.

Sunday, December 6, 2009

Leveling With You


When I was in college I came up with an idea that I grandly called the "Levels Theory".  According to the levels theory,  on the first level, people believe something is true.  Then the common wisdom comes to reverse that truth and believe the opposite.  That would be the second level.  Then again the truth believed in the first level is adopted but with the added sophistication of taking into account the second level's opposition to constitute the third level. And so on it would go.

While you might think this is my mere restating of Hegel, levels theory is not a thesis, antithesis, synthesis process.  It is thesis, antithesis, thesis+, antithesis+ and so on.  It looks at truth as more of a wave that increases amplitude with each iteration.  Yes, I understand it is a bit nutty.

However, I saw another example of it the other day when I started reading Barbara Ehrenreich's new book, Bright-sided: How the Relentless Promotion of Positive Thinking Has Undermined America.  As a psychology PhD I am well steeped in notions of human behavior based on negativity--psychopathology,  Skinnerian psychology (where you can shape through appropriate rewards) and even motivational psychology based on drives and fear of failure etc.   Martin Seligman tried to take a new look at psychology when he rejected these negative forms of explanations and started to look at what ultimately was called Positive Psychology or the Psychology of Happiness.  So there you have examples of levels 1 and 2.   Ehrenreich seems to be rejecting Positive Psychology, particularly in the context of disease, because it is based on the incorrect assumption that positive thoughts will cure you.   My friends with cancer agree.  They have enough to handle with their disease.  They don't want to be responsible for its course if it takes a bad turn because somehow they were not positive enough!  And recently there were news reports that research shows "grumpy is good" as least as far as it seems to promote clearer thinking.  It would seem to me that this rejection of positive thinking and happiness as the source of all that is good must be a level 3 idea.  I am not seeing synthesis, just a reaction to the level 2 phenomenon of deifying positive psychology.

For me the jury is still out.  I am interested in what Ehrenreich has to say but keep thinking that she is more of Eeyore saying "Thanks for noticing."  But then again Randy Pausch was a self described Tigger until the end and the end did indeed come. As I recall from the Last Lecture, Pausch did not think positive thinking would change his survival outcome since he had a particularly virulent terminal cancer.  He maintained that positivity changed the quality of his last days with his family and did indeed give him opportunities and experiences he might not have otherwise had.  Maybe that's all any of us should expect from focussing on the positive.

A Fish Tale


Yesterday in a fit of pique I posted a rant on FB about my hatred of halibut.  I suppose it was partly caused by my queazy stomach.  Perhaps my husband's continuing absence contributed because after about a week of his being gone I start to get really cranky.  But I was really getting tired of dealing with the smell of  fish in my house.  I do not cook fish at home because it never comes out right.  However, my mother in law regularly cooks fish--frequently halibut-- and last night, at least on FB, I  succumbed to my latent desire to  reclaim my house so I can control its smells and the foods I am being offered to eat.

But then again, even without all the psychological explanations, I simply dislike halibut.  I remember that my mother made a creamed halibut dish frequently on Fridays when I was a child, back in the pre-Vatican 2 days when good Catholics did not eat meat on Fridays.  One day she sent me to the fish market (remember those?) to buy the halibut and my 7 or 8 year old memory could not recall the fish that started with "H" that she had asked me to buy.  So I told the fishmonger that I wanted haddock and proudly trotted home to find out my mistake.  Luckily my mother used the haddock anyway in the dish.  We decided the dish tasted better with haddock and thereafter never had the creamed halibut again.  Perhaps my lack of memory was in fact a sign that my distaste for halibut (chewy and dry even in a cream sauce) needed to be addressed.

My disdain for that fish has only gotten worse over the years.  Occasionally at a restaurant I have thought that I would try it in a different presentation and it never fails to disappoint.  So I resolve to eat halibut no more and to do my best to get it out of my house.  Otherwise I will need to buy stock in scented candles and Febreze.