Pearl Harbor Day - 2020



Pearl Harbor Day - 2020

In My Bloodstream: Lisinopril,  Amlodopine,  Omeprazole, Tamsulosin
On The Stereo: Light That Match: Down Like Silver


Firstly, I must apologize for the expected typos to follow.  For whatever reason, my neuropathetic ( not a typo - my newly created, more meaningful adjective) left hand has become most uncooperative of late, and I am constantly forced to perform do-overs on the keyboard.  My typing speed is at an all-time low.

Thank you to the many who have sent well-wishes and have shown concern for my most recent operation and the expected pathology results.  I will give you what I can.

My operation was set for December 2nd, and I was expected to check in by 9:30.  I knew it was to be a long day, and Kat was to take the day off from school.  I thought it a bad idea, as I was going to be behind closed doors for the full day, due mostly to Covid 19 precautions.  I saw no need for her to miss teaching her class so that she could be alone in an inhospitable hospital waiting room, with hard-backed chairs and sick people traversing the area.  She eventually recanted her position, and I made other plans.
My good friend and neighbor, John Messinetti had been offering me assistance for a long time, and this time, I took him up on his offer.  He and his bride, Maria, would be most happy, he said, to drive me to Moffitt.  He had wanted to take some photos in a nearby park in Tampa, and this would be his opportunity.  

It was not too long ago, that I would not have asked for help from anyone not family.  But I have been writing for some considerable time, about the need to allow friends into your life, and to include them in your cancer journey.  Both the giver and the taker are better for it.  My buddy, Mess, was earnest in his offer.  And he is a caring friend.  I was happy to share their company and conversation on the trip to Moffitt.

My day was most interesting.  Moffitt had recently developed a new weapon to fight cancer, and I had the chance to try it out.  

When melanoma takes root in the trunk of your body, it has been normal procedure to remove the tumor and to search for lymph nodes which might be involved in the transport of the disease.  Fifteen or so years ago, I had a smallish melanoma occur in the center of my chest.  I was in hospital in Naples,  and after the cancer was excised,  the surgeon went on a safari to hunt for lymph nodes.

He cut a swath from nipple to nipple and removed clusters of nodes, mostly from under both armpits.  Then, he had to insert tubes to drain my lungs, stitch me up, and sent me home, dragging along my drains and a plastic pouch to collect the liquid combination of blood and whatever else was in there.  Two weeks later, I had to return to have the tubes removed.

His nurse was assigned the nasty task of removing my new plumbing, as surgeons do not, typically, worry about the "small stuff".  She got me to sit on the edge of the examination chair, and, with my bride watching, she gave the plastic tubes a sharp tug.  Nothing happened.  That is not true.  I said "whow!"  I thought to myself, "That really hurt."   But the tubes had not moved.  Not one iota.  She tried again.  And again.  She was tearing up.  She was hurting me badly and was not able to complete her assigned task.  She apologized and went off to fetch the surgeon.

He returned, obviously aggravated that she could not manage this simple procedure on her own.  He explained to her that one sharp tug would do the trick.  Did she not know that?  He barely acknowledged that Kath and I were in the room.  He had to leave something more important to handle this menial task for which she had proven incapable.  

He told me to hang on to the edge of the seat, and he gave the tubes a mighty yank, almost pulling me clear of the chair bottom.  I regained my seat and looked down to see my plumbing, still fully attached.  The nurse had begun to openly weep and the surgeon was searching for his composure.  Kath had her head in her hands.  And I was starting to think that these tubes and bag might remain a part of my life, forever.  

I was in pain.  Not just sore.  In pain.  In terrible pain.  My chest was burning and there was no evidence that the drains were going to concede their position.  Later, after several more attempts and failures, the doctor's foot on the chair bottom for leverage, I was freed.  They cleaned up the red, watery mess which flowed from the drains and my chest, and after they patched up the open holes in my chest, we left.  I could hardly breathe.  The pain had been excruciating.  The surgeon and his nurse were left to mend their relationship.  There had been acrimony and embarrassment.  Publicly.  The poor lady had been shocked by the pain and the entire scene in which she had borne witness.  This had not been medicine as she thought it to be.

And that was my lymph node story.  Sorry.  The good news (?) was that after harvesting several clusters of nodes, under both arms, none were found to have melanoma.  But what a horrendous way to find that out.

And now I was headed back to Moffitt for another surgery, after which a search for infected lymph nodes would begin anew.  With the memory of the last episode dangling still.

At 9am, I said goodbye to my friends and thanked them, when they left me at the hospital doors.  They sincerely offered to stay, but I was alright on my own.  Kath would be coming to be with me for the afternoon, and to drive me home.

After checking in, I went to my first appointment in radiology, to discover Moffitt's new device in treating cancer.  

It was then I learned of the plan.  I would receive four injections, very close to the melanoma site, on my back.  They were basically at compass points.  The injection substance was a radioactive liquid.  The premise was that the radioactive material would be sensed by my body's immune system and then be drawn in by my lymph system.  Since the foreign material came from the melanoma site, only those lymph nodes attached to that site, would show up on the scan.  So, eureka!  If the cancer had entered the lymph system, obviously a bad thing, we would know exactly where it had traveled.  And we could excise any nodes harboring those villains.

However.  Since we had no idea where those nodes might be, we had to take pictures of any place in my body where lymph nodes would reside.  And that was a lengthy process.  I lay on my back, with my hands stretched over my head, for well over an hour.  In fact, the entire process took about two hours.  The camera was rotated up and down and round and round.  As each picture was taken, the technician eliminated all those which showed no evidence of an infected lymph node.  It was akin to playing "Where's Waldo".  Before I was dismissed, she said she had located four or five heroic nodes.  They had done their job.  If my melanoma was spreading, they had found where it was and where it was headed.  

I apologize for this lengthy description.  But if you had traveled with me on my last trip to find infected lymph nodes, or, in fact, have gone through the same ordeal, you would realize what a miracle this was.  I know that this is not a cure for cancer.  But it most certainly improves our chances in the fight.

                                                       Scar remains after 15 years of healing.



                            


                                 New site of lymph node removal.  The bruising will soon disappear.

From there I went directly to pre-op, to remain in isolation until the surgeries.  I removed all my clothes, put on a fancy hospital gown and mesh cap, and crawled into a gurney, to await my trip down "the green mile".  I cannot tell you how many attendants, nurses and doctors came to visit me.  They all had questions and tasks to perform. There was much redundancy.  They took no chances.  They gave me pills to alleviate nausea and pills to relax me into a euphoric state.  There was care and compassion.  There were words of encouragement.  I was in magnificent hands.  Dr. Harrington was the last to say hello and let me know that he and his team would look after me.  

And moments later, somewhere around 1pm, I was wheeled into the operating theater.  There were a lot of people waiting for me.  We chatted as if at a cocktail party.  One of the anesthetists knew I was born in Scotland and wanted to know if he should visit there, as his family were Scottish.  I told him that he should research The Royal Scotsman, a train dedicated to skirting the country's coast, stopping often at historic sites and allowing visitors a worthy tour.  I told him that I always had wanted to take my grandkids there to give them a sense of their heritage.  But I had not yet done so.  That it was my dream which was slipping away from me.

And someone said "goodnight".

I woke up, with my Child Bride at my bedside. I remained groggy for a while, and by the time I was helped to the car, all the medical staff had gone, but for my nurse.  It was 6:30.  

It had been one long day.  Kath took me home.  We had soup for dinner.  All that I could handle.  I took some serious meds.  And I was in bed by 10.

The surgeries were successful.  Dr. Harrington had visited with Kathy and told her the had removed all the cancers.  There was a single lymph node removed.  He said it did not look abnormal, but it had been sent to the lab for testing.  I was to return in two weeks to have stitches removed and should not lift anything over 5 pounds in the meantime.  

Still waiting for a biopsy.

For those who have cancer, treat it as a gift.  It will make you stronger.  More resilient.  Grateful.  Thankful. Open.  Loving.  Kinder.  This pandemic is nothing if you can manage cancer.  Rise above it all.

Be back soon to finish this story.

Thank you all.  You make my life so much better.  

And thank you, my Babe, for making my days brighter.

As always, your comments, be they kind, or slings and arrows, are always welcome.

jrobinmullen@nexteppartners.com (and others)

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