Post-Op: Six months

How surreal to think back to June, when a walk down a hospital hallway was a major effort and my internal works were still readjusting after the surgery, which was six months ago today. Now (knock on wood), I’m good.

Good for full-time weeks at The Buffalo News, where I’ve been writing a lot of obituaries. Good for bridge games five or six days a week. Good for a few beers or wines on the weekends. Good for everything except lifting more than 10 pounds, climbing more than two flights of stairs and staying up past 2 a.m. In some ways, it seems like I’m better than before. For instance, no more getting up in the middle of the night to go to the bathroom.

        Sure, I’m still taking three medications for blood pressure, which seems to be under control, along with a statin and a baby aspirin for my stent-enhanced heart. But as far as the doctors are concerned, I’m cancer free and the ticker’s doing OK, at least until the next round of checkups in the spring. I wake up in the morning and say to myself, hey, I’m here. I’m grateful. Every day really is a blessing. 

Post-Op: Third month plus a week

   I thought that going back to work Tuesday after 13 weeks of extended sick leave would mean that I'm totally recovered. But it doesn't. I started getting a little ragged around the edges as I watched the 10 p.m. TV news. When the city editors suggested that I go home early, it seemed like a really good idea. 
   It turned out to be an evening of exhilaration and stress. Exhilaration at the applause with which the newsroom greeted me when I walked in shortly after 5 p.m. Joy at seeing all my colleagues again and discovering that they still thought I should continue as the Candyman. (Thanks to Barb O'Brien for providing a starter supply of sweets.) And then there was satisfaction in getting organized to once again tackle one of my primary assignments -- the Reporter's Notebook column.
   But it was not a matter of simply settling back in front of the old familiar computer screen. The massive reorganization of the newsroom had gotten to my desk, which had been packed up and moved. It took an hour to find and activate things that I didn't want to do without -- the cordless phone, the wireless mouse, the mini electric fan, the drugstore spectacles. It took another hour to do a rudimentary restoration of the settings that were lost during the installation of the new Dell laptop computer, which is attached to an outboard keyboard and display screen. It took more than one try to find out which of the copying machines was doing the printouts of my Reporter's Notebook e-mail.
   Setting up the files for Reporter's Notebook turned out to be as astute move. At 9 p.m., 45 minutes before the first edition deadline, the editors realized they did not have a column for Wednesday. I was able to whip one together and transfer it to the city desk just in time. After that, though, I was beat. Guess I've got some more recovering to do.

Post-Op: Three months

The CT scan today (Wednesday) at Roswell Park Cancer Institute confirms it. No malignancies. Cancer-free right now, and everything looks good for the future. Come back again in six months for another CT scan, says the oncologist, the dapper Dr. Saby George. CT scans every six months for three years, then once a year after that. 

The blood test looks good too. Everything within normal levels. Cholesterol is down. Liver and kidney functions are fine. The CT scan also shows the heart looking normal, Dr. George adds. Is my urostomy arrangement doing OK, he asks. I assure him that it is. I note that all we have to do now is bring that high blood pressure back to where it ought to be. Sooner or later, we'll find the right combination of meds to do the trick.

And so next Tuesday, the day after Labor Day, I go back to working nights at The Buffalo News. My long extended sick leave is over. What can I say after I say, "Hallelujah!" 

Post-Op: 2 months and 4 days

Ask me how do I feel and if I were a bell, I'd be ... the Liberty Bell. Not quite the way I came out of the casting mold, but still ringable in the right circumstances. 

I've been playing bridge regularly, to be sure, though I hit the gong there only about half the time. Gardening would be more of a bell-ringer if I could go more than 60 to 90 minutes before needing to quit. 

I wasn't up doing for our annual party during the Garden Walk July 25 and 26, either. Sitting on the shady front porch in the afternoon was more my speed. Even so, thanks to a rainy June and some help from my friends, the yard once again was at its best, except at the corner, where the concrete had been dug up for installation of a new handicapped access sidewalk. Bad timing. 

Although I'm not supposed to lift things that weigh more than 5 or 10 pounds, I managed to broom and scrape out the crappy topsoil the city installed after the new sidewalk was poured. The DPW guy in City Hall had agreed to let me handle the landscape remediation, but word apparently didn't get down to street level.  

The replumbing for my bladder, meanwhile, seems to be working fine. (I wonder, however, how long it will take for the incisions to stop being red and crusty and become just scars.) Heart issues, meanwhile, are looming as the bigger concerns at the moment. After a revision in blood pressure meds, I'm pumping numbers that stray into the danger zone. On the plus side, there don't seem to be problems with the newly-instituted statin. No side effects that I've noticed so far. If that's all there is, I'll ring another bell.

Post-Op: Month one, week two, day two

Good news from my first visit to a new primary care doc -- Dr. Jon Kucera at the Northwest Buffalo Neighborhood Health Clinic, who is health proxy Bill Finkelstein's doc. My vital signs are all good. And some not so good news. After comparing my EKGs from December and April, which is what revealed that I'd had a heart attack, he said I should be on statins. 

Now I've resisted suggestions of statins for several years. I'm leery of the side effects (Monica's old boss was hospitalized by those side effects) and because they just seem like too much of an article of faith in the medical community. One of these days, they'll discover that they're actually harmful, like Tylenol. Nevertheless, us heart attack survivors are at high risk for a repeat episode, so if anybody should be popping a statin, it's somebody like me, a point driven home during the conversation about statins on "On Point" on NPR this morning. Like it or not, it looks like Lipitor ahead after the next visit to the cardiologist. 

Meanwhile, I seem to be gaining stamina. Wednesday began with an hour of cloudy, cool-weather weeding (the big Buffalo Garden Walk is a little more than a week away) and ended at the Sportsmen's Tavern with a rollicking show by Rosie Flores, the Rockabilly Filly, who I know from the days when I was going to the South by Southwest music conference every year in Austin. What's more, she still recognizes me. "You're so cute," she said.

Thursday, which also started cool, began with another hour of weeding, this time in the shade, (front yard is starting to look pretty good), followed by a visit to opening day of the annual Italian Festival in North Buffalo. Then, after a much-needed nap, it was off to the weekly free concert (the Buffalo Philharmonic playing Stevie Wonder songs) at Canalside downtown, which gave Traci, my niece visiting from Phoenix, a look at our revitalized waterfront. Big crowd. We all took lots of photos. Attached is a pic of Traci in the one of the Canalside attractions -- the giant Adirondack chair.

Post-Op: One month, one week, two days

   The good news is that I seem to be getting stronger. Today, Thursday, July 9, I drove outside the city limits for the first time since the surgery, a 20-minute trek through the rain to the Airport Bridge Club for my first visit to the bridge tables in, well, one month, one week and three days. 
    More good news there. Paired with Jean Macdonald, a capable player whose plans to play golf had been scotched by the weather, we came in first North-South with a 59.58% game. 
    But that was about all I could manage. I came home and fell asleep while waiting for a friend to arrive with Chinese food for a late lunch, then fell asleep again later watching Seinfeld reruns on TBS. I've still got a way to go.
   The bad news is I'm still looking for leakproofing on my urostomy bag. Sunday night and Monday night I awakened wet at 5 a.m. and had to apply a new appliance.
   Wednesday found me and health proxy Bill Finkelstein back at Roswell Park Cancer Institute, talking with an ostomy nurse who had a few suggestions about alternate appliance configurations, where to place the overnight catheter bag (not on the floor) and sleeping on my left side. Wednesday night was dry. Here's hoping for two in a row.

Post-Op: One month

   Yes, it was Wednesday, June 3, when I checked in to Roswell Park Cancer Institute for the surgery that removed a Stage 2-B cancerous bladder, a prostate gland that was 10% cancerous and a pair of lymph nodes that happened to be hanging around nearby.
   It's been a bumpy month of recovery, what with nine days in the hospital and adventures with dehydration, low blood pressure, blood in the urostomy bag and leakage from one of the incisions. Nevertheless, my surgeon, Dr. Guru, believes that I am now cancer-free and, for the past week or so, it seems like those bothersome complications are behind me. Excuse me for a moment while I knock on wood.
   Today, Friday, the visiting nurse, Maria, took a look at the incisions and said the scabs were healing well. Everything else seems to be proceeding as it should. The fatigue even seems to be subsiding, albeit ever so slowly. I can walk up to eight blocks now. But then that's my limit. And I still need naps.
   I'm also champing at the bit to do some gardening. But during the past hour, while Monica was mowing the lawn, I was reminded of one of my other limits -- the five-pound lifting limit. While seated and pulling weeds out of some of the many small pots on my flat garage roof, I felt a pain in my lower right abdomen after I moved the heaviest of the pots, which may have weighed as much as 10 pounds. The pain is gone now, but I have new respect for that five-pound limit. I don't want to feel that again.

Post-Op: Day 25

   "You look good. Your color is good," my surgeon, Dr. Guru, said Friday afternoon as he strolled into the examination room in the Urology Department at Roswell Park Cancer Institute. "I wish I felt as good as people say I look," I said. I'm still fatigued, I explained. I don't have enough energy to be up and doing things for more than a couple hours or so.

   This, he said, is normal. It will get better. As for the other complications -- the leaking surgical incision, the blood in the urine last Sunday -- those have stopped. And my blood work Friday, that was good. 

   The urine sample last Sunday, on the other hand, showed bacteria. Not unusual, he said, since we joined together body parts that aren't meant to go together. The section of intestine that collects the output from the kidneys still wants to act like an intestine, not a bladder, and it will have bacteria. To protect from infection and be on the safe side, he prescribed 10 days worth of Cipro.

   As for that feeling that I still have compression stockings on my toes, Dr. Guru said that also was not unusual, a leftover from the surgery, when my body was feet-up for hours. This too, he said, will pass. 

   To the doctor's amazement, neither health proxy Bill Finkelstein nor Monica had any questions. We'll see you in six weeks, he said. And after that, check-ups twice a year. Or maybe only once a year. All that's left to do is hydrate heavily, rest and recover. Wonder how long recovery road is going to be. From here, I can't yet see the end of it. 

Post-Op: Day 20

    First the stuff in the urostomy bag Sunday afternoon looks like Hawaiian punch. Then like cranberry juice. Then like dark cherry juice. I call health proxy Bill Finkelstein. Send a picture to my phone, he says. 

   Shortly after 6 p.m., just as Monica is about to put dinner on the table, Bill calls back. Get down to Roswell as soon as you can, he says. Dr. Syed is there right now. Last week there was one emergency weekend run to Ward Seven West. And now this weekend, two. I'm a little alarmed. Will I have to stay the night?

    With Monica and Bill looking on, Dr. Syed sees dark red goopy things in the bag and proposes that this may be partially clotted old blood that's decided to move out. He sticks a tube into the stoma (no feeling there ... amazing), draws out a sample of what's inside and designates it for a lab test in the morning. I'll be going home. Keep an eye on it and keep hydrating, the doctor says. Pointing to the bottle of water at my side, he adds, "That's your buddy."

    Today, Monday, the colors begin as pink grapefruit juice and evolve into lemonade. Only drama comes when I stand up abruptly from the computer this evening and catch the edge of the bag against the edge of the dining room table, separating the front of it from its adhesive backing. A quick replacement is in order. Though I can probably handle that by myself, I'm grateful I'm not home alone.

    Meanwhile, I take my longest walk since the surgery this afternoon -- 4 1/2 blocks to the M&T Bank on Elmwood Avenue and back, unaccompanied and a little tentative, picking out the shadier sides of the streets. I come home hungry and ready for a nap. 

Post-Op: Day 18

Recovery is not a straight line, my surgeon, Dr. Guru, said Thursday in Roswell Park Cancer Center, moving his hand up and down to illustrate. Seeing one of the downs before him at this first post-release examination, he declared me dehydrated and ordered an infusion of saline solution. 

So the two-hour visit went into overtime -- a morning-long IV session, with a half-hour search for a workable vein ending at the base of my right thumb. Please, I entreated the gods who look after you in situations like these during one of my gassy abdominal cramps, don't make me deal with a bowel movement while I'm hooked up. 

The IV worked. My weary voice perked up. My shuffling step was springy enough that I turned down a wheelchair and exited on my feet. Nevertheless, on Friday, when a technician was checking my sleep apnea machine to see why it was drying out my mouth all the time, he turned to me and said, "You look dehydrated."

So I have renewed my quest for fluids I can swallow in quantity. Beer doesn't count, I'm told. What a shame. I've fallen back on Vitamin Water (about to polish off my second of the day) as an alternative to just plain Poland Spring. Health proxy Bill Finkelstein bought me a mango-pineapple smoothie from McDonald's, recommended by one of the bridge players who relied on that while recovering from colon surgery. Could be a winner. It has real fruit in it and it's definitely tasty.  Recommendations, anyone?

Recording my fluid intake now, with the goal of least three quarts a day, I see all I need to do is six to eight ounces per waking hour. Doesn't sound that hard. But it is. 

Anyway, once I was hydrated, the leak revived through the small incision scab next to my navel. Coincidence? And once again, the struggle was on to patch it up and keep it from soaking me from the waist downward. 

Monica finally turned to a mini urostomy bag like the one that worked so well after Dr. Syed applied it at Roswell a week ago. But the bag caught nothing. The incision still leaked. Maria, the visiting nurse, gave it a try this morning (Saturday), using some paste to improve the seal, but again no luck. Finally, Bill set up another visit to Roswell, where a nurse on my last ward, Seven West, determined that the nearby bag collecting urine might be the culprit. Now, with two new bags, so far I'm dry. Bliss. 

Post-Op: Day 12

    Gee, but it's good to be back home, even though everywhere I look, there are things I want to clean, weed or rearrange, but can't. In the meantime, Monica has decided to thin out my wardrobe while she has the energy advantage. "Strike while the iron is weak," she told a phone caller.
    But the pleasures of home have not been without other complications, as well. Not with the basics, thank God. The urostomy is working fine. The 17 stairs to the second-floor bedroom? Not an obstacle. What to wear? T-shirts and sweatpants with elastic waistbands. No, the complications came up elsewhere:
    1. That sore left foot (Monica's diagnosis: plantar fasciitis), which inhibits walking as much as I should.
    2. Constipation (I'll resist dwelling on the delights of strawberry Milk of Magnesia).
    3. The leaky incision just left of my navel, which put Monica's talents as a teenage candy-striper to the test. To soak a succession of T-shirts, bandages, towels and improvised plastic barriers she deployed, it generally took two hours or less.
    And 4. Surprise! Low blood pressure, by-product of the switch from hospital blood pressure meds to the stronger ones at home. The visiting nurse took a reading Friday and it was fine. Had it been checked after that, I might have guessed why I felt so light-headed and listless.
    It was health proxy Bill Finkelstein's alarm at Monica's last-gasp leak treatment -- an Ace bandage around my waist with a towel tucked inside it, on top of the usual little taped-down pile of gauze -- that prompted the phone calls which took us back to Roswell Park Cancer Institute Saturday evening, to the ward I left 48 hours earlier, Seven West. One of Dr. Guru's associates, Dr. Syed, agreed to meet us there around 8 p.m.
    His solution -- a small urostomy bag to fit over the leaking incision. While we waited for one to arrive, I asked for a blood pressure reading. When it came up 71/52 and 72/51, the health care aide thought the computerized testing machine was malfunctioning, but an old-fashioned pump-up cuff yielded the same results. A few laps around the ward lifted it to 90/62.
    Meanwhile, the bag worked. Thank you, Dr. Syed. Once in place, it immediately started filling. And today, Sunday, the seepage seems to have stopped entirely. As for blood pressure, now that my blood pressure cuff at home has been located, the readings are improving, but they're still low. No more pills till they climb some more.

Post-Op: Day 9

    In a few hours, I'll be home after eight days in Roswell Park Cancer Institute, but not without a few anxieties. How will clothes go over the urine-collecting bag? What about the 17 stairs to the second-floor bedroom? And will I have another evening like last night, Wednesday?

    After room service removes the dinner plates, I notice a big wet spot on the front of my hospital gown. The collection bag, changed earlier that day by Katy, one of the ostomy nurses, must be leaking. Another bag change and a new gown, but it also gets wet. The leak isn't in the bag and it's not yellow. It's that reddish lymph fluid, coming from one of the surgery incisions, the one closest to my navel. Lots of gauze and tape are applied and I get another new gown. It works. From there on, only the gauze gets wet.

    Then, as I leave my chair for the evening to brush my teeth and go to bed, I leave a trail of liquid behind me, culminating with a big spill in the bathroom. A major mess. It's from the urine collection bag, a new model with a different kind of release valve that was sent up to us here on 7 West from supply central downstairs. The new valve clicks into the connection with the old overflow bag, but it doesn't hold. 

    The nurse, tall, blond Christie, who used to work in television -- AM Buffalo and the Channel 2 morning news show -- but went back to school to change into a career where she could get the feeling that she was helping people, applies copious amounts of tape to the connection and gets me still another new gown. It works. I doze off to Rita Hayworth's first movie, "The Outlaw," and sleep well until the morning blood draw. 

    Even though Christie ties the tightest tourniquet in Roswell Park, my elusive veins do not show themselves for her. She pokes my arm twice without success and calls for another nurse, who tries once and fails. The third nurse, who announces that she's the one they bring in for difficult cases, finds a promising prospect at the base of my right thumb and nails it. My veins and I will not miss the morning blood draw.

    Dr. Hanzly, Dr. Guru's associate, arrives for his daily visit in the 8 o'clock hour and says that, despite the leaky incision, I'm better off at home. The longer you're in the hospital, he says, the bigger chance of infection. With that, he extracts the line leading to the Jackson-Pratt Drain, which has been pulling lymph fluid out of my abdomen for eight days, and assures me I'll go home with plenty of supplies to soak things up. I'll need 'em. The former drain has been quiet, but not the incision site. It's still oozing like a basement wall in the rainy season. 

Post-op: Day 7

My surgeon, Dr. Guru, walks in with his associate about 4 p.m. today, Tuesday, hands me a stapled print-out entitled "Patient Report," points out the areas highlighted in yellow and declares that I should be pleased.

The bladder? Cancer-free, according to the lab report. The chemo and the TURBT procedures took care of it. The two nearby lymph nodes he removed? They were OK. The bladder cancer hadn't spread. No problem. The prostate gland? 10 percent cancer. It hadn't spread either. Now it's gone. Once I recover, I'm going to be fine. Healthier than before.

The next question -- when should I go home? The associate said a few days ago I could probably leave on Wednesday. Dr. Guru said he wanted to be sure that the now-pale pink fluid draining from my abdomen had decreased to acceptable levels. 

My opinion, having seen the nurses and aides empty the little grenade-shaped plastic collection bulb for the Jackson-Pratt Drain, was that I wanted to be cautious and not remove the drain too soon. My health proxy, Bill Finkelstein, had gone home with a JP Drain still in place after abdominal surgery a few years ago and was back in the hospital with an infection three days later. Fine. The drain can stay for another day. I'll go home Thursday. 

Monday's move to a smaller private room in a regular ward on the seventh floor was accompanied by my biggest parade of visitors. There was Bill, of course, and bridge players Sandi England and Jerry Geiger -- a jolly collection. All we needed was a deck of cards.

Following them were good friends Jack and Shelley Dumpert, who promised to weed my garden Tuesday (but had to postpone it due to the cold rain and fog). Then, surprise, Richard Allmond, a friend from the Lost Expedition pub crawl I led back in the 1980s. And finally, Monica and another good friend, Marti Gorman, who showed up just as I was reaching another recovery milestone -- my first bowel movement. Guess I'm almost ready to face the world again. Except for the JP Drain, all my medical missions are accomplished. 

Post-op: Day 5

How am I doing? Wrong person to ask. I'm just the patient here, with no frame of reference as to what's good or bad, aside from the fact that I hurt less than I did yesterday. And that was less than the day before. 
Still, in many ways, I can tell I'm making good progress on that road to recovery. One milestone -- passing gas. Hooray! My lower intestines are working. That was Friday afternoon. Another marker -- eating food, which off limits until I got gassy. Up to then, all I could do was wet my mouth by dipping a sponge on a stick into a glass of water. But now that I can eat, I'm not really hungry. So far I'm just doing soup, yogurt, apple juice and gelatin.
Ask Dr. Guru and his associates and they say I'm ahead of schedule. They say the surgery went well. They say I'm healing nicely (although the right side of my abdomen still kind of burns when I get up from bed or from my chair). And I'm ambulatory. I walk laps around the ward -- 6-East, the intermediate intensive care unit at Roswell Park Cancer Institute -- and I've gone down to the ground floor (by elevator) and out to the garden. Today, however, is the first time I've felt clear-headed enough to write.
Meanwhile, no problems with the urinary arrangement, although it seems very strange not have used a toilet since the surgery. Problem area instead has been the line draining a reddish Hawaiian-punch-like fluid from my abdomen. On Friday, a leak developed around the incision. The nurses finally resolved it by altering a stoma patch, like they use for the urinary opening, Right now, I'm dry.
Monday it's off to a regular ward -- 7-West -- where they won't be checking my vital signs so frequently. Nevertheless, the nurses and health care associates here on 6-East, which is nearly vacant at the moment, have been supportive and attentive, although even they have had trouble finding veins on me for drawing blood. Still, I have no complaints. When can I go home? Maybe as soon as Wednesday. It all depends on how soon they can remove that drain from my abdomen.

Surgery Diary: Day one minus one

     the trepidations crept in on me last night. after all, it's major surgery. what if i don't wake up? what if i do? what put the fears to flight finally were all the good wishes from you folks out there in the electronic ether and the hugs from my colleagues at the news monday night and my bridge-playing buddies at the tuesday game. 
     meanwhile, i got the flowers planted that i bought at mischler's over the weekend and had an evening of fun at "the book of mormon," which opened tuesday night at shea's performing arts center downtown. thanks again for all your encouragement. my proxies will provide updates for the next day or two. 

Week 19

The countdown began in earnest last Tuesday, May 26. I took the last blood thinners before discontinuing them in advance of the surgery, which is next Wednesday, June 3, at Roswell Park Cancer Institute. OK, platelets, time to thicken up.

          I’m good to go. The pre-op examinations a week ago, last Friday, at Roswell Park confirmed it. A stoma nurse looked me over and marked an X on my stomach, just above the navel and to the right. The anethesiologist thought everything was OK. An EKG and a blood test showed nothing to worry about. And the surgeon, Dr. Khurshid Guru, the man who brought robotic surgery to Roswell Park, seemed satisfied that everything was in order.

          The major questions about the surgery were answered at the previous pre-op meeting with Dr. Guru, right before my heart problems showed up. The only surprise, to me, was his suggestion now that my hospital stay might be 10 days. Previously, I’d been told it would be six to eight days. One thing they’ll want to see is how soon I’ll be able to poop.

As for the surgery itself, most of the info I already knew. It’s going to last six hours. The bladder, prostate and a couple lymph nodes will be removed. A section of my small intestine, a piece of the ilium, will be transported, blood vessels and all, to hook up with my kidneys and serve as a reservoir which will drain through the stoma to an external pouch. Oh yes, and there will be stents helping to keep things open. My assignment – drink plenty of fluids to maintain the flow.

What did Dr. Guru think of the neo-bladder, the all-internal alternative about which my sister-in-law in Arizona had forwarded an Internet link. It’s a longer surgery and a longer recovery, he said, and it’s more appropriate for a younger patient. It takes a bigger piece of the intestine, which still wants to act like an intestine instead of a bladder, and then there are complications involved in making it all work. One fine day, I keep thinking, they’ll make new bladders with 3D printers, but that day isn’t here yet.

Meanwhile, health proxy Bill Finkelstein pressed one of his major complaints – being promised return phone calls and not getting them earlier this month when he wanted to find out the new date for the surgery so he could make arrangements to be there at the hospital. Dr. Guru explained that since the schedule was full, it was hard to find a time, but conceded that callbacks should have been made. My significant other, Monica Neuwirt, who also was there in that little examination room, contended that this was not the kind of thing that Dr. Guru should be concerned with. Well, yes and no. Does everybody have these problems?

Week 18, Day 6

   Now when people ask how I feel, I tell them, "My cardiologist says I'm fine." And if he thinks I'm OK, then I'm OK. 

   I talked with my cardiologist, Dr. Edward Spangenthal, on Monday after an EKG and after questioning by his nurse Dawn and stethoscope listens by him and his assistant Evelyn. The twinges I've been feeling in my chest, he said, are nothing to worry about. The EKG was good. The heart sounded good. A blood enzyme test turned up nothing. 

   So twinges and all, I should stop worrying. Heart-wise, I'm good to go for surgery the following week, on Wednesday, June 3. I'll find out all about it Friday at the pre-op get-together with the surgeon, Dr. Guru. 

   The entire visit at Roswell Park Cancer Institute was unexpectedly quick and easy, less than an hour. I barely got to crack open my New Yorker magazine before I was called in for the EKG. The hard part was setting up the appointment.

   Health proxy Bill Finkelstein started calling Dr. Spangenthal's office at Buffalo Medical Group at 8:30 a.m. Monday, sat on hold for 45 minutes twice, then got through just to be told that he sees patients at Roswell Park only on Mondays and Thursdays and his schedule was full. 

   But then Bill did an end run -- a conference call to Amey, the assistant to Dr. William Morris, the man who inserted the stents in my heart. She heard about my twinges, made a call, then got back to us. Get to Roswell Park as soon as you can, she said. By any means necessary, as Spike Lee puts it at the end of his movies. Sho nuff.

Weeks 17 & 18

Suddenly I’m thrown back to the big question that taunted me in the middle of the chemo treatments a couple months ago – how active can I be? Only this time, the limiting factor isn’t fatigue from the chemo. It’s those newly-installed stents in my heart.

          Not that I hadn’t been advised to take it easy, but I felt good after getting the stents. So last Sunday, Mother’s Day, two weeks minus a day after the stents, the lawn needed mowing. It’s never seemed like heavy exercise. I figured it wouldn’t hurt as long as I beat the height of the 80-degree heat and the sun by going out at 10 a.m. By the time I finished some 45 minutes later, I knew it was too much.

          Since then, I’ve felt on-and-off pains and tingles. A call to the cardiologist’s nurse on Monday prompted two pieces of advice: 1. Don’t do that again and 2. If you feel bad, go straight to the emergency room at Buffalo General Hospital. So on Thursday health care proxy Bill Finkelstein also did extra duty as my lawn mowing proxy.

          But the heart thing has become much more worrisome than the cancer thing. The cancer is treatable and predictable. It’s causing a major change in my life and it certainly could snuff me out, but it shouldn’t. The heart, on the other hand, could turn on me at any minute and kiss my butt goodbye. That’s what happened to my cousin Marsha, my mother’s brother’s daughter. She died suddenly Wednesday of a heart attack in Florida at the age of 62.

          Meanwhile, I’ve been playing bridge by day and working by night. Today, Friday, the bridge was a regional tournament in Rochester, an hour’s drive away on the Thruway. At least at bridge, I told a friend, there are retired medical professionals in the room. What if you get stricken while you’re driving, he asked. Guess I’ll just have to pull over, I said. Sudden thought – better not put the car on cruise control. 

Week 16, Day 6

Post-stent checkback Monday with cardiologist Dr. Edward Spangenthal is my first visit to Roswell Park Cancer Institute that lasts less than an hour. And now that spring is here in full flower, it’s the first visit where the cold air blows out from the main lobby instead of gusting inward.

There’s almost no wait before a nurse takes my blood pressure and pulse, well within the normal range, and assesses my blood oxygen – 99 percent, up from pre-stent levels. Another nurse listens to my chest with a stethoscope and asks questions about medications and side effects.

Then Dr. S. himself steps in, does his own stethoscope tour, and says that things are good. He wants to keep me on blood thinners for three more weeks while the stents heal in, then go off them for a week prior to the bladder surgery. I’d resume them later when the urology surgeon, Dr. Guru, gives the green light.

That puts my big date sometime in early June, exact time TBA. We get to speak a little later with one of Dr. Guru’s assistants, who says that he does surgery on Mondays, Tuesdays and sometimes Wednesdays. Earliest date, then, would be June 1. 

Week 15, Day 6 & 7

Let's call it the Joseph A. Banks deal of heart procedures. Go in for three stents to open up obstructed arteries, come out with four -- two in each artery. The surgeon, Dr. William Morris, said he decided to use two smaller stents in place of a larger one.

This time there was hardly any wait in the cardiac staging area at Gates Vascular Institute. I rolled into the operating room a little after 11 a.m. Monday and out around 12:30 p.m. Dr. Morris said he was pleased with it. Great. If it's OK with him, it's fine by me.

He went in once again through an artery on my right wrist and I scarcely felt anything, aside from a little pressure in my upper chest, a pressure that reappeared briefly in the afternoon, but it's been gone ever since. I could see a few things -- the probe and a stent, which looked like a bullet on the video screen -- but not the doctor or the nurses, who were mostly behind big baffles. 

Health proxy Bill Finkelstein and I had checked in at 7 a.m. and were delighted to discover that we'd be back in Room 25, a suite with floor-to-ceiling windows looking north onto a rainy day. Finding a good vein for the IV again was a problem. The first nurse gave it two tries, then called in a colleague, who examined my left arm for a couple minutes, found a spot near Friday's IV mark, and nailed it. 

The rest was just waiting and welcoming a parade of nurses and aides collecting blood samples and vital signs, a procession that continued every couple hours all afternoon and night. "Nobody sleeps in the hospital," one of the nurses noted. Still, all my vital signs were in order. I felt good. Restless, even. 

Bill left mid-afternoon Monday and missed my only visitor, bridge player David Donaldson, who showed up around 5. Monica, who came at midday, stuck around until the dinner hour, working on her computer. While waiting until it was safe to eat, I reached a long-awaited reading milestone. For the first time in decades, I'm up to the current issue of the New Yorker. 

I broke my daylong fast with the fruit plate with cottage cheese. In the spectrum of hospital food, it's a hard one to screw up. Later on, I phoned in another request for mandarin oranges, a yogurt and a chocolate chip cookie. The tray appeared with oranges and two yogurts, no cookie. Cookies must not be heart-healthy. Same thing happened Tuesday morning. I ordered toast. It came with no butter.

Eating like that was one of the discharge instructions from Amey, Dr. Morris' assistant, along with advice to take it easy for a while and avoid anything strenuous, like yard work or weight lifting or running marathons. She said I'd probably feel tired. She was right. At the moment, even after a nap, I still feel drained. 

Week 15, Day 3

          “Didn’t feel a thing,” I announce triumphantly to health proxy Bill Finkelstein as a nurse named Trish wheels the gurney into the room/suite Friday afternoon at Gates Vascular Institute. And for good reason. Nothing happened.

          Dr. William Morris, ready to install three stents in my heart arteries, had an emergency case in the morning and then gets called back to do more work on the patient in the afternoon. I lie on that gurney in the staging area for 90 minutes, saline solution dripping into the IV in my arm, before Trish comes along to say Dr. Morris is going to be much later than expected.

          The doc himself comes down to the room/suite shortly after 3 p.m. to apologize and relate that he has two in-patients to work on before me. That would get me into the operating room really late, he says, and he would not be at his best. He’ll see me first thing Monday morning. Well, second thing, after his assistant, the animated Amey Dziulko, reminds him that he has a left-and-right that morning that needs to come first.

          So everything is on hold for the weekend. Dr. Morris assures me that I would live until Monday. And it gives the blood thinning meds three more days to kick in.

          This turn of events leaves much to unravel early next week. Appointment with my sleep doctor Monday morning? Canceled. Bridge partners Monday and Tuesday? Notified. Sunday night sick day at The Buffalo News? Reinstated as a working day, but now I’ll be off Monday and Tuesday.

          All this after a day that seemed to start off well enough at 9 a.m., after a couple adjustments. When they assigned me to a dismal windowless inner room, Bill Finkelstein finagled us into another one of those room/suites with a view, like we had Wednesday. And then there were my hard-to-find veins, which resisted volunteering for IV duty until a second nurse came in and shifted from the right arm to the left. Will things fall in line as smoothly on the return visit at 7 a.m. Monday? Here’s hoping.

Week 15, Day 1

         It turns out that I’ve been a heart attack waiting to happen. And indeed it did happen sometime earlier this year, probably in the middle of February, during that week when I was so wiped out that I spent almost all my time in bed. Not that I really noticed at the time.

          All this gets confirmed Wednesday with an angiogram at Gates Vascular Institute, successor to Millard Fillmore Hospital on Gates Circle and now a slick, modern appendage to Buffalo General Hospital in Buffalo’s ever-expanding Medical Campus.

          The personable angiogram doc, Dr. William Morris, no relation to the theatrical booking agency, delivers the verdict a couple hours after taking a look inside my heart via a catheter threaded up through an artery in my right arm.

          One of my heart arteries is completely blocked, he says. That was the heart attack. Two others have major obstructions – one is 70%, the other has three restricted areas, two 70s and a 90. There's a fourth one, too, and it's OK. So I’ll be back at Gates on Friday, when Dr. Morris will use the same arm artery to install heart stents. Following that, an overnight hospital stay and four weeks of generic Plavix, which will thin out my platelets.

          The upshot of all this – my bladder surgery is postponed until June, date to be determined. As Dr. Morris notes, the heart problems have to be taken care of first. Hopefully, the delay in the surgery won’t cause complications. I may be cancer-free for the moment, but the bladder won’t let me stay that way.

          So there are several blessings to count. First of all, thanks to that accidental second-time-around EKG two weeks ago, I’m not going to suddenly clutch my chest and drop dead. Second, I’m not going to expire unexpectedly when Dr. Guru and his robots are digging out my bladder. Third, now that I have the month of May for yard work, I’ll get to plant flowers. (Downside – I’ll be in recovery mode during the run-up to the Garden Walk at the end of July.) Fourth, I’ll get to play bridge in the Rochester Regional Tournament in mid-May, the first Rochester regional in many a moon, which I was very much looking forward to until surgery started looming.

          Minor blessings: They call the hospital rooms “suites” at Gates Vascular Institute and sweet they are, amenable as rooms in good hotels. Spending Friday night there will be a pleasure.

          Dr. Morris did the procedure through my arm instead the artery in my groin, which is more common and which would hurt more right now. “Dr. Morris doesn’t go through the groin,” his associate physician said.

          Time for the procedure was set back to mid-afternoon on Tuesday, then pushed ahead Wednesday when a big case suddenly came up. The nurses and aides had to rush to prep me. At one point, they felt like backstage assistants prepping the star between scenes – one was asking questions, another was inserting the IV, another was taking my blood pressure and still another was shaving my arm for the catheter.

          I wasn’t knocked out for the angiogram, just dosed with something to make me feel relaxed, which is what Tuesday bridge partner Florence Boyd said would happen, having had one at Gates a little while ago. She also said you could watch the procedure on the doc’s video monitor, which I did. Not very revelatory to my untrained eye, but I caught glimpses of the wire-like probe and some dark squirts of dye.

Week 14, Day 2

The cardiology department at Roswell Park Cancer Institute rings the phone about 10 minutes before the alarm is set to go off Thursday morning. The cardiologist wants me to come early for the afternoon appointment. He wants an echocardiogram.

An echocardiogram is probably the easiest procedure I’ve undergone at Roswell Park. They just put the gel on various parts of your chest and abdomen and roll the gizmo over you. My heart at work sounds like a washing machine. The technician says everything is fine.

The cardiologist, Dr. Edward Spangenthal, says everything is not necessarily fine. He brings out print-outs of my EKGs from December and last week, points to the differences and says there definitely was a heart attack, even though I was unaware of it (someone I talk with tonight experienced the same thing – he calls it a “walking heart attack”). Not a bump in the road that I want to hit. I signed up for bladder, not heart.

At any rate, Dr. S. wants to know if there are any blocked arteries. He wants more tests, the “gold standard” being an angiogram. For that, I get my first look inside Gates Vascular Institute, the new place next door to Buffalo General Hospital, on Wednesday. 

Week 13: Day 3

  I start my last pre-surgery visit to Roswell Park Cancer Institute on Friday by sticking my nose into the phlebotomy unit to say hi and offering to give a blood sample just for old times' sake. No blood test on the agenda this time, I explain. Then at check-in in the urology department, the aide says yes, there will be a blood test and I should get it done right now. Back across the hall to phlebotomy and I put Justine to work. She's good at drawing blood. Hits the vein on the first try and it hardly hurts.

  Then it's back over to urology to wait for the consultation with the surgeon, Dr. Guru. But first there's a session with a nurse's aide, answering questions about meds (no changes) and how I'm feeling (no pain). And then there's a session with an assistant to Dr. Guru, who explains a few things about the surgery. And finally, an hour after my appointed hour, there's Dr. Guru himself, who explains a few more things about the surgery.

  The whole robot-assisted procedure will take about six hours (no coffee breaks?, I ask). There will be one larger incision and several smaller ones. I'll probably need blood transfusions. The incisions won't hurt so much afterward, he explains, but because my lower body will be elevated during the surgery and blood will collect in my head and upper body, I'll feel like I've been beaten up everywhere else. There will be a day or two in intensive care and not-so-intensive care, then a regular room. The whole hospital stay will be eight to 10 days. 

  When I get home, I'll be able to go up and down stairs, but not too many times a day. In Dr. Guru's estimation, I could return to near-normal activities in another four to five weeks, which is less than the three months I've been told to expect. Health proxy Bill Finkelstein remarks that I shouldn't rush things while I'm recovering. 

  Dr. Guru also goes over the list of complications and the chances that any of them would occur. The biggest one is infection, which happens almost half the time. I'll need to be careful. As for surviving the surgery and its aftermath, the chances are very good, more than 95 percent. 

At any rate, he says I've come through chemo well. The CT scan shows there's no sign of cancer outside my bladder, although there's scarring on the inside. And for me to be completely cured, the bladder has to go, along with the prostate and a couple nearby lymph nodes. I shake hands with him as he leaves and tell him I have full confidence in him. Me and God, he says.

  Then, running an hour and a half late, it's over to the anesthesiologist. But first they give me a quick EKG to check my heart. When the doc, Dr. Sroka, comes in, he says an EKG shouldn't have been necessary because I had one in December. It was a mistake to do it, but it turns out to be a fortunate mistake. The new EKG does not look like the old one. Did you have a heart attack? Dr. Sroka asks. Not that I know of, I say. Could the chemo have caused one? Was that why I was so weak in February? 

  Dr. Sroka says I'll need to see the cardiologist, but by this point he's gone for the day. They'll need to do a CT scan and maybe an angiogram. And then there's a consultation with the stoma nurse, which was added at the last minute to my Friday appointment list, but she's gone too. So this isn't my last visit to Roswell Park before surgery after all. I'll be back next week. 

Week 13: Day 1

          How liberating it felt to go to Roswell Park Cancer Institute on a Wednesday and not report to the chemotherapy department. This time it was up to the second floor for a CT scan.

That involved fasting until I got there at 1:30 p.m., a drink of a cold berry-flavored prep solution, then waiting. Once I finally got called in to the radiologist, there was an infusion of dye into my veins, which produced a tingle from my head to my groin; and then a couple trips into the doughnut hole of the CT machine.

Mine was the last CT scan of the day and, subsequently, I was the last patient of the day for the urologist, the dapper Dr. Saby George, who said this would probably be the last time we see each other. He said he looked at the CT scans and saw no cancer. For the moment, I am cancer-free. Only about 33 percent of his patients reach this, he added.

Nevertheless, the bladder will have to go. The cancer had invaded the muscle wall and it has a high chance of recurring. If it did, Dr. George noted, there’s a chance that chemotherapy won’t be as effective the second time around. So the next step is the consultation with the surgeon, Dr. Guru, on Friday. I have many questions. 

Week 11, Days 4, 5, 6 & 7

I accidentally bang my afflicted left hand against the sliding door of the West-Herr Toyota courtesy van Tuesday morning and it hurts like hell as it swells into a red welt. How long will I have this vein-inflamed side effect, I wonder? 

I just had a cancer talk with the shuttle driver, who went through four years -- four years! -- of chemo to beat leukemia. He had to retire early from his job, had chemo at Roswell Park every day all day at first and couldn't get a bone marrow transplant from his family because none of them were a match. Because of the chemo's effect on his legs, he walks with a cane, but he's cured and happy to be driving the shuttle three days a week. 

So I'm counting my blessings. I keep something close to a normal schedule, aside from ending my evenings a little earlier than I used to. There's that sinus condition, which erupts into sneezes and sniffles occasionally. And the zinging in my ears every once in a while. And blurry vision, which compels me to wear one of my many pairs of drugstore cheaters a lot and may or may not be related to chemo. And some lingering fatigue. And my hand. 

But chemo is over. No treatment Wednesday. Nothing but a month of recovery with some tests to confirm it before the surgery on May 4. Health care proxy Bill Finkelstein wonders how firm that surgery date really is. He's decided not to wait until my meeting with Dr. Guru on April 10 to get a confirmation.

Week 11: Days 1, 2 & 3

So Terry Gross is interviewing the doctor who wrote "Cancer: The Emperor of All Maladies," subject of a Ken Burns documentary series on PBS next week, and he talks about how intense chemo treatments used to be and how many of the advances in recent years have been in palliative care, with better drugs to reduce the side effects like nausea.

I can attest to that. Nausea is what you're likely to get with Gemcitabine, my final chemo infusion on Wednesday, and part of the prep before they hook it up is an anti-nausea pill, Compazine. I've been continuing the Compazine at home, lest those occasional little volcanic burps erupt into a Kilauea. So far, so good.

What I have mostly is the fatigue. More than once Wednesday night I settled down in front of a "Seinfeld" episode and next thing I knew, there was another sitcom rerun on the channel. I finished that off with 10 hours in bed, soaking up sleep. Thursday and Friday, out and about as usual to bridge, to lunch, to work Thursday night, I still dozed off in front of computer screens, slow-moving bridge hands and long stop lights. 

What else do I have? A fuzzy brain. Fuzzy vision, too. That zinging in my ears still crops up. Stuff still tastes funny. And then there are the sore veins, especially in my left hand, still swollen more than a month after that hand last got the Gemcitabine. 

Can you blame me for having an attitude about where to stick the IV for my final infusion? Right arm only. That attitude ran smack into a nurse I hadn't had before, Connie, a black woman who's been at Roswell Park Cancer Institute 32 years. 

Connie wasn't going to let me tell her what to do. She took her time sizing up my hide-and-seek veins, tied off my right arm above the elbow, had me flex my fingers a few times and then got out the alcohol swabs. Darned if she didn't nail it on the first try. She also got the doctor's permission for a simultaneous infusion of saline solution to keep the Gemcitabine from burning my veins. The fatigue started setting in halfway through the half-hour session. 

And that's the end of chemo. Hallelujah! Better days are ahead. Next: A CAT scan April 8, followed by a consult with the surgeon, Dr. Guru, two days later. 

Week 10, Days 1 & 2

Not much to say about Day 2, Thursday, except that as an alternative to naps (the first taken before noon), more exploration of how much sleep I could get in front of the big-screen TV in the living room. I had no energy for anything else.
Quite a bit of sleep, as it turned out, helped along by some seriously bland March Madness in the evening. The Purdue-Cincinnati basketball game, in which I had little interest to begin with (aside from my brother Tom being a Purdue alum), was a real snorer, since neither team seemed to have the will to prevail. By the time it went into overtime, I'd long stopped wondering which of them would.
More to say about Day 1, Wednesday, which was infusion day, and for my next to last chemo treatment at Roswell Park Cancer Institute, my main goal was avoiding pain.
No problem in the phlebotomy clinic (or "phleblotomy," as someone there was calling it). A bit of a problem a couple hours later in the chemo unit, however, where the nurse, Kim, graciously set us up in the best cubicle on the place, the big one with the two chairs and a bed that we enjoyed during the very first treatment two months ago. It turned out to be the best place for it, since health proxy Bill Finkelstein spent most of the next hour on two phones in the final throes of wrapping up the closing on the sale of his mother's place in Florida.
Meanwhile, Kim was having trouble finding an vein, especially after her first attempt in my chemo-afflicted left hand was unsuccessful. Her uncertainty after that was palpable. We asked if the nurse was on duty who found a vein a week earlier. Doreen. Doreen strode in, slapped my right inner forearm, spied a likely spot and hit it on the first stab. Did the doctor approve infusing the saline solution along with the Gemcitabine? No signature, just two red rubber stamps on a slip of paper that said I'd seen the doctor. Except I hadn't seen the doctor. Worked for the nurses. Worked for me. Just one more to go.

Week 9, Days 6 & 7 (in progress)

What I learn Monday is not to trust my first impressions this week, especially the ones that feel pretty good getting out of bed. They don't last. The heavy feet and slow brain set in and, try as I might to shake them off, they prevail. 

Nevertheless, I go play bridge. ("We'll have our usual s**tty game," partner Barbara Sadkin promises on the phone). But we do better than usual, finishing among the winners (52%), despite my generally passive play. 

After a nap at home, my first impressions return and I call the office. I'm coming in, at least for a while. Then, when I get there, I'm so mentally listless that I struggle to put words together. I throw in the towel around 9 p.m., beating the big crowd that would exit an hour later from the Sabres hockey game in the arena down the street. 

Today, Tuesday, St. Patrick's Day, feels much the same. Just come out for lunch, bridge director (and health proxy) Bill Finkelstein says, after I tell him I have no partner lined up for either the morning or afternoon game. He's serving corned beef. Hard to resist.

Week 9, Days 3, 4 & 5

Don't know if it's the steroid pills and the anti-nausea pills or something else, but Friday and Saturday are near-normal days, packed with activity. 

Bridge both days (a winner Saturday with a 65% game, best score of the year so far), shopping, a couple fine Local Restaurant Week dinners (last-minute luck gets us into Coco over on Main Street on Friday, while Brioso in Williamsville on Saturday is the first place in the 10 that I called where I could get a reservation for six at a reasonable hour). All that without naps.

Sunday starts out just as perky, but soon gets woozy and wobbly again now that the steroid prescription has run its course. After picking up the Sunday Buffalo News and a stop at Target, the rest of the day descends into doubt. Muscles droop. The brain fogs in. After lunch, I want nothing more than a nap. But first a call the city desk at The News to tell editor Rod Watson I'm not going to make it in tonight. That's a decision that still feels right after the nap.

Week 9, Days 1 & 2

Thanks to bridge player, film buff and wine fancier Mike Silverman for coming up the best description of the condition I'm in on Thursday after I clumsily tried to explain it to him -- woozy and wobbly. 

Yes, the brain and the legs have become unreliable again, but not so much as to discourage what's turned into a full day. That's included trips to the post office and the car wash (yes, it's warm enough for that, finally), plus chipping away the remaining ice on the path to the back door at home (a six-foot long stretch, melted to a thin crust on the far edge by another day of glorious March sun). 

And now, after a nap, I'm at work.

Nor did it discourage my bridge game. Maybe it was because partner Florence Boyd and I were on defense most of the day. At any rate, I made fewer mistakes than usual and we came in first North-South. 

As for the chemo at Roswell Park Cancer Institute on Wednesday, it was more easily endurable than last month, thanks to a few discoveries that we've made along the way. 

First of all, you can request (and get) an expert phlebotomist in the Phlebotomy Clinic. Result: She hit the vein with little pain. 

Second, you can request (and get) one of the better vein-finders in the Chemotherapy Clinic. On Wednesday, after chemo nurse Katherine didn't spot one, it was Doreen. She found one halfway down my right forearm on the first try.

And third, you can request (and get) saline solution in combination with one of the chemo drugs, Gemcitabine, which reduces its vein-burning characteristics. 

There's still some confusion about #3. We asked the chemo doc, Dr. Saby George, if he needed to approve this, as the chemo nurses had told us. He replied that he doesn't need to and that he doesn't like to micro-manage. Then we got a contradictory answer from the nurse in charge in chemo. Oh no, she said, the doctor usually has to approve.

At any rate, I got the saline solution and the requisite veins are happy. Happier than the veins on my left hand, which are still sore from the Gemcitabine four weeks ago. 

During the Cisplatin infusion, which came before the Gembitamine, I felt no effects at first and wondered when they would kick in. Halfway through the two-hour process, I found out. The fatigue enveloped me and I could no longer stay awake to read. 

Later, after a hearty dinner at soon-to-close Torches on Restaurant Week specials (beer & cheese soup, mac & cheese wrapped in porchetta and a dessert -- I'd fasted on water, tea and crackers all day), I could hardly stay awake at all. I was in bed by 9:30 p.m.

My day also included a sit-down with a new (to me) member of the Roswell Park team, the social worker. By his request, it was without my health proxy, Bill Finkelstein. 

After asking me how I felt about things, he got to what seemed to be the real purpose of this conference, the picture-taking of me and a health care worker last month, the one that prompted a sit-down with a hospital security officer.

I told him that I had consulted with a lawyer about this (didn't invoke his name though -- your anonymity is safe with me, Mickey) and we have every right to take pictures as long as the health care worker doesn't say no (which she didn't) and that I would fight this if they tried it again. The social worker then suggested that Bill was abrasive and that we would get better results if he was more diplomatic. He then showed up for the conference with Dr. George, but said nothing. Apparently just an observer. 

Week 8: Days 1, 2, 3, 4, 5, 6 and probably 7

A week without a chemo treatment and I'm feeling good. There are longer intervals between trips to the washroom and no naps in the afternoon. I start getting sleepy mid-evening, but that's it. 

I've played bridge almost every day (last Friday in St. Catharines, Ont.), gone shopping in the afternoons and worked each night (except Friday and Saturday, of course). I've been to the dentist and the dermatologist. 

Now that the temperature is finally peeking above freezing, I've chipped the ice off a path to the garage. I've had wasabi with sushi and Tabasco with soup without digestive backlash. Alcoholic beverages, on the other hand, I'm still avoiding. 

This lovely grace period comes to a halt on Wednesday, when I go back to Roswell Park Cancer Institute to start the third round of chemo, beginning with the double infusion of Cisplatin and Gembitamine. Will I be flattened by fatigue again for a week or more? Could be. This time, at least, I know it's coming. 

So I've stocked up on bottled water and Tuesday I'm getting my hair cut, figuring that if it doesn't happen now, it could be two or three weeks before I'm up to it again. By then, if I'm lucky enough to not start losing my hair, I'd look like a mountain man. 

Week 7, Days 5, 6 & 7

This is as good as I’m going to feel in this cycle, I tell the bridge players when they ask how I’m doing. Still a little tired, still a little fuzzy around the edges. A bit more pep and I’d be almost normal.

Yes, I’m back at the bridge tables, but my game is nothing to brag about. In fact, it’s been costing me my naps, thanks to a late start Monday and a stop for lunch Tuesday. I’m sleepier than usual as the evening progresses at the office.

Keeping my blood percolating each night, however, are what’s become my specialty these days – obituaries. Major ones for notable folks, both beloved. One is former WKBW deejay Don Burns, who became the godfather of the rave scene in Toronto. The other is local author Margery Facklam, a woman who kept snakes and porcupines for pets and who wrote some 30 books on natural science, very successful ones, for children. 

Week 7, Days 2, 3 & 4

On the upswing, but not as far up as last month. Back then, I could go to my bridge game, drop home for a nap, then go to work and maybe wrestle a couple bears or wildcats. I can't handle that much now. 

This time, the trip to the office is all I can muster Thursday. It turns out to be a full evening, minus bears and wildcats, but not without computer lock-ups. 

On Friday, I make it to bridge, but don't have enough energy to go out to lunch afterward. It's straight home to bed instead. I rally for Vietnamese food with friends Marti Gorman and Jim Jacobs at the Niagara Seafood Restaurant later. 

On Saturday, Boris the cat has a check-up at the vet at 11 a.m. During the wait to see the doc, I duck across the street to the hardware store and buy a new snow shovel, which I use back home, along with the ice chipper, to attack the crusted snow and ice on our treacherous back stairs. 

After a warm-up and a bite, I set off on a short round of errands which once again test my energy levels. More ginger molasses cookies from Carla's Crumby Creations at Horsefeathers Winter Market before closing time at 2. Prescriptions and fizzy water and a few other supplies from Tops Market in Black Rock. And I'm flagging. At least driving is vaguely restorative, because I need more of that fabulous artisan yogurt from the Farm Store, which is just a couple blocks from home, and it's only open on weekends. Worth the stop. I score the last four jars of their Fig Tea flavor. 

Greeting me back home is an extravagant and unexpected gift -- a huge bouquet of flowers worthy of a wedding or a funeral or, in my case, somewhere in between. It's a get-well wish from old friend and former Buffalo News freelance critic Pat Donovan, an extremely funny lady with whom my contact is usually just e-mail and Facebook. I'm overwhelmed. Boris likes it too. Especially the ferns. 

Then I crawl into bed and nap. Deeply. 

Revived a couple hours later, we join friends Dan and Susanne Sack for dinner at Marco's on Niagara Street, a restaurant chosen for its promise to be well-heated (Niagara Seafood Restaurant was frigid Friday night, despite its newly-installed vestibule). Marco's other promise -- you shall not be underfed. All of us take home big packages of leftovers. 

Week 7, Day 1

Which is quicker -- go for the initial blood draw in the Chemotherapy Department at Roswell Park Cancer Institute, where I have to check in anyway, or check in there and then go get it done in Phlebotomy Department, which allegedly adds an extra step to the handling process? 

This week the chemo people seem ready and willing, so why not? Turns out there's still a two-hour wait for the results. No time differential at all.

When the pager calls me back to the chemo department, what takes a lot more time is finding a vein for the IV. The first chemo nurse tries two of them in my right hand and arm, but neither gives the blood-red signal of success. Two tries and out, she says. She won't do a third. I appreciate that.

She summons another nurse, who tries a third vein. Still no luck. They assess my left hand, which got the last two IVs, and declare the veins too hard, after-effects of the harshness of the chemo drug, Gemcitabine. Third and fourth nurses step in, look again at my right hand, and talk about calling still another nurse, George, who never fails to find a vein. But before they do, they spot a prospect between my thumb and index finger. It works. 

Given the tender location, I brace for the worst with the Gemcitabine, which hurt a lot last week, but the first nurse buffers it with an immediate warm blanket and a simultaneous infusion of saline solution, which dilutes some of the nastiness. This, it turns out, has always been an option. It's a good one, the least painful of the Gemcitabine infusions so far. And now a week off. 

Week 6, Days 6 & 7

This must be the upswing. How else could I finally make it back to the office on Tuesday, at least in a limited and assisted way? Friend Broady takes me downtown mid-afternoon (just my third venture outdoors since Friday the 13th). Monica gets me back mid-evening. 
And how else could I hang in there longer than expected, fueled by only one nap for the day? Twelve days worth of backlogged e-mail, two Reporter's Notebook columns to assemble, I spend five hours digging myself out of a hole.
Complicating excavations is the balky Buffalo News computer system. My ancient Windows XP machine has barely gotten humming when it locks up and needs a reboot. And then it locks up again and needs another reboot. Meanwhile, the editors are waiting for Wednesday's column.
Then, later, with Monica idling at the snowy Scott Street curb downstairs, it locks up again when I try to send Friday's column to the editors. Second-richest man in America, our beloved owner, Warren Buffett, and he can't give us decent tools to work with. I seethe all the way home.
Monday, I couldn't have done all that. That's a two-nap day, enhanced with my sleep apnea machine. The sinus infection obliged me to abandon it recently because I couldn't breathe, but now, with sinuses improved (but not cured), I give it another try and immediately see the difference. Not in duration of sleep, but in depth. The dreams! One involves flaming architectural elements of Victorian houses flying wildly through the air. I wonder if my subconscious has a special effects budget big enough to keep doing this.