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.