Post Op
The other day my wife slipped on a stair, one of those unexpected things that just happen and that when it happens is something that usually puzzles you since you're so familiar with your home's layout or a place you've frequented; you turn and bump your knee in the car door or your shoulder hits the cabinet when you swing around, or you bonk your head on the shelf when you stand up. Generally you briefly give that inanimate object a look as if searching for something else to blame but you know that it was simply you, and an accident, and that you were just careless and not paying attention. The result is usually minor, an embarrassing moment to rub your shin or to scratch your head, but sometimes the result could be borderline catastrophic...a glance away while driving and a swerve into a railing, or in my wife's case a possible broken ankle; since she is only six weeks out from her hip surgery the doc was concerned that the pelvic bone socket which holds the new ball joint implant may have fractured and if so would possibly require the implant's removal and an even more extensive re-surgery. Alas, after a bit of moving her legs and ankles every which way, each turn a reassurance from the doc telling her that she should be screaming or wincing at the least, it was determined that she had suffered just a level one sprain (levels two and three sprains affect different ligaments and tendons and prove more serious). She was sent home with the famous RICE advice: Rest, Ice, Compression and Elevation.
Entering a clinic, even a well equipped one, is one thing, but for those who have major medical events happen to them, the entry is usually to a hospital. An operation for something as complicated as a prostatectomy can take anywhere from 1 to 6 hours* since the prostate is so near the bladder and rectum and also surrounded by muscle; many such operations are now done robotically with the Alien-looking Da Vinci unit now being in its fourth generation, complete with 3-D imaging. While not quite the rapid spider-like operation done in the futuristic film Prometheus, the Da Vinci unit can be used for everything from throat to heart & lung operations (a surgeon remotely guides the device). The prostate, as with the pancreas, is one of those potential silent killers that lurk within our bodies, things hard to discover if they're becoming cancerous and often requiring extensive and aggressive treatment to contain or ideally, eradicate. The prostate of course, is a male organ that few men want checked (the dreaded finger poke in the rectum by a doctor) but is as essential as a PSA test, the doctor feeling for nodules and firmness and signs of bleeding, all done quickly and efficiently. In one person's case, a PSA test that normally showed quite low one year had spiked to above 10 the next, and it was revealed that a biopsy sample of six different sites showed aggressive cancerous cells had reared its head unexpectedly. The recommended treatment for this person was the above operation, a prostatectomy.
None of this is cheap, as anyone who has received a hospital bill will realize. A one night stay can easily average $1200-1500 without the additional doctor's and lab fees. Quite an expensive overnight. In a piece in AARP, the cost of fighting cancer in a hospital was glaring: Surgery -- $45,000; Chemotherapy -- $30,000; Radiation -- $50,000; Drug therapy -- $15,000. Said the piece: Average costs for the disease's treatment run in the $150,000 range...11 of the 12 cancer drugs that the Food & Drug Administration approved in 2012 were priced at more than $100,000 per year...Sarah Kelly is a licensed clinical social worker for the support group CancerCare, which fields 250 to 300 calls a day to its hotline in New York City. She cites two comments she often hears from patients: “I don’t want to bankrupt my family,” and, heartbreakingly, “I can’t afford to live.” One personal finance site notes that many insurance companies have lifetime limits; undergo a second or third operation and that limit may be reached and resulting payments denied (the Affordable Care Act, which many Republicans in Congress and President Trump wish to do away with, currently prevents some of these limits from being exercised).
A heartbreaking and courageously personal story in The New Yorker revealed the toll that cancer (in this case, breast cancer) and its resulting treatment can take on a person; when the author is given her dosage of the toxic doxorubicin, she writes: Doctors at first did not believe patients who described doxorubicin’s cognitive effects, or minimized the patients’ complaints as cancer-related unhappiness. MRIs of people who have had this chemotherapy for breast cancer indicate damage to the premotor and prefrontal cortices. Patients report that they lose the ability to read, to recall words, to speak fluently, to make decisions, and to remember. Some lose not just their short-term memories but their episodic ones—the memories of their lives. I was given doxorubicin with cyclophospha- mide, a drug approved for use in 1959, in a common treatment combination called dose-dense A.C. chemo. Cyclophosphamide is a medicalized form of a chemical weapon developed by Bayer scientists under the name LOST and outlawed in 1925. Mustard gas, as it is also known, has always done its worst as an incapacitant rather than as a killer, but it can kill a person, too. During the war, LOST filled the trenches with brilliant-yellow plumes. During cancer, it comes in plastic pouches, and no one in the pavilion speaks frankly about what it is. Although four dose-dense rounds effectively eliminated many parts of me, neither of these drugs appeared to significantly reduce my tumor. After we were done with all that cellular annihilation, my own semi-annihilation was obvious, but my tumor remained intact. It remained as the full measure of shadow against the radiance of the screen.
It returns one to the question of the value of life, how much can we or will we pay to stay alive? Or perhaps from an outsider's view, how much is it worth to keep us alive? What is our worth, as I asked in an earlier post. As an interesting aside I picked up a book by Lydia Fenet, an auctioneer for the famous auction house Christie's and where she's raised monies for hundreds of charities (half a billion dollars, to date). Her introduction began with this: You were curious, right? That's why you picked up this book...Nobody picks up a book titled The Most Powerful Woman in the Room Is You unless that is who she wants to be. I want this book to change your life. I want it to inspire you, motivate, and push you to be the best you can be -- and to raise up other people along with you while you do it. I'll give it a quick glance, I thought, another "motivational" book; but before long, I had finished it. Beyond telling you to set personal goals and also about her rather interesting experiences of capturing a crowd (often CEOs, highly influential people and yes, billionaires), she dives into what are surprisingly simple but important values, to write thank you notes and to be honest, especially with yourself. Who do you want to be and what do you want to accomplish? And how will you spend your time? For those with a serious medical condition, that last question might be the most important one, not one of time but of remaining time.
Anne Boyer, author of the piece in The New Yorker, goes on to add her rather gut-wrenching observation: People with breast cancer are supposed to be ourselves as we were before, but also better and stronger and at the same time heart-wrenchingly worse. We are supposed to keep our unhappiness to ourselves but donate our courage to everyone. We are supposed to, as anyone can see in the YouTube videos, dance toward our mastectomies, or, as in “Sex and the City,” stand up with Samantha in the ballroom and throw off our wigs while a crowd of banqueting women and men roars with approval. We are supposed to, as Dana does in “The L Word,” pick ourselves up out of dreary self-pity and look stylish on the streets in our colorful hats. If we die later, as Dana does, we are supposed to know that our friends will participate in a fund-raising athletic event and take a minute, before moving on to other episodes, to remember that we once lived. We are supposed to be legible as patients while navigating hospitals and getting treatment, and illegible as our actual, sick selves while going to work and taking care of others. Our actual selves must now wear the false heroics of disease: every patient a celebrity survivor, smiling before the surgery and smiling after it, too. We are supposed to be feisty, sexy, snarky women, or girls, or ladies, or whatever. Also, as the T-shirts for sale on Amazon suggest, we are always supposed to be able to tell cancer that “you messed with the wrong bitch!” In my case, however, cancer messed with the right bitch. During treatment, you must have a desire to live, but it is also necessary to believe that you are a person worth keeping alive.
Whether it is cancer in the breast or the prostate or the pancreas, or even that stray glance away from the road that sends you reeling into a tree or a guardrail, at some point we will all have to question our worth. As the famous line goes, the only person interested in reaching a 100th birthday is the 99-year old. Our pup of 15, our beloved German Shepherd, was put down the other day, an end-of-life decision made by us and one that is never easy. Her life was invaluable to us, something we tried to keep going indefinitely. But there were battles within, many won and now, one lost. Our own self-worth has been damaged and weakened...and once again, life doesn't blink. As I told my wife, soon that will be us, here and gone and life will in all likelihood not notice. We have to take away the only thing that will matter when we also give in to outside forces, that of our honest knowledge of ourselves...were we a good person, did we help others, and as my wife always reminds me, did we emanate love.
*If watching an actual prostatectomy surgery doesn't bother you (in this case, edited down to about 1/5 the time) then this video will give you an idea of the many things that a surgeon has to dodge in order to not nick or cut blood vessels or nerves, all while working to remove the cancerous portion of the prostate (or the prostate itself). Prostate cancer is believed to be genetic...
 |
| Da Vinci robotic surgical unit: NPR Photo |
None of this is cheap, as anyone who has received a hospital bill will realize. A one night stay can easily average $1200-1500 without the additional doctor's and lab fees. Quite an expensive overnight. In a piece in AARP, the cost of fighting cancer in a hospital was glaring: Surgery -- $45,000; Chemotherapy -- $30,000; Radiation -- $50,000; Drug therapy -- $15,000. Said the piece: Average costs for the disease's treatment run in the $150,000 range...11 of the 12 cancer drugs that the Food & Drug Administration approved in 2012 were priced at more than $100,000 per year...Sarah Kelly is a licensed clinical social worker for the support group CancerCare, which fields 250 to 300 calls a day to its hotline in New York City. She cites two comments she often hears from patients: “I don’t want to bankrupt my family,” and, heartbreakingly, “I can’t afford to live.” One personal finance site notes that many insurance companies have lifetime limits; undergo a second or third operation and that limit may be reached and resulting payments denied (the Affordable Care Act, which many Republicans in Congress and President Trump wish to do away with, currently prevents some of these limits from being exercised).
A heartbreaking and courageously personal story in The New Yorker revealed the toll that cancer (in this case, breast cancer) and its resulting treatment can take on a person; when the author is given her dosage of the toxic doxorubicin, she writes: Doctors at first did not believe patients who described doxorubicin’s cognitive effects, or minimized the patients’ complaints as cancer-related unhappiness. MRIs of people who have had this chemotherapy for breast cancer indicate damage to the premotor and prefrontal cortices. Patients report that they lose the ability to read, to recall words, to speak fluently, to make decisions, and to remember. Some lose not just their short-term memories but their episodic ones—the memories of their lives. I was given doxorubicin with cyclophospha- mide, a drug approved for use in 1959, in a common treatment combination called dose-dense A.C. chemo. Cyclophosphamide is a medicalized form of a chemical weapon developed by Bayer scientists under the name LOST and outlawed in 1925. Mustard gas, as it is also known, has always done its worst as an incapacitant rather than as a killer, but it can kill a person, too. During the war, LOST filled the trenches with brilliant-yellow plumes. During cancer, it comes in plastic pouches, and no one in the pavilion speaks frankly about what it is. Although four dose-dense rounds effectively eliminated many parts of me, neither of these drugs appeared to significantly reduce my tumor. After we were done with all that cellular annihilation, my own semi-annihilation was obvious, but my tumor remained intact. It remained as the full measure of shadow against the radiance of the screen.
It returns one to the question of the value of life, how much can we or will we pay to stay alive? Or perhaps from an outsider's view, how much is it worth to keep us alive? What is our worth, as I asked in an earlier post. As an interesting aside I picked up a book by Lydia Fenet, an auctioneer for the famous auction house Christie's and where she's raised monies for hundreds of charities (half a billion dollars, to date). Her introduction began with this: You were curious, right? That's why you picked up this book...Nobody picks up a book titled The Most Powerful Woman in the Room Is You unless that is who she wants to be. I want this book to change your life. I want it to inspire you, motivate, and push you to be the best you can be -- and to raise up other people along with you while you do it. I'll give it a quick glance, I thought, another "motivational" book; but before long, I had finished it. Beyond telling you to set personal goals and also about her rather interesting experiences of capturing a crowd (often CEOs, highly influential people and yes, billionaires), she dives into what are surprisingly simple but important values, to write thank you notes and to be honest, especially with yourself. Who do you want to be and what do you want to accomplish? And how will you spend your time? For those with a serious medical condition, that last question might be the most important one, not one of time but of remaining time.
Anne Boyer, author of the piece in The New Yorker, goes on to add her rather gut-wrenching observation: People with breast cancer are supposed to be ourselves as we were before, but also better and stronger and at the same time heart-wrenchingly worse. We are supposed to keep our unhappiness to ourselves but donate our courage to everyone. We are supposed to, as anyone can see in the YouTube videos, dance toward our mastectomies, or, as in “Sex and the City,” stand up with Samantha in the ballroom and throw off our wigs while a crowd of banqueting women and men roars with approval. We are supposed to, as Dana does in “The L Word,” pick ourselves up out of dreary self-pity and look stylish on the streets in our colorful hats. If we die later, as Dana does, we are supposed to know that our friends will participate in a fund-raising athletic event and take a minute, before moving on to other episodes, to remember that we once lived. We are supposed to be legible as patients while navigating hospitals and getting treatment, and illegible as our actual, sick selves while going to work and taking care of others. Our actual selves must now wear the false heroics of disease: every patient a celebrity survivor, smiling before the surgery and smiling after it, too. We are supposed to be feisty, sexy, snarky women, or girls, or ladies, or whatever. Also, as the T-shirts for sale on Amazon suggest, we are always supposed to be able to tell cancer that “you messed with the wrong bitch!” In my case, however, cancer messed with the right bitch. During treatment, you must have a desire to live, but it is also necessary to believe that you are a person worth keeping alive.
Whether it is cancer in the breast or the prostate or the pancreas, or even that stray glance away from the road that sends you reeling into a tree or a guardrail, at some point we will all have to question our worth. As the famous line goes, the only person interested in reaching a 100th birthday is the 99-year old. Our pup of 15, our beloved German Shepherd, was put down the other day, an end-of-life decision made by us and one that is never easy. Her life was invaluable to us, something we tried to keep going indefinitely. But there were battles within, many won and now, one lost. Our own self-worth has been damaged and weakened...and once again, life doesn't blink. As I told my wife, soon that will be us, here and gone and life will in all likelihood not notice. We have to take away the only thing that will matter when we also give in to outside forces, that of our honest knowledge of ourselves...were we a good person, did we help others, and as my wife always reminds me, did we emanate love.
 |
| Our 15-year old pup, Haley...the real meaning of life. |
*If watching an actual prostatectomy surgery doesn't bother you (in this case, edited down to about 1/5 the time) then this video will give you an idea of the many things that a surgeon has to dodge in order to not nick or cut blood vessels or nerves, all while working to remove the cancerous portion of the prostate (or the prostate itself). Prostate cancer is believed to be genetic...
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