Monday, April 22, 2013

Frostbite Without the Freeze

Hospitals are evil things. Doctors are forces of blackness and evil: The higher their learning, the more profound their dark intent. For, the higher their learning, the farther from humanity they fly: the patient becomes mere man-meat, with no humanity attached it him or her at all.

Take a toe. A little toe. The tiniest toe: the "wee-wee-wee all the way home" toe. Give it the tiniest of infections and place it on an inpatient ward of a hospital: Everyone will ignore it. Everyone will assume its benign nature. And, in a week or two, it will be rotting into its own hell; making life intolerable for its owner, and buckling under the immunosuppressant chemotherapy it is subjected to until it looks like frostbite.

I remember frostbite: I had seen it in Alaska in the dead of winter: Folks subjected to long hours of winter's cold; their extremities with flesh turning black from lack of fluid nutrients.

That's the color flesh I saw in Steve's small toe ("wee-wee-wee") on Monday morning, before I went to my chiropractor's appointment. It was the color we saw after me appointment with a new client at 2 p.m. It was the color the ER physicians saw when we drove to Long Beach to have his foot checked because, having seen frostbite before, I knew that if we didn't get him to a physician, he might lose his foot.

I hate hospitals. They cure but they make their patients insane. I hate leaving the husband I love at the mercy of those hellish healers. My last words to him upon leaving: Be an asshole. Complain about everything. Ring them 10 times an hour. Be such a pain in the ass that they will want nothing more than to cure you and get you the hell out of their sight.

On an outpatient basis, they are my heroes. On an inpatient basis, they are the medicinal incubi and succubi of The Test and Numbers and Values: as for their inpatients' souls, the data say the word is spelled incorrectly, and they are located on the bottom of the foot. It's a pity they paid so little attention to these extremities the last time they had him in their clutches.

Thank God for the spiritual healers we have on our side for this fight, or all would be lost: Joy, meet Robin; Robin, meet Joy.

Sunday, April 21, 2013

Drain-Train Back-Crack Tooth-Uncouth Web-Celeb

Steve’s been home and out of the hospital for 10 days now, so things are starting to revert to the new normal, which is a Godsend for us both.

The biggest beat to the new routine is pleural draining. This sounds really creepy and quasi-surgical, but it’s really quick, painless and tidy, if done correctly: Just removing the old dressing, hooking up the chest catheter (a small plastic tube with a one-way valve and a clamp) to the drainage bag, initiating the syphon (with a small bulb on the bag’s tube) and drawing off about a liter of fluid: Clamp the line, sterilize the catheter end, slap on a new dressing and you’re done. We repeat this every three to five days, and the pressure has been lessening each time, so we’re getting a handle on the condition and Steve’s lung capacity is stabilizing.

The only other real health problem is the small toe on his left foot: Since he has the catheter, he’s taking sponge baths at the sink rather than showering, so his feet haven’t been getting washed regularly, and a nasty fungal infection has taken over between the last two toes on his left foot. It’s also drying out and cracking the callouses, and the whole foot is getting involved. On advice from his primary physician’s nurse practitioner, we’ve started twice-daily foot baths with gauze between the toes to dry them out.

This last Thursday we went down to the VA on Long Beach and Steve had appointments with his psychologist, primary care physician, oncologist and pulmonary care technician. We got gauze, saline and pain relievers from the primary care physician for the foot, and about a dozen of the draining kits from the pulmonology department. By the time we left the pharmacy department on our way to the car, Steve had a BIG box on his lap full of all this stuff. I told the pharmacist, “We’re opening our own hospital.” She thought that was pretty funny.

We’re also getting back to routine activities other than just watching the television. I’m trying to get Steve out and walking around at least twice a week, and walking up and down the stairs at home at least a half dozen times a day. Even with the cancer, his health is really good, so keeping his stamina up is important. Every time he wears out and he flops down, I say, “Time yourself and see how long it takes to get back your breath.” That way, he can see his stamina is improving.

As for me, I’m going in several directions, healthwise.

One of my fellow chamber of commerce members, Dennis Buckley, is a chiropractor who has written a couple of books, and I’ve done two book covers for him so far. After doing the last one, I asked him if he would be willing to trade out some treatments, and he agreed. It was the best decision I could have made.

Sitting at the computer for hours a day, my back and neck were a mess. After my first treatment with him, I was able to turn my neck around and really look behind me when changing lanes on the freeway. I’ve also noticed that my shoulders don’t droop like they used to, and my posture is getting better without even thinking about it. His associate, Harrison Darling, has given me a couple simple neck exercises that have helped keep my back loose and supple.

On the health downside, I had a damaged front tooth that broke off last week. There’s no pain, and it was in need of attention, but I had run out of money and was waiting for my dental insurance to renew before proceeding. When Steve’s health issues emerged, the dentist was put on the back burner, but no longer: with the tooth missing, my smile doesn’t exactly charm.

I’ve got an appointment with my dentist on Tuesday, and I’m going to propose taking the plunge: remove the six remaining maxillary teeth and fit me with an upper denture. (I would prefer this to a series of root canals and caps, partial dentures and their concurrent costs.) Also, it is a procedure I can afford with my present insurance coverage.

On the upside for both of us, we stopped smoking in early March (the 4th for Steve, the 6th for me). I have been nicotine-free for two weeks now (no patches or gum). I don’t have the urge to smoke, but I do have the urge to do “something” in those periods when what I would do was smoke: after a meal, getting into the car, taking a break from work, with the first cup of coffee in the morning. I’m not sure whether it’s worth my time to come up with substitute things, or whether I should just let those behaviors drop away over the next couple of weeks.

On the design studio front, I finally got my remaining 1500 brochures labeled, stamped and into the mail. The mailing list I purchased was a good one, because it’s been almost a week and I haven’t gotten and returns in the mail. I’m finally down to a couple hundred of the brochures, which means I’ll need to design something new soon for the next mail campaign.

As a result of the mailing, I have three appointments next week with potential clients (an antiques dealer wanting a website, a Realtor wanting a website redesign and a golden retriever rescue organization gearing up for an upscale fundraiser in September and needing graphic coordination). This of course is on top of a few ongoing clients I presently have, plus several clients planning projects in the next few months.

Also, Paul Little, the CEO of the Pasadena Chamber of Commerce, let me know that they want me to head up not only the design but also the production of their directory next year, so that is another major project slated for the second half of the year. Now, if I can just get Martha over at ASC to hire me to design those two biographies they’re planning on publishing, things will be golden. And I really love working with her.

As a business person, I have to say that it looks like the recession is finally moving into the past, and people are more confident about planning for the future without feeling the need of an economic safety net in case the whole thing collapses again.

Thursday, April 11, 2013

These Two Dancers Walk Into a Barre…

Steve had his first chemotherapy infusion session today. It took about 2-1/2 hours, and he doesn't seem to have suffered any immediate side effects from the procedure. It is finally the beginning of his outpatient treatment, which we have both been wanting to start for weeks now.

At the oncology consultation with Dr. Klein (which occurred right after the last blog entry), Steve was having trouble getting breath, so she ordered a chest X-ray and a blood panel: We could stop at Radiology and then at the Phlebotomy Lab for those tests, then go to the Emergency Room, where they would take care of the breathing problem.

The "solution" at ER was Steve readmitted to the hospital (something neither of us wanted). It took the pulmonologists, cardiothoracic surgeons and attending physicians a full week of tests and prodding and poking to all agree that it was wise and safe to place a chest tube into Steve to draw off the excess pleural fluid to help improve his breathing.

So, after being admitted on March 27, the procedure was done on April 2. He was released on the 3rd, and on the 4th we got to drive back down to Long Beach for a pulmonary consult so the doctor could show us how to drain the fluid and rebandage the site afterwards. All very straightforward and far preferable to having Steve trot down to Long Beach for a weekly procedure.

Hospitals are great places of curing, but not for healing. Home is where you heal. By the time Steve got home on the 3rd, his health, both physical and mental, was adversely affected by the hospital stay. It took a week at home to get back to normal and regain some of his physical stamina. He's now back to going up and down stairs, going out and picking up the mail, helping with the dishes, and I keep pushing him to keep expanding on that stamina: Spending four of the last six weeks in hospital beds can do horrible things to a person's body and spirit.

On the business front, I have taken some of this time to finish folding up the remaining 2,000 brochures from the printing I did last year when I started the business. They've been sitting in boxes under the dining room chairs, so I decided I should do something positive with them and do a little promotion: I bit the bullet and purchased a business-to-business mailing list online, then used it to set up a 1,500-name mailer list.

Last year, I sent out the brochure (a square) with a 6"x9" Post-It pad with the company logo. I had to put them in an envelope, since you cannot send out a square piece as a bulk mail item, only as first class.

I sat down and did the math, and realized that sending the square brochures as first-class mail was actually cheaper than going the envelope route with bulk mail charges. And, besides, the shape of the brochure emphasizes the shape of my logo, so it makes sense to send them that way. And how many square pieces of mail do you get?

So, we now have nearly 500 mailers ready to go into the post this week, and 1,000 more ready for stamps and mailing labels. I figure if I send them out in three batches of 500, it won't be too overwhelming. Hopefully, that will kick start the business, which is not stagnant now, but I don't have any really big projects ongoing at the moment, so income dribbles in here and there.

Whatever business does come down the pike will have to be worked into Steve's treatment program and retirement plans; that's a given. He's filed online for his Social Security and SDI and handicapped parking placard, so we'll be up and running in a couple weeks. And he already belongs to AARP, so we're all set.

On the personal front, I stopped smoking on March 7 (Steve stopped on the 5th) and I stopped the patches on April 5. I tried the gum for a day or two, but it really doesn't do anything for me, so I quit using it on Sunday. This means that I have been nicotine-free for nearly four days straight (the first time in 44 years).

There was one point, while Steve was in the hospital, that I went off the patches and smoked a pack over a two-day period. The upshot of the experience was actually positive, since I got no real pleasure out of the act of smoking; it was just another nicotine delivery system, so I was back on the patches the next day.

I'm getting "the urge" three or four times a day, but it doesn't translate into a desire to obtain cigarettes and smoke them; it's an abstract urge to "do something" (which is how 1,500 brochures got folded!). And if the cravings get bad enough, I can revert to the gum. I don't think that will happen, though: I just want the nicotine out of my system and out of my life.

On the health front, my blood pressure, both systolic and diastolic counts, have dropped 10-20 points, (now about 124/68 and my resting pulse is down from 86 to 64. I have gained back five or six of the 27 pounds I lost last year, but I can keep an eye on that: With everything else that's going on right now, I'm not going to throw dietary constraints on myself while trying to cook properly for Steve.

So here's hoping that the chemo will be effective as hell and that Steve will tolerate the regimen well and we can get really aggressive in managing this disease. As they say: So far, so good.

Because, to be honest, I want to get to some of that fun retirement stuff.