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Feb 14, 2007  It's been quite a while since I made an entry here simply because this is reserved for the good stuff and there just hasn't been a lot happening for several weeks - until now.  Begin the saga of the kidney stone.  I woke up Sunday morning with a sharp pain in my right side.  I didn't jump for the pain meds immediately because I like to experience new pains for awhile and see what's going on.  I 'm also a practitioner of "Leave it alone and it might just go away."  It wasn't a severe pain but definitely uncomfortable.  (Note from Maria: John said 4-5 on a scale of 1-10 at that point.) Also it felt like it could (should) go away - maybe with a bowel movement or whatever.  No such luck.  I whined, and complained, and moped around until mid-afternoon and then went for the Vicodin stash about 3:00.  The pain began to subside in about 30 minutes and I drifted in and out as I watched TV.  Four hours later, I popped two more happy pills, which would take me up until I would be asleep for the night.  By bedtime, I'd realized that the napping had been in part caused by the onset of of a cold and not just the drug of choice for "House" (the TV Doctor of the show by the same name).  I had a miserable night, waking every few minutes to sip something to moisten my mouth since my nose was totally plugged and I had to breath through my mouth.  I continued to feel like hammered doggy-doo (a technical term) all day - getting dizzy when I stood, sinuses hurting, nose bleeding, etc.  "Could it get any worse?" I whined to myself.   Maria, taking pity on me said, "I'm calling the doctor and you get off your sorry ass and get ready to go!"  (M: Sounds like something I'd say.) We went to the infusion center about 3:30 where they gave me two liters of saline, thinking I must be dehydrated.  I told the doc about the pain and they thought it might be related to the chemo, but was likely just intestinal.  Sine die, game over, end of issue.  HA!

As we drove home, I started to hurt again, same place, same feeling, only more severe. (M: This time a 7 on the aforementioned scale of 1-10)  I didn't wait around;  I hit the Vicodin right away, expecting relief in 30-45 minutes.  That time came and went and the pain actually worsened.  I told Maria it reminded me of the pain I had with a stone about 25 years ago (that kind of memory just doesn't go away).  I've see numerous descriptions of kidney stone pain - all likely correct and most involving a twisting knife - but I describe mine as follows, which I know all you men can relate to.  Imagine that for some cruel, inexplicable reason, you have been endowed with a singularity - a testicle in the approximate vicinity of your left kidney.  Now imagine that your worst enemy, let's call him Valdemort, has just inserted a hot vice grip deeply into your side, grabbed the testicle with its serrated grips and begins to squeeze.  Every once in while he twists the screw on the end of the tool to tighten it a bit more, and, just for kicks, gives it an extra hard squeeze or a little twist.  Remember, since it's a vice grip, there is no lapse or momentary relief - ever - just PAIN and More PAIN!  Whew!  I'm glad to have that out of the way.  It hurts just describing it.

So I continued the Vicodin all night with little success.  Maybe I achieved a half an hour to an hour of semi-relief with each dose.  I would lie awake the last hour of each 4-hour period, counting the minutes until I could take another dose and hoping that this time it might work.  I got virtually no sleep with the pain and the cold working in tandem to reduce my miserable existence to a sniveling blob of protoplasm lying in sweat-soaked sheets next to a mountain of dirty Kleenexes.  But, as I popped my morning dose of Vicodin at 7:00, a miracle happened:  Within two minutes, the pain completely went away.  Had I beaten it down?  Had I drugged it to death? Had I died?  No matter.  Whatever, it was It was wonderful and I was fully prepared to accept it.  The day was pain free, but I still continued to feel pretty crummy (remember the doggy doo thing?).  The night had left me with a clue, however, that just dawned on me in conjunction with the miracle.  I had peed only about 250 ml of dark concentrated urine during the night.  This was after a 2 liter infusion and about a liter of water during the night.  Hmmmmm?  It really did feel like a kidney stone, although not quite in the right place.  Maybe the 2 liters increased the hydrostatic tension in the kidney and caused the stone to start its migration again - going to the light (the doctors later concurred with my diagnosis).  Also, kidney stone pain can just go away for no reason once is settles down (lodges) somewhere comfortable.  This was also suspicious to me.

Maria, again in her firm yet gentle way, asked me if I would accompany her to the infusion center for some more juice and where she had arranged for Dr. S to drop by so I could inform him of my symptoms and what a pain in the ass I was becoming, which I did, and which he did (we both do what she says). 

After listening to my sad tale as described above, Dr. S became concerned and wanted me to check in to the emergency room - right then - for an evaluation.  He thought it was possible it was a stone and didn't think it was related to any of the known or expected reactions to the chemo.  This I did.  After a CAT Scan and a couple of x-rays the ER doctor proclaimed me to have a stone - not merely a stone - but a STONE - a stone to be proud of - a stone to write about - a stone to be photographed (and you know I will).  Dr. A, the UG guy, came by to see me this morning.  He said he would try to get it out Monday which was the soonest possible.  I said, hell, I'm not doing anything on Monday so that works for me.  It's a day surgery-type deal, under anesthesia.  He will first insert a stint into the urethra.  If this sounds scary and uncomfortable to you, don't worry - it's not happening to you.  But I'm scared as hell!  I just don't like folks messing around down there.  I told him to order extra stint material (joke).  However, this stint thing will hopefully keep the urethra open so that the larger pieces can pass trough without me having to bite on a silver bullet or emblazon fingerprints in the toilet cover.  Then he will blast the stone (Lithotripsy) to break it apart.  Then I drink fluids and rinse the little suckers out of there.  My buddy Eddy had one a few years ago.  He said the trick is to not pass out while you're peeing after they remove the stint, and recommended sitting down.  I'm sure it's not as easy or as painless as I've described it here.  I'll give you the full story here next week, assuming I survive, and as soon as I'm up to typing.

Feb 20, 2007  Well, I was supposed to go in yesterday at 5:30 a.m. to undergo the Lithotripsy but "luckily," I was admitted at 2:00 a.m. as a result of a temperature of 102 - so I was already there.  The admitting physician said she didn't think they would do the procedure because of the temperature and likelihood of some kind of infection.  The temp actually returned to near normal around 9 p.m. or so, but they gave me some antibiotics and admitted me anyhow.  All the doctors apparently conferred and decided to go ahead with the process.  This left me no time to fuss or worry over it.  They woke me up about 7 (I was first on the schedule) and the next thing I knew, I was in a small operating room with a doctor, and anesthesiologist, and several nurses.  The doc said they were going to go up into the bladder and have a look (cystoscopy), break up the stone, and insert a stint.  They turned my lights out and the next thing I new I was awake in recovery, talking to a couple of nurses.  I'm a little foggy but I believe the doc said he broke the stone(s) up with a laser.  He also put in a stint the keep the urethra open so the stone fragments can pass out without me passing out.  I can report that the first several times you pee after this procedure is less than fun.  It just hurts on a number of levels!  Yesterday and last night it looked like I was still bleeding a good bit but it might be abating a bit today.  Now for the scary part.  The discharge instructions say that I, Me, Myself, am supposed to remove the stint on Friday morning.  The doc didn't tell me about that, at least I don't remember him telling me.  How, you ask?  Well, there's a string hanging out and I'm just supposed to grab it and pull until something that looks like a stint comes out.  I think I have a few more questions before that happens.

I'm really looking forward to going in Thursday to get the shot that will help my voice out a bit.  I'll tell you all about it here, but for now, suffice it to say that it involves a long needle through the Adam's apple and into the left vocal cord.  'Nuff said!

Feb 25, 2007 There's probably a medical term for this, which John would explain in some hilarious malapropism, but I'll just say that the doctors also "washed" the insides of John's lungs with saline, and then sucked it out to remove the mucous and, hopefully, harvest some cells they can analyze to determine what, exactly, we are dealing with here. So far, no definitive answers, though both doctors said it doesn't look like what you would see if the cancer had spread. There is nothing in the bronchial tubes. We hope to have some information about one of the lab tests by the end of today. If we are lucky, they'll identify something they can actually treat and the treatment won't make John feel sicker. My darling husband is such a fighter and I know it is taking most of his considerable strength of character to relinquish control over this situation while he awaits more information. In the meantime, Dr. S is watching over him with great compassion and care and John keeps breathing and trying to remain in the moment. It is enormously scary to feel like you are suffocating or to be claustrophobic with all the masks and tubes and wires attached to you, so the fact that he is bearing this all with such courage and grace is amazing to the rest of us mortals.

Feb 27, 2007 While John is breathing better with the nasal cannula, it may be partly due to the fact that he is on massive amounts of steroids, delivered in a glucose solution. Because of the sugar they are loading into him, they have to do an hourly finger prick test and give him insulin to counteract it. Makes it hard to get any sleep. Besides, the steroids keep him jittery. The jittery feeling can be interpreted by his body as "anxiety" which makes it even harder to fall asleep. You might know they "have something for that," too. There's quite a complex cocktail of stuff running around inside him, "fixing" certain things, but each with its own side effects. While they still don't know what is causing this pneumonia, they are treating a lot of things. He may start growing a second head, with all the steroids, and it will probably have ideas of its own about how to proceed. It's scary stuff to be using with someone who already has cancer, but it is another example of weighing the risks against the benefits and making the best call for the current conditions. John is reluctant to say that he's turned the corner yet, although he admits he can see improvement and might be willing to say he's "cautiously optimistic." When he can breathe well without steroids and when the x-rays are more than marginally improved, he will be more confident. But at the moment, he's taking it one step at a time, as he always does, which is why he's our hero. I don't know if there is anything to the idea that people are given to handle only what they can handle, but if that is so, John must be known all over the universe as one strong dude!

Feb 28, 2007  Dear Friends, I’m writing from the hospital to all of you who have been so thoughtful as to send me emails, cards, or verbal good wishes. As you know, I’m a bit under the weather right now. This whole cancer thing’s not as great as it’s cracked up to be. However, my spirits are buoyed each day by the kind and thoughtful emails that you send me and that Maria prints off and brings in to me each day. You can’t possibly know how much they mean to me. But lest we get all carried away, I have absolutely no intention of dying today, or tomorrow for that matter. Too many things to do, too many fish to save, too many fish to “not save” and too many friends and loved ones to enjoy.  So save the really great stuff for last. But keep those missives coming.

--John