To Pee or Not To Pee

  

Turning over in his grave.



Frederic Foley

 A few years ago I had some minor surgery done. It was on an outpatient basis and I was discharged directly from the recovery room soon after the anaesthesia wore off. I went home relatively happy. Then when I got home and realized wife #2 wasn't home, I was downright ecstatic. I just kind of lolled around the apartment, watching TV and having a grand old time. Oh, and learning Mesilas Yeshorim*, too. And I have a bridge to sell you. After a while I had a slight urge to relieve myself, um, urologically. I waited a while (till the commercial) and went to do my thing. Nothing. Pushed a little harder. Still nothing. By now the slight urge was no longer slight. I will not bore you with the gory details. Suffice it to say I was back in Maimonides that night, having a large, black amazon of a nurse introduce me to my first experience with a Foley catheter. Invented in 1935 by Dr. Frederic Foley, a urologist, it is basically a tube with a balloon on the end that is inserted into one's whatchamacallit to drain his bladder. Anyway, back to the nurse. Her hands should fall off! I've gone through painful procedures before. I would have preferred root canal (perhaps without anaesthesia) to the way she manhandled me. Poor choice of words, but you get the idea. Again, I won't share the details, but I made up my mind that if anyone every wants to do that to me again while I'm conscious, they're going to lose an extremity or two. Now let's fast forward to me waking up from my induced slumber at Columbia Presbyterian. I had a bag of urine hanging at the side of my bed. That meant that I had a Foley. Taking it out hadn't been nearly as bad as putting it in, so I wasn't too upset. So a few weeks later the time came to yank it out. Afterward, I was supposed to be able to pee. Uh-uh. Not so fast, Kimosabe. Couldn't do it. They gave me Flomax. Nope. They gave me Hytrin. Nada. They gave me Proscar. Nein. I was as dry as the Sahara at noon. Not the Mojave, because I've already used that in a previous post, and no, let's not have another contest because I don't remember which post and I'm too lazy to try and find it now. So they decided to put the Foley back in. I told the nurse that if she hurts me I will find her and her family and force them all to listen to Celine Dion for twenty-four hours. Then she did a remarkable thing: she put it back in and didn't really hurt me much at all. Obviously it's never going to be my favorite way to spend time with a young lady, but it wasn't nearly as terrible as I remembered. Columbia was discharging me soon so they decided to leave it in and let Silver Lake deal with my urological issues. At Silver Lake they tried something new to stimulate urination. It's called a straight cath. What they do is insert the damn thing and then pull it right out again. Why this is supposed to work, I have no idea. Well, it didn't. Back to the proverbial drawing board. Stuck the Foley back in for a few days and bombarded me with everything they had: Flomax. Hytrin. Proscar. Stuck my finger in a cup of warm water (I made that one up). When they finally took it out again, I went to the bathroom and tried to relax, to clear my mind and consequently my bladder. YES! Success! There'a a scene in the movie "The Green Mile" where prison guard Tom Hanks is urinating for the first time since a prisoner with magical healing powers cured his urological tract infection. When the stream starts and there's no pain, a look of absolute ecstasy washes over his face; the man is in heaven. That's pretty much how I felt. Proud, too. After all, I had peed all by myself! I texted Chayie and the kids: "Stop the presses! I peed!!" What a guy!

PS Check out that picture of the bard. Would someone tell me when he had time to write? Can you imagine how long it took him to get dressed in the morning??

*Mesilas Yeshorim=a scholarly Jewish tome.

"He Was At Death's Door"

 I called Hatzoloh the other night. Don't get nervous, I'm fine. Last week I bumped my knee. I remember it distinctly because I was sitting at my computer desk, just as I am now, and my knee came in contact with this piece that juts out and I said some not nice things to the desk. I can't write them here because this is a family blog. Anyway, since I'm on Coumadin (rat poison...remember?), whenever I bang myself I get a black and blue mark almost immediately. Not this time. There was a bump and it continued to hurt for days later, but no mark. Then something weird happened: I developed this strange looking mark further down my leg, right at the bottom of my shin. It was totally asymmetrical. It looked a little like a map of Illinois, and a little like Wille Nelson. It was red and angry looking, and it hurt a little, too. For some strange reason, I thought it might be cellulitis. Now, I had never had cellulitis, unless you count the time I was in Israel and got a nasty scratch on my leg and went to the hospital just to be safe and the guy there said, "yesh lechah cellulitis" ("you have celluitis"). But I don't think he knew what he was talking about. I decided to go to Dr. Katzenelenbogen to have it checked out. He looked at it and wasn't sure what it was, so he sent me for an x-ray. I found that odd; why x-ray a skin blotch? He wanted to see if there was any bone damage where the bump was. Next day I happened to have an appointment with Dr. DePalo. I showed him my leg and he said immediately, "you have cellulitis." He also took the opportunity to let me know what he thought of Dr. Katzenelenbogen, albeit subtly. Anyway, see how smart I am? And I've never even stepped foot into medical school! He prescribed Keflex, a heavy duty antibiotic and told me to start on it immediately. Apparently this was nothing to sneeze at. Good thing, too, because it's hard to sneeze at the bottom of your shin. I tried. Well, the next day I had a bunch of errands in Manhattan and I was running around all day. When I got home I noticed that my foot had swelled up significantly. I wasn't sure if it was from fluid (edemda) or new blood that was pooling around my ankle, which would mean that I was still bleeding. I called Hatzoloh and asked them to send some guys, but no ambulance and no sirens, please; I had just moved into my new place and did not want to cause a scene at two in the morning. The two EMT's who showed up assured me that the swelling was indeed just fluid, not blood. They were going to leave, but they needed authorization first. When they wind up not taking someone to the hospital, it's called R.M.A., or "Refused Medical Attention". There was a time when they could do this on their own, but apparently someone had died a while back, so now they had to check in with a supervisor first. At 2:30 the guy they happened to get on the phone was Yisroel Brody, one of the guys who had transported me to the hospital months ago during one of my many "bumps in the road". They told him who I was. I heard his reply through the cell phone: "yeah, I know the case...the guy was at death's door". And that, my cyber-friends, was the whole point of this post. Yeah, he said, the guy was at death's door. I've heard it many times before, but every time I hear it again, it creeps me out and I get into my "gotta be a better person and gotta make better use of my life" mode. That's not a bad thing. So thanks, Yisroel Brody, for another wake-up call.

It definitely couldn't hurt.

PS Willie is fading away, thank G-d, and the x-ray actually did show something funky about my bone (a break in the bone "envelope" or some such thing)...way to go, Dr. K.!

 

Snot Easy

Hey, if she can do it...

For about 5 months I breathed with the help of oxygen. When I had the trach, the O2 was delivered directly through the hole in my neck. After I was weaned off the trach, however, I got my oxygen through nasal cannulae (plural for cannula). See the lady on the right? That was me. Still is occasionally, when I have a bad day. Well, here's the thing they don't tell you about cannulae: there are prongs on that thing that fit into your nostrils. They're annoying as hell until you get used to them. What's more, they have a tendency to irritate the lining of your nosie. I even had chronic spontaneous nosebleeds for a while. But the worstest part (worstest is even worser than worst) is the booger situation. You see, if you have an option of breathing through your mouth, your nose being stuffed or clogged or full of various sundry foreign objects is not much of an issue. If, however, your only way to get enough air to survive is through the ol' proboscis, you have to have really pristeen nostrils. And of course we all know that whether or not you have boogers is not really up to you. There are times when you can be relatively booger-less, and other times when it seems like you've got enough icky stuff up there to fill a small pool. You know, the kind you blow up. Now, there are four ways to get rid of boogers: 1. Medicated sprays, 2. Saline sprays, 3. Nose blowing, and 4. Nose picking. Medicated sprays (e.g. Afrin, Neosynephrine, etc.) work great, but they're extremely habit forming. Bet you didn't know that, did you? They feature something called the "rebound effect", whereby the more you use them, the more you need them. They're awful stuff. Saline sprays are safe, but they don't really work that well, and nose blowing helps sometimes, but not always. That leaves picking. Picking one's nose is, of course, the least socially acceptable option, especially if one is in a public place. Like on the subway, for example (unless you get on the D train at 50th Street and get off at Rockefeller Center, in which case you'll generally have a whole carfull of fellow pickers). One is liable to be on the receiving end of a good many dirty looks or even nasty comments. And if you're wearing a nasal cannula, you obviously have to remove it before you can insert the digit of your choice and go digging, so it's even more difficult to be understated and discreet. Unfortunately, while I was using a cannula, picking was the only reliable way to make sure I didn't keel over for lack of oxygen. Fortunately, I didn't get out much. I personally believe that U.S. Americans are unable to do so...no, wait a minute, that's not what I personally believe. I personally believe that every nasal cannula should come with a little card, licensing the user to clear his nose in the manner in which he sees fit, even if that manner happens to offend a broad segment of the population at large. Or at small. I never understood that expression, "at large" (just in case you can't tell, this is another written-in-the-middle-of-the-night post). Or better yet, instead of a card, perhaps a sign you can hang around your neck explaining to the cute girl sitting across from you that you're not the disgusting human being she thinks you are; you're just a poor old guy who had a really bad case of pneumonia and now must pick or die.

My Dead Roommate*

Yes, he's really dead.

Ever see a dead guy before?  Didn't think so.  Go ahead, take a good look.  Not pretty, is it?
Betcha wanna know how it came to pass that I have a picture of the dude, dontcha?  Listen to this:  I was in Beth Israel the first week of January.  My roommate the first night I was there was a man named Mr. Warm.  I kid you not.  Mr. Samuel Warm.  That's him on the left.  Mr. Warm was 99 years old.  Mr. Warm was not a happy camper.  And he was quite feisty.  He had a private aide sitting with him all night.  He yelled and kvetched and pushed her away all night.  Every time she came near him he yelled, "go away, kurva**!"  She finally took the hint and left him alone.  I try to be a good person.  A compassionate person.  But Mr. Warm was driving me crazy.  I wasn't in such great shape myself, what with being in Beth Israel and all.  Sleeping in hospitals is iffy at best, and quite frankly I just wanted him to shut up.  I felt guilty about it but truth be told, that's what I wanted.  In the morning he was still carrying on.  He was speaking Yiddish and my Yiddish is fairly good, but I had no idea what he was talking about.  So I asked a nurse if they could possibly change my room, and she said they'd work on it.  About 9:00 AM there was suddenly a bunch of people in white coats gathered around Mr. Warm's bed.  First they drew the curtain.  Then they told me to get lost for a while.  Oooooookay.  I went to the patients' lounge.  I was davening *** when a nurse walked by.
Did Mr. Warm settle down yet?
Um, yes.
Is he okay?
I'm not allowed to discuss it.
Are they gonna change my room?
Not necessary anymore; Mr. Warm will be leaving.
I found that odd.  Couldn't be that he was all better.  So, hmmm.  What else could it be?  Put on the ol' thinking cap, Rocky.  YIKES!  Mr. Warm was no longer...warm!  Or breathing for that matter!  Good thing I'm not a detective.  I felt badly for him but he was, after all, 99 years old.  Then something really creepy happened: they left him in my room until 2:30.  I had a dead roommate for five and a half hours.  They covered his body, but not his face.  Class operation Beth Israel, right?  If they had brought him lunch, I would have been really upset.  Unless they had lasagna that day, in which case I would have asked for his portion.   So being the macabre lunatic that I am, I realized that this might be my only opportunity to ever photograph a dead guy.  So I did.  Got a problem with that?  Okay, here's where I get all philosophical and religious and stuff.  When I got over the icky feeling of having a roommate who had already checked out, I started pondering.  I'm a good ponderer.  I pondered what his life might have been like.  Was he a holocaust survivor?  Was he a nice man who gave lollipops to kids in shul or a grumpy old coot...even when he wasn't so old?  I realized that I'd never know.  All my knowledge about Mr. Warm was what I could glean from his last few hours on earth.  Not a fair sampling at all.  Was he rich, poor, righteous, evil, honest, gentle?  And whom was he really hollering at?  Was it the aide and the doctors and the nurses and me, or was there someone else there in the room with him, someone only he could see...was he calling the Angel of Death a kurva??  Looking at that husk of a face for five and a half hours convinced me that none of it mattered anymore.  They were gonna put him in a plain wooden box without even change for a buck and send him off to meet his Maker.  There's an awesome beauty and symmetry to that.  He takes nothing with him, and yet he takes everything that really matters.  His baggage goes him.  Good luck, Mr. Warm...I hope you were a nice guy.

* This post is (very) loosely based on a mass email that I sent out on January 13th, 2010.
** Kurva is Yiddish slang for...um...a Lady of the Evening, if you will.  Or even if you won't.
*** Davening=praying.

Life On Prednisone

It seems like I've been on Prednisone since the Bush administration. The first one. The doctors tell me it's a miracle drug. The doctors tell me I wouldn't have survived without it. I tell the doctors I'm not sure it's worth it. You want side effects? I'll give you side effects (see link below)! No, I don't have all of them but believe me having some of them is quite enough, thank you very much. Anyway, as of this writing Dr. DePalo is weaning me off of it. He has added another medication, Imuran, which (in theory at least), is supposed to eventually replace the Prednisone
and protect my lungs from being eaten by my liver. Or something like that. Do I look like a doctor to you? But to quote the good doctor, "neither of these meds is chicken soup...we just have to decide which poison to give you." He inspires a lot of confidence, doesn't he? He believes that Imuran has fewer fun side effects, so we're gonna go with that. Meanwhile, I don't know my own body anymore. The Prednisone or the rest of the crap I take or perhaps some combination thereof has made recognizing myself every day quite challenging. One doesn't realize how comfortable and familiar one is with the topography and workings of said body. When your various extremities and appendages any sundry body parts start changing and shifting and behaving in ways to which you are not accustomed, it can be quite disconcerting. What I like to call "Balloon Head Syndrome" (see above) is a direct result of Prednisone. Wanna know what I look like? Just picture Jerry with red hair and you've got a pretty good idea. I look like someone inflated my head with a bicycle pump. Kinda feel like that, too. I look in the mirror every morning to check whether or not my head has finally floated away. No such luck...yet.
http://www.webmd.com/drugs/mono-9383-PREDNISONE+-+ORAL.aspx?drugid=6007&drugname=Prednisone+Oral&pagenumber=6

The following link (Imuran side effects) has been added by popular demand:
http://www.webmd.com/drugs/drug-13983-Imuran+Oral.aspx?drugid=13983&drugname=Imuran+Oral

Life on Coumadin

"I was bruised and battered,

I couldn't tell what I felt,

I was unrecognizable to myself"

-Bruce Springsteen, "Streets of Philadelphia"

I've been taking Coumadin since my episode with Atrial Fibrillation. It's an innocuous enough looking pill, but apparently it's potentially quite dangerous because it must be monitored extremely closely. I go to Dr. Katzenelenbogen usually about every week to ten days and he takes blood to see what shape my blood's clotting factor is in. If the numbers are a hair off in either direction, my dosage gets changed. For example, I've been taking 2.5 milligrams a day every day except Wednesday. Why Wednesday, I have no idea. Anyway, I went to see him last week and called him Monday to check the results and he told me to take one extra milligram that day only, then to go back to my old schedule, except without skipping Wednesday. If that sounds confusing to you, imagine how I feel! I'm not the most organized person in the world, and I have the short-term memory of a three-toed sloth. Now, I'll bet you didn't know that three-toed sloths were famous for having lousy short-term memory. I'll bet you thought they were just famous for their...um...sloth. Well, there are two possible reasons you didn't know about the sloth's memory problems: firstly, nobody gives a damn about it, and secondly, I made it up. it's 2:08 AM and I have an appointment with Dr. DePalo tomorrow and he's going to yell at me for being too fat and I can't sleep so I'm writing this and the three-toed sloth just flew into my mind as an example of an animal with a lousy short-term memory. At some point I should really try to segue back into discussing Coumadin, but I'm too tired for segue-ing, so I'm just gonna go back to Coumadin abruptly. You know, I really like that picture of the sloth; sloths are actually quite ugly creatures, and that photo makes this particular sloth look downright cute. Should we name him? Come on, it'll be fun! We haven't had a contest on this blog in a long time. As a matter of fact, I think I still owe Surele a Lexus. Okay, send me your best name for the sloth, and you can have one of my grandchildren. I'd offer you one of my kids but they're all growed up and might hit me. I'm going to finish this post soon, I promise. I just want to explain the dalmatian. Because Coumadin thins your blood, it makes you especially susceptible to bruising. Heck, if I even think about bumping into something, I get a black and blue mark. They're all over my body: on my arms, my legs, my belly (yes, my belly). Hence the dalmatian (spots all over...get it? Of course you do; youre not reading this at 2:21 AM!). Another thing about Coumadin: it's supposed to prevent certain medical crises (primarily strokes and heart attacks) from occurring, but if they do occur anyway, it seems the Coumadin makes matters worse, because you bleed more and that limits your treatment options. In the case of stroke, it makes the stroke itself worse, because the bleeding in the brain is more severe. You know what? I think I'll skip tomorrow's 2.5 milligrams of rat poison. Good night.

Night of the Cheesecake

I don't remember if I've already mentioned this in a previous post, but when I came out of sedation, I had definitely lost a few marbles. I stared at my watch and tried, usually without success, to figure out what time it was. I had no idea how to work my cell phone. My neurologist tells me that there had definitely been some oxygen deprivation to the ol' gray matter somewhere along the way. He also predicted that any damage that may have been done will heal eventually, so I'll be left with my old brain, just the way it was. Gee, thanks...big bargain. Chayie and I had an incident that illustrates just how bizarre my brain was functioning when I first got home. Prednisone can cause the glucose levels in your body to go haywire. Consequently, if someone is on it for a prolonged period of time, it is recommended that he check his glucose level a few times a day and give himself Insulin shots if necessary. Naturally, he should avoid foods high in sugar; candy, ice cream, cake, etcetera. I had been behaving quite excellently, not eating any of those verboten foods. Then, about two weeks after I got home, Shavuos arrived. Shavuos is a very cool Jewish holiday, commemorating the giving of the Torah on Mount Sinai (the mountain, not the hospital). It's only two days long and makes very few demands. One of the customs of this festive holiday is the eating of dairy products, with an emphasis on cheesecake in particular. Chayie, of course, being the balabusta* that she is, made a few different kinds. I abstained from sampling any of them during the holiday. I was very proud of my willpower; I love cheesecake...who doesn't? One night at about two in the morning, Chayie came down to the kitchen and found me sitting at the table with four or five slices of cheesecake in front of me. These were not little slivers, mind you; these were gezunta** chunks of creamy deliciousness. What are you doing, she wanted to know. Stating the obvious, I said I was gonna eat cheesecake. I explained that I had been so good over the holiday that I was entiltled to a little reward. Chayie said I should pick one piece and eat it, that'll be my reward. When I decided which one I wanted, she promptly chucked the rest in the trash. Somewhere, a cow was crying. Okay, that story was weird enough on its own. Wait till you hear the punchline. Next time Chayie brought up it up, I had no recollection of the incident whatsoever. None. Nada. Zero. Gornisht. Try as I might, the entire episode had apparently been stricken from my memory. Had I been somnambulating? Or perhaps sleepwalking? Or both?? Bottom line is that I don't remember the Night of the Cheesecake ad hayom hazeh***. This was during a period of time during my recovery when I was talking to myself in my sleep rather loudly. I wonder how many of my brain cells met their untimely demise as a result of my induced coma. I wonder, too, if they'll ever be replaced. Right now I notice a marked inability to focus on one particular task for very long. I like Honey-Nut Cherrios, don't you?

*Balabusta=Excellent homemaker, baker, cook, etc.
**Gezuta=Literally, "Healthy" also used to describe a portion that needs to be lifted with a crane.
***Ad Hayom Hazeh=To this very day.

Zelig

I've mentioned Zelig and Hatzoloh a few times in previous posts. Hatzoloh is a volunteer ambulance service that operated in several different Jewish neighborhoods. All members are either Emergency Medical Technicians (E.M.T.s) or Paramedics. Their average response time is quite remarkable; call them and they'll usually be at your door within four or five minutes. Zelig lives across the street from Chayie, and he's one of the head honchos of Hatzoloh of Flatbush. This is a short post just to publicly give kudos to one of the unsung heroes of my recovery. Zelig bent the rules for me not once, but twice. Hatzoloh of Flatbush ambulances typically bring the patient to one of the local hospitals like Maimonides or Methodist. Or, if the patient is an idiot, Beth Israel. Zelig arranged for me to be brought to Mt. Sinai twice. He also lent me his pulse oximeter. Every time I tried to give it back he said "keep it as long as you need it. When you feel 100% okay, you can give it back." He was also the first person to diagnose my Atrial Fibrillation. He's a quiet, unassuming guy who did a lot behind the scenes to try and get me well. Just want to go on record here and let everyone know how much I appreciate it.

Miscellaneous

Betcha didn't think I would ever be so obvious and corny, right? A missile with "aneous" written on the side for a post called "miscellaneous"? Well, big shot, what would you do? See, if I hadn't already set a precedent by using a picture or two in every post, there wouldn't be a problem. But because I have, I now feel it incumbent upon myself to always have at least one quasi-clever image to go with my profound wisdom of the day. Well, here's a news flash: there are no pictures for the word miscellaneous! It's a miscellaneous word! Now, as a linguist you might feel sorry for the word miscellaneous, but if you did you might wind up in a rubber room because a word has no feelings, silly goose! It's simply that: a word. You might feel sorry for a bug, for example, and still maintain some semblance of sanity, for a bug, as lowly a being as it might be, is still an animate creature. Perhaps even feeling sorry for a mother-in-law would be okay. But a word? Please. So please accept my humble apologies for having stooped so low as to use such a ridiculous picture. Okay, now that we got that out of the way, what did I want to say again? Oh yes, miscellaneous. The last post was about my butt and various other sundry Dr. Youngblood issues. I guess that occurred in June or July. It is now October 24th. Since July, there have not been any major crises, poo poo poo*! Before I started blogging back on July 12th, I made a list of subjects I wanted to cover. I've touched on most of them but there are still a few things to write about regarding my journey. So that's what I'm going to do from here on out, since I think I've pretty much covered the big stuff. The future posts won't necessarily be in chronological order. It's be more stream of consciousness-ish. Just thought I'd let you know.

* Poo poo poo: Hmmm. How do I explain this? "Poo poo poo" is a written expression of the sound Jews make when they're spitting in order to ward off the Evil Eye. Did that make any sense? Didn't think so.

No Ifs, No Ands, One Butt



Disclaimer: Not My Butt.

One thing about having pulmonary problems: you're not in pain. Yes, there are times when you can't breathe, but there's never any actual physical pain. Except, of course, the pain that comes as a result of what the doctors do to you. In spite of Dr. Youngblood's insistence to the contrary, the procedure hurt like hell. Whenever he poked or prodded me trying to mine my butt for marrow, I felt it a shooting pain down my leg. And he poked and prodded me for a good ten or fifteen minutes. As it turned out, the pain I had to endure during the office visit was, unfortunately, only the beginning. "You'll feel a little sore for a few days," said Dr. Youngblood. A little sore. Hmmm. Not the adjective I would have used. My tush was so sensitive I had a hard time sitting, but the real challenge came at night. I was in extreme pain and could not find a comfortable position in bed. If I changed position in my sleep, the pain was so intense it would wake me up. I began to suspect that something was rotten in Denmark. Or something like that. I mean I started wondering if this was what he meant when he said a little sore, or was something wrong? My son-in law Yehuda came by one day and I had to ask an embarrassing question: would he look at my rear end and see if it looked okay (you can't check your own, you see. That's one reason I never understood the expression "watch your back"...it's a physical impossibility). So I lowered my pants and Yehuda, in his inimitable way, said "holy @*%#&!!!" He informed me that my backside was now host to the Mother Of All Hematomas. My rump, he said, was red and blue and purple and looked something like an eggplant. I thought he was exaggerating. He told me to smile and hold still, then he pulled out his cell phone and snapped a picture. A photo of my posterior for posterity, as it were. When I saw the photographic evidence, I realized that "holy @*%#&" was indeed an appropriate response. I called Dr. Youngblood and told him. He seemed unimpressed and somewhat blase'. So I sent the picture to his cell phone. Five minutes later he was standing in Chayie's living room; I think I actually scared him. He was surprised, he said, that there was that much bleeding, but he was quite certain it had stopped. I wanted to tell him that if I were to bleed to death that night, I'd be sure to tell him the next morning that he may have been a smidge wrong. But I didn't say that. I behaved. Remind me next time: if the choice is listening to the advice of an experienced physician who knows my medical history in his sleep or taking my chances with some wet-behind-the-ears guy who thinks he knows it all and can do no wrong, always go with the young whippersnapper...NOT!

A Dentist in a Previous Life?

The Bone Marrow biopsy (still three of the scariest words ever) was to be performed at Dr. Youngblood's office. I had not yet been given the green light to drive, so Chayie chauffeured me there. "There" was pretty far: his office is out in Yehupitz* somewhere. My Tzadeikes** sister sat dutifully in the waiting room, blissfully unaware of the horrors that were unfolding in the inner sanctum of the evil young doctor's lair. I was instructed to drop my drawers and lie on my side, as per the picture below. Dr. Y. informed me that he was first going to numb the area with a shot of Lydocaine and then go fishing around for some marrow. "This won't hurt a bit," he assured me. "You shouldn't feel any pain, but if you feel uncomfortable because of the pressure, just tell me and I'll stop." Hmmm...now where have I

heard that before? When I was a kid my family used a dentist in Boro Park named Irving T. Mandelbaum***. I'm not certain whether the good doctor had ever actually attended dental school or not, but back in the 50's and 60's it really didn't matter much. The instruments dentists used back then were so primitive they looked like props in a bad Vincent Price movie. Those of you old enough to remember rotary phones and the Everly Brothers will remember those drills. Ugh! The thought still makes me shiver, all these years later. No shpritzing water. No high-tech, no high speed. Just Dr. Mandelbaum's foot on the pedal that controlled the damn thing and his paw in my mouth. And in those days, dentists didn't wear gloves. He washed his hands (thank G-d for small favors) and then proceeded to shove his hairy knuckles in my mouth; sometimes it seemed they were halfway down my throat. Anyway, I still remember those immortal words: This shouldn't hurt a bit. You won't feel any pain, but if you feel too much pressure, just raise your hand and I'll stop. So here it was maybe fifty years later and I'm lying helpless on a table with my butt in the air and the guy is taking a phrase straight out of my childhood nemesis' playbook...straight out of the deepest, darkest recesses of my psyche. One of Mel Brooks' earliest films was "The Twelve Chairs". There's a song in the movie called "Hope for the best, expect the worst". That's how I felt, lying there, helpless on that table. And that's just what I got: the worst.

* Yehupitz: Yiddish slang for "the Boonies"

** Tzadeikes: Righteous woman

*** Not his real name, although I'm not sure why not!

Dr. Youngblood* Strikes Again!



Translation: "Dead Rat Ball". How utterly charming

They kept me for a few days after all the tests and then discharged me. It was good to get home after my cardiac scare. I was determined not to go back to the hospital under pretty much any circumstances. I was, however, still tired and dizzy and weak, oh my! Turns out that even after receiving three units of blood, I was still quite anemic. My hematologist, Dr. Youngblood*, still wanted to know why. Consequently, he was still insisting on a bone marrow biopsy. This is something that scared the hell out of me when he first brought it up (see "Transylvania Transfer", October 6th). I managed to stall for a while and then I had the good fortune to go into A-Fib and wind up back in Mt. Sinai where he couldn't get me in his evil clutches. So how did he get back in the picture? Glad you asked. Because my heart had gone into A-Fib, they had put me on Coumadin. Coumadin is a blood thinner. Its generic name is Warfarin. Guess what else it's used for. Give up? Are you ready? Warfarin started life as rat poison! I kid you not. The cute little vermin eat the Warfarin, it causes massive internal bleeding and they go to that big garbage dump in the sky. When I heard this little tidbit about the new kid in my medical arsenal, I became quite nauseous. The new kid in my medical arsenal? What the hell does that even mean? Has there ever been a more ridiculous mixed metaphor? I've gotta stop writing this drivel at 6:00 in the morning. My brain does not function that early. I mean, come on; that big garbage dump in the sky was bad enough. But the new kid in my medical arsenal? Sheesh! Anyway, Coumadin needs to be monitored so your blood doesn't become too thin and then start leaking out your ears or some such thing. So I had to go to Dr. Katzenelenbogen every week or so and have him check my blood. I'm still doing that, ad hayom hazeh**. On one such excursion, the blood came up dangerously thin (I had to eat broccoli and cauliflower for a week, don't ask) but also quite hemoglobin-less. Hence Dr. Youngblood was once again summoned. When I informed Dr. Katzenelenbogen that Dr. Youngblood planned on doing the biopsy, he responded (quite rationally, I might add) that it might be better to wait till I was off the Coumadin, mostly so that I don't bleed to death during the procedure. That, he thought, might impede my recovery, perhaps even permanently. Pshaw! said Dr. Youngblood. Nonsense, poppycock and all other expressions of ridicule. How quaint of Dr. Katzenelenbogen to express concern for his patient! I must have been absent the day that was taught in med school. The fact that Dr. Katzenelenbogen has shoes older than Dr. Youngblood should have told me that I ought to give his opinion more weight. Should have, but apparently did not. I allowed myself to be verbally bullied into scheduling the procedure. In retrospect it was a very bad idea. In retrospect so was the Hindenburg, but who cares about retrospect? Or the Hindenburg, for that matter?

* Still not his real name.
** Ad Hayom Hazeh = to this day.

He Has What?!

Not Igor, but kinda looks like him

Ever hear of the HIPAA laws? Enacted in 1996, the Health Insurance Portability and Accountability Act is a complicated piece of legislation that was designed primarily to protect health insurance coverage for workers when they change or lose their jobs. One provision in the bill is the so-called "privacy rule". Simply stated, it prevents health care providers from discussing a patient's case with just about anyone without jumping through myriad hoops or dealing with yards and yards of red tape. A doctor needing access to a patient's chart, for example, must first sign away his firstborn. While privacy is perhaps a good thing, the HIPAA laws take what was originally a valid concept and carry it to such a ridiculous extreme as to make it completely unworkable. I bring this up because of something that happened during my third stay at Mt. Sinai. After the transesophageal whatever I was transported back to my room. My roommate, Mr. Morgan, was in middle of ordering dinner. Mr. Morgan seemed like a very nice, albeit reticent man. Anytime I tried to strike up a conversation with him, I got no response. When they wheeled me back into my room, however, I noticed a sign on the door for first time: "BED A is hearing impaired". Aha! So he wasn't being antisocial or anti-semitic or anti-anything...he was just being deaf! So anyway, the dietician was asking him what dessert he wanted. The conversation went something like this: "Do you want chocolate ice cream again?" "Say again?" DO YOU WANT CHOCOLATE ICE CREAM?" "One more time?" "DO YOU WANT CHOCOLATE ICE CREAM FOR DESSERT??" And so it went. The next day three doctors came in and had a chat with Mr. Morgan. HIPAA laws notwithstanding, they were, of course, loud enough for me to hear. Hell, they probably heard them in the lobby! One sentence was enough to scare the dickens out of me. "Mr. Morgan", they said, "We hope your hearing will improve once we treat your meningitis." Say what? He has menin-freakin'-gitis?? Do these neanderthals not know that when one is on Prednisone, one's immune system is most likely compromised?? I was livid. I stormed out to the nurses station (you may have already guessed that I'm something of a habitual stormer) and demanded an explanation. The nurse in charge, after looking at me like I had two heads, informed me that she was not allowed to discuss the diagnosis or condition or favorite color of another patient with me. HIPAA laws and all that, you see. I said if I died as a result of being assigned a highly contagious roomie while having a total of about four white blood cells, not only would I make sure that my estate sued the bastards, but I would come back to haunt the sixth floor in perpetuity. Lucky for me, my nurse that day was a very nice, very helpful chassidic guy named Igor. He happened to be passing by and heard my rather heated exchange with Nurse Ratched. He whispered to me that he'd look into it. A few minutes later he came back and informed me that there were several different types of meningitis and assured me that the one from which Mr. Morgan was suffering was not contagious; I was in no danger. About ten minutes after I went back to my room the Administrative Nurse came to see me and reiterated (is there such a word as "iterate"?) what Igor told me. Everything was fine. They were aware of my condition, Dr. DePalo was aware of everything they did, and I had no need to worry. I asked her if she had ever heard of a hospital making a mistake. She said yes. It was supposed to be a rhetorical question.

Not Igor, either; pronounces his name "Eye-gor"

What Becomes of the Brokenhearted?



I've always had confidence in my heart. What I mean to say is, for some strange reason I always felt that no matter what else went wrong, no matter which other organs wound up disappointing me, my heart would go pumping merrily along, reliable and stalwart. As it happens, I was right. My heart was indeed in A-Fib, but no one seemed overly concerned. The one thing they were worried about was whether I might have a blood clot floating around somewhere. Apparently a heart in A-Fib can throw off clots which in turn can wind up in your lung. Not a good thing at all. They took me for a test called a Transesophageal Echocardiagram, or T.E.E. I've had echos done before; they're a piece of cake. Or is it, "they're pieces of cake"? Dunno. At any rate, they're not invasive at all. All it is is a sonogram of the heart. This transesophageal thing, however, was a different story entirely. They shove a camera down your throat. You know how much I love that. First they sprayed my throat with a numbing agent. Then they had me drink some vile concoction to numb me deeper down in my gullet. They assured me that what they were using was enough to keep me from gagging. Wrong! The procedure must have lasted about ten minutes; I gagged through the whole thing. Well, I didn't have any clots, thank G-d, so the next step was to zap my heart back into what they call "normal sinus rhythm." That's exactly what they do: they zap you with those paddles you see on doctor shows on TV, where they yell "clear!" before they use them. But they put you out first. They told me beforehand that this works about 90 or 95% of the time. Then they stuck a needle in my arm and next thing I knew, it was over. And it had worked, too! Were things finally looking up?

Bump in the Road #5

I managed to stay home for a couple weeks without incident, so I was finally starting to believe that perhaps all the little detours on my road to recovery were over.  Alas, it was not to be.  On a Saturday night (when else?),  my breathing was not all that bad, but my heart felt really funky.  I think everyone gets palpitations occasionally, but this was something else entirely.  The heartbeat just felt...erratic.  A pulse oximeter not only measures your sats but your heart rate as well.  So I stuck the little sucker on my finger and waited to see the reading.  My heart rate was all over the place.  It went from 74 to 132 to 81 to 186 to 99, back and forth with absolutely no discernible rhyme or reason.  Chayie called Zelig Gitelis, head of Hatzoloh of Flatbush.  He lives across the street, and he came right over.  He said it looked like Atrial Fibrillation, A.K.A. A-Fib.  Basically it means that the rhythm of the heart has gone haywire.  Another trip to Mt. Sinai, Zelig?  Absolutely, Rocky.  Well, I figured, at least this time I get to avoid the Lasix.  Right?

Mud on the Canvas

When I got to Mt. Sinai, it was like old home week: Oh, you again...how ya doin'? The same nurses in the ER, the same doctors, etc. There was a Dr. Khan, a nice, young guy I remembered from just a few weeks before, whom I had decided was much too good looking to be a doctor. He looked like one of those TV doctors, kind of a cross between Patrick Dempsey ("Dr. McDreamy", for the uninitiated) and Jimmy Smits ("Jimmy Smits", for the uninitiated). He remembered me, too. He gave me one of those "what are you doing here again" looks and then he wanted to put me on a c-pap machine. It's funny how the longer you're sick, the more familiar you are with all the ways they can torture you in hospitals. I had been on a c-pap once before, in Beth Israel; they're insanely uncomfortable. I told Dr. Khan that I preferred trying to hold my breath until the coming of the Messiah to having that G-d-awful contraption strapped to my face again. They gave me a regular oxygen mask instead, and it was enough. My breathing was okay and my sats went up into the 90's. So since the c-pap machine had been ruled out as this week's cruel and unusual punishment, they hung an IV loaded with about a keg of Lasix. I think I may have mentioned in a previous post that I find it difficult to pee in a prone position. That complicates matters when I'm in a hospital room...it's even more complicated in the ER. There are people running hither and yon and sticking their noses into everything. Except when you want one of them; then they're nowhere to be found. They get antsy if they see a guy with an oxygen mask and an IV pole standing rather than lying down like a good little drone. So I had to pull the curtain and try to be discreet. The thing is, Lasix is brutal. Being discreet once is relatively easy, but being discreet literally every five minutes becomes something of a drag. There came a point where I didn't even bother getting back into bed anymore. Thank heavens they found me a room relatively quickly where I could pee in peece. I armed myself with not one, but two urinals and I was up literally all night. Dr. DePalo came to see me bright and early Monday morning and was not happy. The gist of what he said was that I was doing this (winding up back in the hospital over and over) to myself because of my eating/drinking/salt consuming habits. "I'm an artist," he said, "and you're throwing mud on my canvas". Gee, I had never heard myself referred to as a work of art before, but then again, I had never had a doctor quite like DePalo before. In the same breath, he acknowledged that Prednisone makes you hungry and thirsty, so sticking to his regimen was damn nigh impossible. Suck it up, Zweig, he said. Look at me, fit as a fiddle, he said. Stick it in your ear, DePalo, I said. Okay, I didn't. But I wanted to. Should have, even.

Bump in the Road #4: This was a Bad One!

Staff of Zombies at Beth Israel

Inexplicably,

I kept getting

sick on weekends.

A few weeks after I was taken to Mt. Sinai for the first time (on a Saturday night), it was, as Yogi used to say, deja vu all over again. Late Shabbos afternoon I felt really lousy. I didn't like using the pulse oximeter on Shabbos, but I had been told that in my condition it was okay. For me that's always been one of the beauties of Judaism: the sanctity of human life takes precedence over any other religious considerations. If that means driving someone to the hospital on Yom Kippur, not only is it permissible, it's obligatory. So there I was, finding it very difficult to breathe whenever I got up and moved around. I walked from the couch to the dining room table and back and took my sats: they were in the high 70's. Of course if anything under 90 is considered unacceptable, you can imagine how bad 78-79 is. I couldn't remember a time since I got sick when they were that low, unless you count my time in Beth Israel, which you shouldn't because I was being treated by brain-eating zombies masquerading as health care professionals. I couldn't believe how bad my sats were, so walked around in a circle for maybe fifteen seconds and then took them again. Again they were in the 70's. This was all while I was connected to a concentrator, mind you. I sat back down on the couch and looked at the concentrator. I was on two liters of oxygen. I bumped it up to three. My niece Blimi came over to me and asked me why I didn't just take deep breaths. I couldn't. It's hard to describe how it feels. It's sort of like if someone had built a wall in your lung and your breath can only go up until where the wall is and no further, no matter how hard you try. I bumped the concentrator up to four liters. Didn't accomplish squat. I sat on the couch for a few hours without budging, trying to convince myself that the limited breathing I was able to manage would be enough to keep me out of Mt. Sinai. Uh-huh. And the Easter Bunny should be here any minute. I bumped the concentrator up to five liters, the maximum. All the while I kept taking my sats; they never got above the mid-80's, and that was with me sitting still. When Shabbos was over Chayie and I discussed our options. I wanted to stay home and tough it out. She wanted me to survive the night. We tried to figure to out if those two points of view were mutually exclusive. We finally came up with the idea of buying a baby monitor so Chayie could watch me and make sure I was breathing during the night. So my nephew Mendy ran out to Rite Aid and got one. By the time he got back, it was pretty apparent that I needed to be hospitalized. Again we called Hatzolah. Again we conned them into taking me to Mt. Sinai. This time I felt so lousy, I was convinced that I would be coming home in a box.

This Life is a Fleeting Breath...

This life is a fleeting breath
And wither and how I shall go,
When I wander away with death
By a path that I do not know?
-Louise Chandler Moulton
(1805-1938)

Iron Lung

So His Highness ordered that I be tethered to R2D2 or an oxygen tank until further notice. That includes all three scenarios: moving, sitting, and sleeping. Life with two prongs up your nose. I asked if I'd ever be oxygen independent. He didn't know. I asked his associate, Dr Patrick Chae (whom I couldn't stand). He didn't know, either. I asked the sweet little birdies in the trees that sing in the springtime. They pooped on my head. Now, if I asked you (hypothetically, of course, since no one reads this damn thing) if you'd want to live like that, what would you say? I wasn't yet convinced that I would survive, but I sure as hell didn't want to spend the rest of my life dependent on a machine. I know it's a terrible analogy, but in my own feeling-sorry-for-myself mind, it reminded me of the iron lungs that were used back in the 50's during the polio epidemic. I read an article online about a woman named Diane Odell who died recently after spending fifty-eight years in an iron lung. Fifty-eight years! She contracted polio when she was three and died at sixty-one when the generator failed in her home in Jackson, Tennessee. How ironic is that: she survived a disease that was an absolute scourge when she was a kid, only to meet her demise because of an electrical storm that knocked out the power she needed to draw breath! Okay, so here's the thing...would I want to live like that? Would you? My answer is an emphatic "no!" Of course being hooked up to a concentrator is not the same thing as being in an iron lung, but I found the possibility of not eventually being able to breathe on my own brutally depressing. I kept being reminded by my sister and others about how very far I'd come, that I needed to be patient. I didn't want to be patient. I wanted to be healthy...I wanted to be well.

Transylvania Transfer

Hemolytic Anemia

If you recall I
was supposed
to get more blood

before this latest

mini-crisis popped up.

I was grateful to be home again
and my breathing was okay, but I was still
lightheaded, dizzy, shaky and extremely weak. My hemoglobin numbers were in the 8's, certainly nothing to write home about. I called my hemotologist and we arranged to have me transfused once more. He felt that another two units (pints) should do the trick. He still wasn't sure why I was so anemic, and he wanted to find out, so he uttered three words that might be among the scariest I've ever heard: Bone Marrow Biopsy. Okay, I thought, I have leukemia. It's been nice, folks; check please. No, insisted Dr. Youngblood*, I just want to do the test to rule some things out and possibly identify the root of the problem, he said. Don't worry, he said. Well, easy for you to say, buster; it ain't your marrow being shoved under a microscope! I wasn't thrilled about it for two reasons: 1. It sounded very ominous, and 2. He tried without much success to convince me that it wasn't a painful procedure. I do it all the time, he said. In my office, he said. None of this made me feel any better. So I stalled. I said I was busy, which is pretty funny considering how pretty much all I was doing back then was sitting around and scratching myself. He said it wasn't a rush, but he wanted to get it done eventually. He thought my anemia might be due to "chronic illness." Basically that means that because you've been so very sick for so long, your bone marrow figures, oh the hell with it and throws in the towel. At least that's how I understood it. Another possibility was that I had hemolytic anemia, the abnormal breakdown of red blood cells. There can be many causes of this, not the least of which is prolonged use of certain antibiotics, among them Bactrim, Vancomycin, and Dapsone, all of which I had been on. Anyway, I shlepped out to Long Island to the hospital where Dr. Youngblood was affiliated, and they hooked me up for the transfusion. It was a long procedure, taking around four or five hours for two units, but I was in a bed where I could doze or watch TV, so I didn't really mind. Then about 3/4 of the way through the second unit, something started itching on my left arm. Then on my right arm. Then on my face. I called the nurse in and she informed me

that I had broken out in hives. Not too common, she said, but not too rare, either.

They gave me Benadryl and stopped the transfusion. So I wound up getting one and three quarters units of blood and Benadryl to take home as a fabulous parting gift.  As long as no one said anything about a b-i-o-p-s-y, I wasn't complaining.



Not that kind of hive, ya little dope!

*Definitely not his real name!

There's a New Sheriff in Town

I was discharged on Friday. I had not yet been to see Dr. DePalo in his swank Park Avenue office. Park Avenue is very ironically named; the one thing you can't do there is park! I had not yet been given clearance to drive, so I had to be chauffeured wherever I went. Chayie drove me that day. She circled around a day or two and finally wound up putting the car in a lot. That's also ironically named; if you park there it's gonna cost you a lot! Get it? A lot! My gosh, I am soooooo clever today. I'm on a roll, which is good because yesterday I was on an onion bagel. We had to walk about a block and a half from Lexington to Park, all uphill. It was understandable that I was huffing and puffing, but Chayie wasn't doing too hot, either. She was having trouble with her knee and was krech'tzing* right along with me. When we got to his office, Dr. DePalo had his serious face on. I could tell he was going to tell me something I didn't want to hear. Then he spake: "Ron," he said, "There's a new sheriff in town.  From now on you can't eat or drink or use salt the way you used to. The Prednisone will make you retain fat and retain fluid and you'll keep winding up at Mt. Sinai. I'm gonna put you on a regimen and make sure you stick to it.  Also, I want you on oxygen 24/7 until further notice, kapish?" Sheesh, this guy was tough!  Only problem with the oxygen was that I didn't have any.  Because my sats were above 90 when I left Silver Lake, Big Brother Oxford, in their infinite wisdom, decided I didn't need any and therefore didn't provide any.  So Sheriff DePalo got on the horn and whipped them into shape.  Almost as soon as he hung up, there was a concentrator and a bunch of tanks of O2 sitting in Chayie's living room.  Gee, Dr. DePalo...tanks a lot! (couldn't resist.)

* I don't really know an accurate translation for "krech'tzing." It's different than "kvetching," which is really just complaining. Krech'tzing is sort of like moaning, but not quite; it's more intense. It has more...shmaltz.

Aqualung



With Apologies to Ian Anderson

I was so freaked out by being back in the
hospital that the first
thing I asked Dr.
DePalo was,
"are you planning anything invasive?" I had made up my mind: I would never, ever allow myself to be hooked up to a vent or have someone cut another hole in my neck. If G-d wanted me to die, so be it. I was so afraid of that damn machine that in my mind, it was no longer an option. Of course if push came to shove and they told me my choice was either a vent or a coffin, I might have wussed out. I don't know. Suffice it to say, at this point, not being given that doomsday scenario, my resolve was firm. Dr. DePalo looked at me like I had two heads. Why would I want to do anything invasive, he said. Relieved, I asked whether the good doctor thought I could be discharged before the weekend, another question I was almost to afraid to ask. Absolutely, he said. I wanted to kiss him. No tongue, but definitely a nice peck on the cheek. He went on to explain that I had not had a relapse per se'. I was back in the hospital because of fluid in my lungs, a condition known as Pulmonary Edema. One possible cause was the scarily named Congestive Heart Failure, or C.H.F. But they took an echocardiagram to rule that out, and it turns out that my heart is in reasonably good shape for someone my age. Also someone who's had it broken so many times. According to Dr. DePalo the Prednisone I'm taking is responsible for the fluid retention. He still hasn't explained how it winds up in my lungs, at least not to my satisfaction. So as of now, I can't get no satisfaction. Anyway, the fluid starts in your feet and ankles and then spreads upwards, which seems pretty counterintuitive to me. I'm not really a Scrabble player, but I gotta believe that counterintuitive has got to be a great word. Or for Hangman! It would be great for Hangman! But, once again, I digress. When you've got fluid in your lungs, it affects your breathing. The more fluid, the harder it is to breathe. Dr. DePalo's plan was simple: give me huge bunches of Lasix and have me pee everything out. Lasix is a diuretic. Wait, that's not quite descriptive enough; calling Lasix a diuretic is like calling a Harley a bicycle. You take Lasix and you pee. And you pee. And then just when you think you're finished, you pee some more. So he gave me a hefty dose through an IV, handed me a couple urinals and bade me a fond adieu. I probably should have just moved my pillow into the bathroom and slept on the toilet. I spent most of the night standing (I find it difficult to pee in a prone position) at my bedside, trusty urinal in hand. Every time I managed to doze off a little, my bladder would have none of it. I think the C.I.A. should abandon waterboarding; all you really need for an effective interrogation is about a gallon of Lasix and a clothespin.