We have reached the end... at both ends!

Family, friends, and Colleagues:

Good news! Today's procedure went very well - with positive results!

First and foremost, the procedue took place in the bowels... of the hosptial... (Once again, I couldn't resist).

I did not find the laxative ritual difficult. Sure, the solution they had me drink (1/2 after 4:00 p.m. and 1/2 this morning) was not the most pleasant tasting, I found it only mildly offensive to my taste buds. And because I did not eat much solid food in the days leading up the procedue, I did not suffer the explosive outcomes I had expected. (Again, do you really think I would let this one slide... ooops, I did it again).

I was placed under conscious sedation and had the endoscopy first followed by the colonoscopy. 
Jennifer and Rosie prepped me, and Patti assisted Dr. Mahmoud Lajian with the procedures. 
While I don't recall much of the endoscopy, I do recall asking questions during the colonoscopy during which I could see the procedure on the monitor. I was not in pain, but did experience mild discomfort. My root canal hurt more.

After about a 15 - 20 minute stint in recovery, Christine and I went to get something to eat, which I stomached just fine.

Now for the rusults!

The endoscopy - The Upper GI:
- I hava a hiatal hernia
- Duodenum was biopsied to rule out celiac disease
- No ulcers
- No tumors

The Colonoscopy - The Lower GI:
- No polyps
- No bleeding
- No tumors
- No tumors
- NO TUMORS!

Next up:
Blood work - follow up on 5/30
Appointment with Dr. Zu on 6/3
Follow up with Dr. Lijian with 2 weeks.

We are pleased with the results, needless to say. We appreciate all the love, support, and encouragement you have so graciously show us throughout a challenging 4 - 5 months. 

When you have a moment, please let Christine know what an incredible spouse, partner, friend, and rock she is. I would appreciate it. Without her love, determination, and faith, I don't know what I would do.

Today is a beautiful day!

Upcoming Tests

Today, I saw the GI Guy - sounds like he works for the government, which given all the crap he must deal with, ain't too far from the truth - for a consultation.

He reiterated some of the concerns that Dr. Zu had re: my anemia. In order to rule out some of these possibilities, I am going to have a colonoscopy and an endoscopy this Friday.

Because I have a history with neuroendrocrine tumors, Dr. Lajian wants to rule out that I don't have a carcinoid tumor in my upper or lower GI tract which may be bleeding.  Neuroendocrine tumors can manifest themselves in the GI tract. And can be benign or malignant.

Of course, this is only one possibility, one of the more serious possibilities. I may also have polyps or other minor common abnormalities that are causing the bleeding.

As Christine always says, ain't nothing to worry about until there is something to worry about.

Thanks for your encouragement and support. We will continue, we will persist, we will endure!

A Look Back

I was talking with a student today after school about the persuasive speech he was working on. Somehow, in our discussion, I recalled NPR's now-defunct program, "This I Believe." I pulled up a particular speech for him - one that related to his topic -, and remembered that I had written my own "This I Believe" essay. Although I wrote this pre-diagnosis, the sentiment expressed herein seems particularly apropos right now. And so I share it with you.

Life presents us with joy and with sorrow. Good times are sandwiched in between not-so-good times, making life an interesting array of experiences and adventures. Family issues, personal issues, relationship issues, work issues, school issues, issues, issues, issues. From an early age, I have had my share of issues. But I suppose to refer to them as issues gives power over to them. I may not have asked for many experiences I have encountered, they were meant to be. I didn’t ask to be the ninth child of nine children, the youngest in a large Roman Catholic family. But I was.  This is the life I have been granted, that has been given to me. And throughout my life, I have had my share of adversity. But it is because of that adversity that I am who I am today. I wouldn’t trade it for the chance at a better, happier, more peanut-butter-and-jelly, perfect life. This I believe: I believe that the human spirit is indomitable, that it can endure hardship after hardship and triumph. Through my experiences and adversity, I have survived. I have come through and flourished because I can confidently proclaim: “Here I am world. This is who I am.”

When I was in the fourth grade, my mom was diagnosed with lung cancer. Being the youngest in my family, I knew my mom was ill, but my dad made the decision not to tell me that mom had cancer. The “c” word did become part of my vocabulary, but not because someone had to tell me what it was and what it could do. I witnessed it first hand. I saw it in the faces of my siblings and the fear in my dad’s voice. I saw it in my mom’s face when she returned from the hospital. I wasn’t told until after mom survived this first bout with cancer that she had been given the last rites. I wasn’t told that she had almost died. I wasn’t told a lot of things. And because of not being told, I knew. I knew that anything that could not be spoken, especially to a ten year old, must be grave. My mom survived her first bout with cancer, and lived a productive, creative, and meaningful life, a mother of nine children and wife of almost forty years. The cancer never fully retreated. Lung cancer was followed by brain cancer was followed by breast cancer was followed by everywhere cancer over the course of thirteen years. My mother died in 1990 when I was not quite twenty-three.

My mother never lost hope during her battle with cancer. Her spirit never wavered; her faith never faltered; and her sense of humor never faded. Even when hospitalized for the last time, she would respond “Great!” when asked how she was doing. “Complain” wasn’t in her vocabulary. In watching her, I saw true strength first-hand.  Weakened and feeble from the ravages of cancer, the strength of her spirit couldn’t have been more evident. It is with the same spirit she lived her life. It is only fitting that it would also be the way she embraced her death.

It is the power of my mom’s spirit that has enabled me to endure some of the hardships and challenges in my life: Sibling rivalries, addictions, and suicide attempts; the heroin overdose and death of my sister; my own encounter with brain surgery; and watching my dad grow older alone. A high school teacher now, I look out on my students and want to tell them that they will make it despite the challenges they encounter in their lives, that they will make it because of the challenges they encounter. Sure, I have my moments of doubt and uncertainty, of days when I don’t feel very good about who I am or the job I am doing, or the type of husband I am. I would say to them embrace the challenges they experience in life. Don’t try to soften the reality of the pain, anguish, or suffering you may endure. For I truly believe that it is in our moments of greatest despair and weakness that we discover our genuine strength. If not for the challenges in my life, I would not have the perspective and wisdom to share in my job as a high school English teacher and coach. I would not have recognized the beauty and strength of my wife, Christine, and the strength of my spirit would not have had the opportunity to pull me through to allow me to realize that life is wonderful, joyful, and full of love.

The Light at the End of the Tunnel

7 May 2014

The Light at the End of the Tunnel

No doubt, I have turned a corner from my bout with pneumonia. My strength has returned, I am sleeping (a lot, I might add), I have put on weight, and I am getting back to a regular routine.

So it came as a bit of surprise when I saw Dr. Zu on Tuesday, May 6, 2014, for my monthly appointment and shot, to find out that my blood levels are way off. While my white blood cell count is stable, my red blood cell count (and all the measures that make up that count) have shown a steady decline over the last two to three months. With Dr. Zu’s vacation, my bout with pneumonia, and my subsequent, brief hospitalization last month, I haven’t actually seen Zu for a routine appointment since February

.

Needless to say, this is not the news I expected nor wanted after a tough few months – and just when I was starting to feel better. Dr. Zu’s primary concern is the source of my anemia. In his words, my RBC suggests that I have lost the equivalent of 2 – 3 liters of blood over the last several months. We have to isolate the source of the bleeding. Because I haven’t had any external signs of bleeding (yes, I know my color has been “off”), he believes that the source may be somewhere in my GI tract.

What does this mean? For starters, I will be taking an iron supplement three times a day. Second, it means additional blood work. And to top it off, it means both a colonoscopy and an endoscopy. Not the light at the end of the tunnel I was expecting – a scope! Lucky me! Of course, these tests will also help to rule out bleeding as the source of my anemia. It is possible that with the medication I take regularly that something is just “off” and we will need to isolate what that is.

While we are not happy with these developments, we recognize the diligence in finding the source of my anemia. As Christine always reminds me: we won’t worry unless we have something to worry about.

Thank you for your continued support and encouragement.

I will keep you posted.

The Continuing Saga of the "Unlucky" and the Medically Interesting

Here's the latest in my continuing journey...

Saw Dr. Miradi, Infectious Disease Specialist Extraordinaire - this guy rocks -, last week.
He informed me that I am one of the "unlucky" ones who has contracted a strain of pneumonia they just haven't isolated. He said I could expect not to feel 100% for another month or two. Ouch! He added that he had "macho guys" in the same boat. I guess it makes things that much easier now knowing that I am "macho." So I had to have a doctor stick a probe into my lung for no apparent reason during my bronchoscopy- results were "unremarkable."

So I persist. Some days are good, some are tough. Still experiencing low-grade fevers and fatigue - and I cannot climb stairs without breathing heavily -, but I would have to say that all is well. Could be a lot worse. I will follow-up with Dr. Miradi in a few weeks. Meanwhile, per his request, I am tracking how I feel daily (body temp, etc.).

Next up: blood work Friday.
Dr. Zu next Tuesday followed by my monthly Sandostatin injection.

Thank you for the positive thoughts and wishes. Without you - and the love of my beautiful Christine -, I would not know what I would do.

All my best!

I am Back...

Good weekend.

I have had a good weekend. While I am still tired – I imagine the fatigue won’t pass for a while – I have been fairly active without major repercussions.
 
I spoke to Dr. Miradi, Infectious Disease Specialist Extraordinaire, and he agrees that I am in full recovery. He did emphasize that I may experience some minor symptoms (fatigue, elevated body temperature) that are indicative of recovery from pneumonia. In short, my body still needs to clear the remnants of the infection from my system. Still no definitive word on the strain of pneumonia I contracted. But at this point, it may be moot, eh?

My plan is to return to work tomorrow and to a regular schedule. I will take things slowly, but I am excited about getting back to my routine and feeling like myself again.

All my love and appreciation for your encouragement and support. Try not to laugh too hard at the HP (Harry Potter) scar. I have an appointment Tuesday to take stitches out.

A Whole New World...

A Whole New World…

Okay, pardon the cheesy Disney reference, but I ventured out into the real world today.

After a good night that included some uncomfortable coughing – see, the coughing is good, but the sore ribs aren't -, I slept well. I have a new appreciation for pillows, that’s for sure. And no detectable fevers!

I visited Patrick Henry today for a brief period of time as a "test" run. I wanted to see how I would respond to increased activity and a possible return to work. It was good! Although fatigue set in rather quickly, the emotional boost from a return to semi-normalcy was awesome.

It was great to see the kids and my wonderful colleagues. In the grand scheme of the universe, my battle with pneumonia has been short. But the time away from the kids, a normal routine and feeling better has seemed like forever.

Much love and appreciation for y’all.

I hope to be back to my regular routine soon although at 20 m.p.h. and not my usual 120 m.p.h.

Move Over Jack Nicholson!

Good morning (good morning), Good morning (to you!)

I had a great night last night, and have been fever free now for 48 hours.  While I am sore as all get out from my fall, I have finally managed to sleep! Hoo Hoo!

Will continue to rest at home. Still on a heavy duty antibiotic and will be for another five days. Return to work looks promising!

In the “this is too funny category”:

Christine changed the dressing on my HP (that’s Harry Potter, folks!) laceration on my forehead last night. In replacing the gauze she used a little too much, making me look like a character from One Flew Over the Cuckoo’s Nest. I could not stop laughing at the absurdity of the situation and, despite the discomfort laughing caused, made us feel human again. I guess what life sometimes throws at us is crazy, but that’s what makes it so real.

Thanks again for all of your love and support! 

Good day today!

I am happy to report that I have been fever free for almost 24 hours! The antibiotics seem to be doing their job - finally!

Christine and I managed to get out to walk, and while I am winded and sore, I feel for the first time in a while that I am getting stronger.

After my standing appointment for my shot – of course, back at the hospital – we popped up to check on Maris. He will be moving to a Shea Family Care Facility in El Cajon in a few days.

Thanks for all of your love and support!

 

Stayed tuned for more good news!

"WTF? Are you kiddin' me?"

Tuesday, April 08, 2014

Dear Friends, Trusted Colleagues, Family, and Fans of Me!

I call this “WTF? Are you kiddin’ me?”

The tale I am about to tell you is true. None of the details I am about to share are fabricated. (Although once you read them, like me, you would wish they were).

Many of you know that I did not feel well in the weeks leading up to Spring break (should the S be capitalized?): low-grade fever, dry cough, chills, night sweats. I continued to show up to work because it kept me focused, positive-minded, and happy. The fevers were responsive to Tylenol/Ibuprofen. Dr. Zu, my oncologist, was in China visiting family for three weeks. (I scolded him for choosing this time to take his trip).

Upon his return, he advised that we rule out any cancer involvement and, because my quarterly scan was due, decided to see what the scan revealed. I had the scan on March 25^th. By this time, however, my fevers were no longer low-grade, and I left school on Monday the 24^th  – my birthday! - with a fever of 103.3. The scan on the 25^th showed no cancer involvement, but clearly showed that I had pneumonia.  Christine and I breathed a sigh of relief. While I try live each day with positivity and a joie-de-vivre, I must admit that I struggled during this time to do so and retreated into a somber shell, depressed and full of angst.

Dr. Zu prescribed a standard, broad spectrum oral antibiotic over the course of 5 days to treat the pneumonia. I started the antibiotic regimen on March 25^th. I planned to use break to rest, recover my strength, and return to work. Christine and I felt better emotionally because we had a course of action and I was looking forward to finally feeling better physically.

Unfortunately, the antibiotic did not work.  The high fevers, while responsive to Tylenol/Ibuprofen, did not dissipate. A fever of 102 on Friday, the 4^th, prompted Zu to hospitalize me for a round of IV antibiotics. An x-ray confirmed that I still had pneumonia in my left lung.  My pneumonia, however, did not respond despite the intense antibiotic regimen.

Enter the infectious disease specialist. Because of the unusual presentation of my symptoms – pneumonia typically has a much more rapid onset- he believed that I had contracted a resistant, funky, unusual strain of pneumonia. The metaphor he used (and if you’re not sure what a metaphor is, see one of our great English teachers) is that pneumonia  is like getting hit by a car and breaking your legs: while the car (strain) keeps going, your legs are still broken (pneumonia). The goal, then, became identifying the strain.

There are standard ways to identify a strain including blood analysis, urinalysis, psychoanalysis – well, maybe not that last one. These all revealed nothing. Another way is identification through antibiotic. If a particular antibiotic mitigates fever, etc. then, by default, it is a particular strain.  While the antibiotics helped a bit, they did not knock down my fevers.

Enter the pulmonologist. (This part will keep you riveted, I promise).  In order to get closer to the infection, he recommended an endoscopy. This involves going into the lung to grab sputum and some tissue (it would have been so much easier if I had a productive cough). Hearing the word “biopsy” on Sunday threw me for a tailspin. (I was reassured that it meant grabbing tissue for analysis).

The pulmonologist performed the endoscopy on Monday, the 7^th. If you are squeamish, you may want to skip this part. Under conscious sedation, the lung guy went into my left lung through my nostril, used a brush to sample some sputum, took some tissue for biopsy, and flushed out the lung. Let me say that I was more conscious during this process than I would have liked.

I should add here that the attendants during this process were awesome. The lung guy was 30 minutes later to the procedure than planned, so Jonas and I rapped about the music on his “I” Device. From the Philippines, Jonas grew up listening to American music. I know my music trivia.

The scope itself was unremarkable (this is a good thing).  The results of the scope won’t be known for a few days.

My medical team decided that it would be best to send me home to await the scope results and that I could manage fevers just as easily at home. Yeah!  (I should note that while I still have fevers, I am having fewer). My discharge was planned, for Tuesday, the 8^th, barring anything crazy.

In anticipation of my discharge, I asked the nurse if could shower (yes, they do allow that). So I ambulated to the shower area and hopped into the shower. I was suddenly overcome with dizziness, steadied myself best I could, and then found myself on the floor of the shower in a pool of blood, having fainted.  In addition to whacking my ribs, I had nasty lacerations on my forehead and chin.

So, they rolled me down to the ER where I received 18 stitches: 10 on my forehead a la Harry Potter and 8 on my chin.

I then had a CT scan to rule out any head trauma and an x-ray to rule out broken ribs, which they did.

Once the admitting doctor reviewed these tests, he agreed that it was okay for me to go home.

I am home…..

Hopefully, the results of the scope will be known soon. Meanwhile, I am happy to be home with Christine, albeit sore and dazed and confused.

I do want to add that my roommate during my stay, Maris, did not have a single visitor the entire time I was there.  Maris, 65, had a bad reaction to his radiation and chemo, and was in a lot of pain.  While I would not wish the last few weeks of my life on anyone, I had the love and support of my beautiful wife, family, friends and colleagues.  I am greatly saddened that Maris appeared to be alone. (This really tears at me). Christine and I plan on visiting him.

Thank you for being part of my life.  I hope to be back soon.

With love, respect, and humility,

Andrew