Day Hike in the Valley of Death

There is arguably nothing worse in the medical preparation world than getting ready for a colonoscopy. Despite the demure names for the preparatory products: “GoLitely” and “Fleet” making it sound like the ensuing results will be like skipping fast through a meadow, anyone who’s crossed this rubicon knows that skipping through a meadow is just a metaphor for ….well, you know if you’ve done the hike. The last time my husband had his colonoscopy, I had also been assigned to have mine and somehow I thought it would be efficient/comforting/collegial/loving/experiential to do it together. Bad idea. But enough about the prep.

Yesterday morning, at 5:15, we did the “fleeting” part – not fleeting enough- and what I thought was how marital vows should really be a lot more specific. The “In sickness and in health” part is just not clear enough. Our vows had been two sonnets by John Donne we recited while gazing lovingly into each others’ eyes. Well actually, Jimmie had looked a little terrified, though he did manage to look fondly at me. I thought about our son’s and fiancee’s upcoming nuptuals, and I thought, “I’ll give them a little advice about this in the next months,” but then banished the thought.They’re going through potty training right now. They have a pretty good idea of the commitment involved.

Smash cut to the endoscopy center’s waiting room. I had about three hours to sit with my friend Dread nudging me in the ribs as I tried to focus on the crossword puzzles. In spite of the fact that it was Thursday, I finished both the LA Times and the NY Times puzzles. On a normal Thursday, I wouldn’t have stood a chance against Rich Norris , Joyce Nichols Lewis and Will Shortz, but the puzzle and the people watching allowed me to survive the three hour wait and quell my nerves at the same time.

I think I’ve mentioned that this new doctor is in Korea Town, and is, not surprisingly, Korean. His clientele is 99.8% Korean, if the three visits to the office are any indication. When you enter, there are two banks of seats in front of a wide marble counter, behind which sit an extremely friendly nurse/reception distaff. Behind them are arrayed the slim folders of thousands of patients, in ordered regularity. There’s no sign in sheet, you know the ones that most doctors have, with the peel-off tabs that when you sign make you feel like someone’s Medicare meal ticket? A small bowl of cellophane wrapped peppermint candies like the ones in the holiday wreath on the back of my childhood kitchen door rest in a glass bowl at the far end of the counter.

Couples, all over 60 are arrayed around the room, generally men with worried looking wives. Two 24” computer monitors adorn the corners of the room, set on low side tables, angled to the center of the room, each draped with two pairs of headphones. Periodically, the main admitting nurse comes over and instructs one of the couples to look at a video; there must be two dozen videos on the computers. They all have the same structure – a large title card with some possible gastric disease spelled out, in Korean, of course. The opening shot is of the good doctor behind his desk speaking in his direct way to you about whatever it is that might ail you. But what follows is horrible, and yet I can’t turn away. Now we are taking the incredible journey into someone’s colon, where destructive conditions await – one video shows a monstrous polyp bulging, leering almost at the camera. But soon this horror abates as we return to the doctor’s office. Each video lasts about 3 minutes. I am impressed with the efficiency of this tool.

I find myself thinking that this must also be a gross breach of the HIPAA rules. After all, I know now what most every man in the room likely has, even without reading Korean. And what will they do for us, who don’t speak Korean? The doctor, whom we’ve met twice, speaks perfect English, so I guess he’ll have to explain it all to us himself.The size of his non-Korean clientele is so small, it wouldn’t have been worth making another 24 videos in English with English title plates. I take comfort in knowing that whatever the results may be, we’ll receive them first hand.

The other people in the waiting room are so interesting. There’s a flighty 45-year-old woman wearing an elaborate sequined Mackie-like camisole peeking out from beneath a chiffon t-shirt. Both are a beautiful dove gray color, and her black tight pants hug slim ankles clad in 5” spiked heels, that current fashion in black strappy sandals with the solid back running up the Achilles tendon? You’ve seen them. This woman is urgently hurried, her large Louis Vuitton bag over her wrist, running about the office,  hair flashing around her head as she looks anxiously to the left and right. She wears drama like a perfume. Even at 8:00 in the morning. You can tell that her wake is littered with traumatized people. Something has clearly gone wrong. I feel bad for her and yet she’s so interesting that I can’t help being fascinated in the same macabre way that draws my gaze to the corner monitors.

And then, I note, all the men who come in alone have a proclivity for having missed the back loop of their pants with their belts. Is this a bachelor issue? I mean 3 out of 5 of them. I was noticing because, like Jimmie, who’s lost weight and whose wife has not caught up sartorially with the tailor, frequently has bunches of fabric around his waist. So it goes with men in the waiting room of the gastroenterologist. And the lone ones who come in without their wives are clearly the worst off, having no one to sit with in the waiting room- no one to view the screen and share the headsets with.

As Jimmie finally emerges from his procedure, the nurse hands me a xeroxed sheet about polyp prevention and cancer. I note immediately that she’s highlighted 2/3 of the paper’s heading. The word cancer is not highlighted. In times such as these, symbols take on huge significance, so I know before going in to talk with the doctor that there’s no cancer. As we sit and wait, I’m sure that Jimmie hasn’t read these signs, but the lack of privacy in the room prevents me from sharing my relief.

Sure enough, the doctor confirms that I had read the signs correctly. He seems a little surprised. The test has refuted what he’d seen in the earlier CT scan. There was only a small polyp, nothing like the leering eye in the waiting room, one which he was able to snip out during the procedure. I wouldn’t say he looks disappointed, but when he said loudly and firmly, “Good News!” there was no smile on his face. It must be difficult to be the bearer of bad news all the time. Most people having invasive tests such as these must not receive “Good News” all that often. As we gather ourselves to leave, he slips out of the room into another exam room to speak to some other patients.

My step was lighter through the day. After working at home on the couch, I walked to Whole Foods, called Chris to make sure he’d received my good news text earlier in the day. I bought some yellow sunflowers to celebrate, and returning home, I knelt at Jimmie’s feet to present them to him, gratitude and relief watering my eyes. Jimmie’s relief welled up too. We hugged, awkwardly because I was kneeling on the floor and then had trouble getting up.

In truth, we don’t have an answer for Jimmie’s weight loss. But the day before, we’d visited his GP, who changed his diabetes meds. I had consulted Dr. Google only about 10 days before all these invasive and unpleasant tests and suspected this might be the culprit. It was satisfying to see the doctor’s Aha moment as he realized it might be pharma-related. Now, in light of the test results, it seems it must indeed be.

Back to the book. No more distractions.

Really nothing’s changed. And yet everything has.  Jimmie’s still 89 with weakening mobility and the runs. But we’d both trekked deep into the valley of death, had stopped to touch the bark on the trees, to feel the reality of the journey and the destination. We’d stopped to sit side by side on the bench at the edge of the path. And we’d made it back out for another day.

Truly Intentional Living

My best friend is having surgery on Tuesday to remove both her breasts. This is her response to a small node of cancer in her right breast from which unfurled the discovery of a dramatic family history of breast cancer. Rather than face later invasive lobular or ductile cancer, surgery, chemo and radiation, she opted to stop it now, by removing the offending breasts. She seems remarkably calm about it, as much as can be determined via a long distance call. She lives half way around the world from me, and never have I felt farther away or less useful.

It is natural to think “How would I deal with something like that? Would I have the courage to lop off my breasts to avoid possible future ailments?”

But I did make a similar decision when I had a total hysterectomy at 35. Or rather, it was made for me when greedy tendrils of endometrium choked both my ureters,  until I became literally toxic.

In retrospect, my life had turned itself upside down over a period of about six months. I had felt restless, no doubt due to the renal poisoning going on inside me. I declared to my husband and son that I wanted us to move to San Francisco, so that I could take a job at ACT as an Assistant Stage Manager, hired locally, no less, which engendered housing costs far beyond the modest salary I was promised.  Jimmie and I flew up to SF, leaving Chris with friends while I interviewed at ACT with the Artistic Director. She assured us that I could work at ACT and there might be work there for Jimmie as well.

I ignored the signs that this was a bad move for us. My husband was working  in Los Angeles, doing occasional TV guest roles, and acting on the stage with his theatre company. Our son was growing up – age 6 then, and attending a school where he was  happy.

The half-baked plan was for me to move up to SF, live in corporate housing near the theatre for the month or so of rehearsals, and while rehearsing 48-50 hours a week,  find housing for us and a school for Chris.  The housing I found was sterile, but close to the theatre.  What I hadn’t counted on was the implosion of my body during rehearsals.

The rehearsals were great – the cast, extremely talented. The play, Tom Stoppard’s “Arcadia,” weaves back and forth through the time and space continuum in an elegant puzzle which is challenging and gratifying to solve in production. The director, Carey Perloff, had impressive energy of intellect and rigor. The PSM, Kimberly Webb, was skilled and inclusive, embracing me as a new colleague. He trained me how to do ACT production notes, which were publishable -so detailed, coming in Issues and Volumes. I spent a lot of time out of the rehearsal room typing up these production notes, which was a good thing, because I was running to the bathroom to vomit at alarmingly frequent  and shortening intervals.

Finally, about five weeks into my stay in SF, I told Kimberly that I needed to see a doctor. They called Dr. Martin Terplan, a physician whose office was up the hill from Union Square and to whom I trudged that afternoon. Dr. Terplan’s office was, for lack of a better term, antique. The dark mahogany panelling in the waiting area glowed through the frosted ripple glass of the entry door. The brown leather benches I waited on were echoed in the exam room. His elderly and kind receptionist, got me in to see him quickly. Dr. T. was rather antique himself, probably in his late 60s or early 70s. I was skeptical but desperately nauseous.

He instructed me to provide a urine sample which he  spun in a centrifuge, then examined on a glass slide in a microscope. Right there, about three feet from where I lay on the wax paper on the table. Now I was really skeptical.

“You are very ill. Your kidneys are not functioning. Take a cab to the hospital and see Dr. Spaulding, who will be waiting for you.” And so, he saved my life.

I did take a cab, not even having time to call my husband in Los Angeles to tell him what was happening There were no cell phones at the time, so I had to wait until I had already had a procedure at the hospital to call him with the news.

The rest, the subsequent return to Los Angeles, surgery to remove my uterus and reattach my ureters, did not happen for some time due to my advanced anemia. The decision to remove my uterus was not automatic, but I had become so enraged at my body by then that I spent little time making the decision. The options, discussed with my gynecologist were only cursorily considered by me. I had come close to death and I was not going to let it happen again.

So I know a bit how my dear friend feels – the betrayal of your body, your history (my grandmother and aunt both had hysterectomies at 35, a fact no one had bothered to tell me until after this episode), and how it feels to come to grips with the decision to avoid medical catastrophe.

But she is braver than I because she has no overt symptoms – beyond a small pea-sized potential cancerous lump.  She has gone to the experts, researched her genetic predisposition to cancer and made the decision to live a future clear of breast cancer. So much more intentional and courageous than my own journey was.  She makes me so proud.

 

Rules to a Long and Happy Life

 I have had the privilege of viewing what it will be like to get old through the prism of my husband’s experience. Getting old is a challenge and largely ain’t pretty; these are the things I have learned through osmosis that I would like to share with you.

1) Consolidate your doctors in a geographic area that suits you and minimizes travel.  When you ask for a referral and the doctor says “So and So” check whether “So and So” still practices in the vicinity of the referring doctor. If he has moved to West Hills, say, ask for another referral. Better yet, start by asking for a referral near your home. If they don’t know anyone downtown, for example, do some research and make a suggestion back before accepting the original referral. This is crucial for your sanity.

2) When you move, seriously weigh the advantages of staying with your old doctor vs. the amount of time you will spend traveling to and from your old doctor and your new home.

3) If you go to a doctor and the doctor makes you wait an hour to be seen, change doctors.

4) When you start to not be able to hear people when they talk to you with their back to you, investigate hearing aids. The first round of hearing aids may not work well. Don’t lose hope. Get another set. If they work it will change your life and your spouse’s and children’s lives for the better.

5) Don’t be ashamed if you find you need a cane. Consider it a badge of honor. Carry and use it confidently knowing that you look just a little more dapper and feel a whole lot more comfortable about walking.

6) Keep walking and exercising as much as possible.

7) If you are a runner, consider adding other sports like swimming of cycling to keep your knees working.

8) Take naps as often as your life will allow.

9) Get out to see theatre and movies whenever you can. It is good to get out and about, and exposure to cultural events keeps your mind engaged and your heart full.

10) Read the paper(s) every day and do the crossword puzzles and sudokus. These will keep your brain agile and keep you informed as to what is going on in the world.

Follow these rules and based on my limited exposure to one who has, you will live a long and happy life.

Spinning into Ice Cream

spinning

So I started a spinning class about a month ago. Fat and sassy from a winter recess spent eating chopped pecan cookies, and flushed with shiny New Year’s resolutions, I walked the half block to the Cycle/Yoga gym in my neighborhood and signed up for 10 classes. In all honesty, it wasn’t the first time I had started a spinning class. I had taken a free demo class three years before when the gym first opened. And that had been one of the most brutal physical wake up calls I had ever experienced. I practically crawled out of the gym after that class.

When I walked into the gym this time, I knew what I was getting into, but this time, I was determined to overcome the lassitudes of my pudgy 54-year-old legs and make them and myself proud.

The first class was predictably disastrous. I had to ask for help setting up my bike. I really abhor being the novice at anything; it always has been so uncomfortable for me. The lean and sinewy trainer with the matchstick arms and iron legs at the front of the class looked like she could be doing the routine in her sleep – it looked so easy for her – I hated her. She was hard and didn’t understand how hard it was for me. (Pouting emoticon)

This is what I now know and it only took me a month to figure this all out – mostly due to the kindness of the subsequent instructor who’s class I found and have been attending three times a week:

1) Use your core – this means you shouldn’t slump your shoulders and heave your body forward and backward by using your arms to pull you to the handlebars.

2) Zero out the resistance before you start the work out. This may seem ridiculously obvious to you if you have done spinning before, but I discovered (in week 3) that when I did that, I could actually move my legs in rhythm with the music rather than once for every two revolutions of the rest of the cyclers.

3) Bring the biggest bottle of water you can carry and drink it.

4) When the instructor says “Tap it up,” do it. Otherwise, you are cheating yourself. And keep going to the end of the song. And then to the end of the next song. And the next. Because it is only 45 minutes and anything is bearable for 45 minutes. When I’m struggling, I imagine myself walking out the door of the gym and into the sunshine, exhausted and happy that I started my day that way.

In one of my classes two weeks ago, before I had actually made it through the class without sitting down and crying, I found myself sandwiched between two identical twin blond sisters. I had gone to “my” bike, set myself up, when the Doublemint Twins came in and chose the bikes on either side of me. Incredibly slim, the the two of them would have fit into one leg of my six-year-old Addidas  workout pants. That was okay. I didn’t have any problem with company – in fact, I was excited to have someone better than me cycling on either side. But half way through the workout, sometime after the hill and before the final jumps, I gasped to the twin on my right, “You girls are killing me.” She shot me a dirty look; I guess I breached some unwritten rule about not talking to someone else during the class. Suitably chastised, I returned to my own misery.

This morning,  they were back, and I selected a bike behind them and to the left. What I saw during the class made me feel so much better. The sister on the left (was it the same girl who had been on the left last time?) wasn’t touching the little red knob on the bike. “Tap it up” elicited nothing more than hummingbird-speed cycling. No wonder she could move her legs so fast! She was at the base level of resistance! I can’t tell you how this cheered me on to the finish line. That and the fact that they both got off their bikes and walked out without wiping them down. No longer the novice, I celebrated their ignorance about the protocols as I cleaned off my bike.

I can have ice cream at least once a week now. You could say I am spinning into ice cream.Ice cream