Bottom Line Healthcare
Last
week, I had another chemo treatment and I would like to share my observations…
Chemo
rooms are divided into coves with cute, wispy names (designed to calm the
nerves) and 2 nurses are dedicated to serve 6 patients. There are 6 recliners that have an extra
chair beside them, tables on either side of the recliner, an electric pump on a
roll able stand that regulate the flow of the poison, and individual curtains
affixed to metal runners on the ceiling that can be pulled around completely if
needed.
A
curtain had to be pulled around the day I was there and I heard the doctor
inform the patient that the correct balance had not been found yet and that the
patient needed to have patience. All I
can say here is that I had the curtain pulled around me once, and it was done
to conceal the horrific sickness I was experiencing, convulsing and vomiting
uncontrollably.
A
few years ago (about 5+/-) there were volunteers who pushed carts with free
ice-cream and huge candy bars around to all the patients in the mornings. At lunch they push carts loaded with catered
food in Styrofoam containers that filled you so full you felt bloated. In the afternoons, they pushed around carts
of homemade cookies and pies. When they
were not pushing carts, they were walking around asking if they could do
anything like help you to the restroom or get anything for you like a soft
drink, water, or crackers in case you were feeling nauseous.
BUT
NO MORE…
Times
have changed as these big healthcare conglomerates have purchased smaller
facilities or have provided all the administrative services to the larger
facilities for a substantial but convenient fee; consequently, there is a huge
focus on the bottom line that only allows for a minimum of patient care.
In
fact, these places have gone paperless and in each exam room there are
computers for the nurses and doctors to use for documentation and while I was
waiting there is a powerpoint scrolling across the monitor screen that begins
with a slide that states:
ORDERS FROM THE CHIEF
Carts
are no longer pushed in the mornings and the afternoons and volunteers no
longer present to serve; but, lunch is still being served but this time nurses
push the carts and each patient is only allowed one half of a sandwich, a bag
of chips, and a soft drink can about half the size of a normal one.
However,
nurses are being paid more and the quality of their care: sticking you and
monitoring the flow does allow you to leave an hour or two earlier than before
the change. Still this is basic
inventory management and if you can turnover the use of recliners faster, then
you can improve your throughput and handle more patients, increasing one’s
daily revenue potentials.
Unfortunately,
the number of patients receiving these chemo treatments has quadrupled in the
last few years, forcing the administration to build a new Oncology Center,
putting them in a highly leveraged situation and the bottom line focus would be
to pay down the debt as quickly as possible.
So
now, the reduction of free food and recliner turnover makes a lot more
sense… but, to a business student, this
is Operations Management 101.
The
average cancer patient has $20 to $30,000 of out-of-pocket expenses that must
be paid annually; so, it is very uncomfortable financially to get sick if you
are not middle class or above with income.
This understanding causes one to reflect on what the healthcare facility
management team is doing to make sure they get those kinds of patients and not
the ones that are in the below middle class levels.
Of
course, this type of situation is never realized until one finally ages into
one’s 60’s and begins to experience a breakdown in the body due to one’s
inattentive lifestyle.
We
should manage our own lives as businesses management their bottom lines.
2014 Medical Update
In September 2013, I began chemo treatments again as my Lymphoma had left its dormant stage and was starting to increase in size in my pelvic and upper body areas. The treatment this time was scheduled for 6 rounds of 2 days (either back-to-back or a day in between) with 28 days respite between rounds. My drugs this time were Rituxan and Triandra. Interestingly, Triandra was developed in East Germany but was not discovered by physicians in the US until after the Berlin Wall came down. Triandra is not as powerful as my previous cocktail of Cytoxin and Fludara but it left me longer lasting days of nausea, 4 days instead of 2.
However this time, instead of waiting until I experienced signs of nausea, I started taking my anti-nausea pills immediately after leaving the chemo room and then every 5-6 hours after that even though the bottle said every 8 hours. I could actually feel (or sense) the suppressed nausea sensation, leaving me in a state of extreme fatigue without appetite and feeling like I was just getting over a bad case of flu. Every once in a while, the toxins would win out and I would end up laying on the tile floor of the bathroom waiting to experience the "joys" of having the dry heaves, as they say, expelling volumes of nothing into the toilet as my body violently contracted and convulsed upward.
But, for the most part that did not happen this "go round," as much as it did before and looking back perceived myself to "sail" through the chemo side effects.
After 3 complete rounds, a CT scan was performed and my Oncologist told me that there was substantial reduction of the Lymphoma which he was pleased to see and that after my 4th round, chemo would be suspended allowing time for my bone marrow to rebuild itself. Chemo is really not to be given if one's platelet count is below 100,000 and my chemo treatment started this time with my platelet count at 74,000 so there was concern from the getgo.
After my first round, I was told I needed a Nupogen shot to stimulate the production of white blood cells because mine was dangerously low. I had never had to get one of these shot before and dreaded the day that I would have to because I had heard that afterwards, it was extremely painful in the bones and joints. The pills I was given to avert that experience must have worked because I never felt that pain fortunately.
In reflecting back upon the history of my chemo treatment, I have had 50 infusions and while my body did not like what it was going through, it tolerated it better than most. And, my Neutrafil count (which are the white blood cells that actually fight infection) has always been within an acceptable range that has enabled me not to contract a terrible illness due to a low immune system. For that, I am blessed.
So, I am now a survivor of 2 cancers so far plus a severe heart attack that should have killed me as it was happening. Five stints have been inserted into my left 3 main arteries averting having to wear a zipper on my chest for the rest of my life. My ejection fraction is half what it should be so I fatigue easily which is difficult to accept for someone as active as I was but it is all part of getting old, I suppose.
Life is different but still good and I am out of the stress of the business world teaching management classes at a local University. At 66, I still consider myself relatively healthy and I still body surf every summer when we vacation at Myrtle Beach; although, my time to surf is typically less than an hour each day from the 6 hours/day it used to be.
At one point in my life, I thought I would want to retire at 62 (now 66) like my parents did and travel the world but I have changed my mind on that as well. I want to teach young minds as long as I can what I have learned during my 40 year career so that they will be better prepared to deal with the "it's nothing personal" business world into which they will soon be thrust.
Besides, this teaching gig is less than 30 hours a week full time, leaving me plenty of time to write for We Were Just Wondering.
BOHICA by Alex Hutchins
I was diagnosed with
"B" Cell Lymphoma around 2007/2008 and was treated by an Oncologist
at UT Medical Center with infusions of Rituxan which held the disease at bay
and allowed to maintain my lifestyle. In 2010/2011, I moved to Northern Kentucky
to work and the Oncologist there did not agree with my maintenance treatment
and decided that a more aggressive approach was necessary, so for 6 months I
was treated with an infustion cocktail of Rituxan, Cytoxan, and Fludara
which not only made me violently sick on the weekends after treatment but
completely destroyed my immune system.
Bottom Line Healthcare
Last
week, I had another chemo treatment and I would like to share my observations…
Chemo
rooms are divided into coves with cute, wispy names (designed to calm the
nerves) and 2 nurses are dedicated to serve 6 patients. There are 6 recliners that have an extra
chair beside them, tables on either side of the recliner, an electric pump on a
roll able stand that regulate the flow of the poison, and individual curtains
affixed to metal runners on the ceiling that can be pulled around completely if
needed.
A
curtain had to be pulled around the day I was there and I heard the doctor
inform the patient that the correct balance had not been found yet and that the
patient needed to have patience. All I
can say here is that I had the curtain pulled around me once, and it was done
to conceal the horrific sickness I was experiencing, convulsing and vomiting
uncontrollably.
A
few years ago (about 5+/-) there were volunteers who pushed carts with free
ice-cream and huge candy bars around to all the patients in the mornings. At lunch they push carts loaded with catered
food in Styrofoam containers that filled you so full you felt bloated. In the afternoons, they pushed around carts
of homemade cookies and pies. When they
were not pushing carts, they were walking around asking if they could do
anything like help you to the restroom or get anything for you like a soft
drink, water, or crackers in case you were feeling nauseous.
BUT
NO MORE…
Times
have changed as these big healthcare conglomerates have purchased smaller
facilities or have provided all the administrative services to the larger
facilities for a substantial but convenient fee; consequently, there is a huge
focus on the bottom line that only allows for a minimum of patient care.
In
fact, these places have gone paperless and in each exam room there are
computers for the nurses and doctors to use for documentation and while I was
waiting there is a powerpoint scrolling across the monitor screen that begins
with a slide that states:
ORDERS FROM THE CHIEF
Carts
are no longer pushed in the mornings and the afternoons and volunteers no
longer present to serve; but, lunch is still being served but this time nurses
push the carts and each patient is only allowed one half of a sandwich, a bag
of chips, and a soft drink can about half the size of a normal one.
However,
nurses are being paid more and the quality of their care: sticking you and
monitoring the flow does allow you to leave an hour or two earlier than before
the change. Still this is basic
inventory management and if you can turnover the use of recliners faster, then
you can improve your throughput and handle more patients, increasing one’s
daily revenue potentials.
Unfortunately,
the number of patients receiving these chemo treatments has quadrupled in the
last few years, forcing the administration to build a new Oncology Center,
putting them in a highly leveraged situation and the bottom line focus would be
to pay down the debt as quickly as possible.
So
now, the reduction of free food and recliner turnover makes a lot more
sense… but, to a business student, this
is Operations Management 101.
The
average cancer patient has $20 to $30,000 of out-of-pocket expenses that must
be paid annually; so, it is very uncomfortable financially to get sick if you
are not middle class or above with income.
This understanding causes one to reflect on what the healthcare facility
management team is doing to make sure they get those kinds of patients and not
the ones that are in the below middle class levels.
Of
course, this type of situation is never realized until one finally ages into
one’s 60’s and begins to experience a breakdown in the body due to one’s
inattentive lifestyle.
We
should manage our own lives as businesses management their bottom lines.
2014 Medical Update
In September 2013, I began chemo treatments again as my Lymphoma had left its dormant stage and was starting to increase in size in my pelvic and upper body areas. The treatment this time was scheduled for 6 rounds of 2 days (either back-to-back or a day in between) with 28 days respite between rounds. My drugs this time were Rituxan and Triandra. Interestingly, Triandra was developed in East Germany but was not discovered by physicians in the US until after the Berlin Wall came down. Triandra is not as powerful as my previous cocktail of Cytoxin and Fludara but it left me longer lasting days of nausea, 4 days instead of 2.
However this time, instead of waiting until I experienced signs of nausea, I started taking my anti-nausea pills immediately after leaving the chemo room and then every 5-6 hours after that even though the bottle said every 8 hours. I could actually feel (or sense) the suppressed nausea sensation, leaving me in a state of extreme fatigue without appetite and feeling like I was just getting over a bad case of flu. Every once in a while, the toxins would win out and I would end up laying on the tile floor of the bathroom waiting to experience the "joys" of having the dry heaves, as they say, expelling volumes of nothing into the toilet as my body violently contracted and convulsed upward.
But, for the most part that did not happen this "go round," as much as it did before and looking back perceived myself to "sail" through the chemo side effects.
After 3 complete rounds, a CT scan was performed and my Oncologist told me that there was substantial reduction of the Lymphoma which he was pleased to see and that after my 4th round, chemo would be suspended allowing time for my bone marrow to rebuild itself. Chemo is really not to be given if one's platelet count is below 100,000 and my chemo treatment started this time with my platelet count at 74,000 so there was concern from the getgo.
After my first round, I was told I needed a Nupogen shot to stimulate the production of white blood cells because mine was dangerously low. I had never had to get one of these shot before and dreaded the day that I would have to because I had heard that afterwards, it was extremely painful in the bones and joints. The pills I was given to avert that experience must have worked because I never felt that pain fortunately.
In reflecting back upon the history of my chemo treatment, I have had 50 infusions and while my body did not like what it was going through, it tolerated it better than most. And, my Neutrafil count (which are the white blood cells that actually fight infection) has always been within an acceptable range that has enabled me not to contract a terrible illness due to a low immune system. For that, I am blessed.
So, I am now a survivor of 2 cancers so far plus a severe heart attack that should have killed me as it was happening. Five stints have been inserted into my left 3 main arteries averting having to wear a zipper on my chest for the rest of my life. My ejection fraction is half what it should be so I fatigue easily which is difficult to accept for someone as active as I was but it is all part of getting old, I suppose.
Life is different but still good and I am out of the stress of the business world teaching management classes at a local University. At 66, I still consider myself relatively healthy and I still body surf every summer when we vacation at Myrtle Beach; although, my time to surf is typically less than an hour each day from the 6 hours/day it used to be.
At one point in my life, I thought I would want to retire at 62 (now 66) like my parents did and travel the world but I have changed my mind on that as well. I want to teach young minds as long as I can what I have learned during my 40 year career so that they will be better prepared to deal with the "it's nothing personal" business world into which they will soon be thrust.
Besides, this teaching gig is less than 30 hours a week full time, leaving me plenty of time to write for We Were Just Wondering.
BOHICA by Alex Hutchins
the PAIN of diagnosis and treatment
by Alex Hutchins
Perhaps this title, for some, is too strong or will scare you away from healthcare, but for those of us like me, who have survived heart attacks, heart surgery, cancer, and blood disorders, it is cooked and served up just about right.
All my life, I had been healthy and active and flirted with sickness in the winters by wearing T-shirts and flip-flops outside and not getting the “standard” flu shot but never saw the inside of a doctor’s office unless it was for my annual physical. And, I stayed that way until 2007, age 60, when I discovered that I had suffered a heart attack that severely reduced the left muscle to pump out blood due to my LAD artery being blocked 100% as well as an 80-90% blockage in the two other major arteries on the left side. Over the course of 2 years, I went to Presbyterian Hospital in NYC 3 times to have those arteries cleaned out and stints inserted.
During the first angioplasty procedure, where cuts were made on my right and left legs, a stitch as put in both legs to hasten the recovery. The local anesthesia that the nurses had given me must have worn off because for about a minute, 30 seconds on each leg, I experienced this excruciating pain as a machine sutured my leg. There were 4 bursts of pain on each leg that lasted about 10 seconds of so, leaving me writhing in pain with clinched fists and watering eyes.
In the recovery room, I asked the nurse about the pain and she said that feeling it 4 times was correct that the first was when the stitch went through; the second was when it was pulled together; the third was when it was tied, and the last was when it was cut free. For the rest of the day all my muscles ached from the tight tension through which I had put them. For the next two procedures, I asked for an additional shot of pain medication before the machine stitched me.
To this day, I still wonder why health care professionals in operating room do not just simply give that extra shot or at least ask the patient about it; but, it probably has something to do with insurance?
During this same time period, it was also discovered that I had Non-Hodgkin’s Lymphocyte “B” cell Lymphoma with a mild form of MDS, a blood disorder. I was watched for a year, and then began a 6 month regimen (6 month on then 6 months off) of lower level chemo treatment to keep the disease from growing.
Obviously, diagnostic procedures are required in order to determine the extent of the illness; but, what is not expected is the trouble that some nurses have when trying to insert the needle for the IV. I don’t know if my case was something special or not but my pre-operating room nurse tried and missed 5 times and it was not until I experienced a “vegal” response, that a more experienced nurse was asked to finish the job. My first thought was: “the patient be damned.”
In order to determine the blood disorder, a bone marrow biopsy is required and at the time of my first one, the procedure was done in the Oncologist’s office with only a local. I was told that there would be about 20+ seconds of pain and vividly recalled my first heart surgery. For 2 months, I delayed the biopsy after becoming terrified thinking about the upcoming pain. I am not sure what bothered me more, the way I was treated by the nurses or the way I felt about myself for having to admit to someone that I was worried about pain.
My wife pointed out to me on numerous occasions how women can endure more pain than males that is especially evident during child birth. She also pointed that she has endured numerous caudal block shots, as painful as they are, certainly I can endure this biopsy. Well, all I can say is thank goodness males and females are different; but, on the inside I felt like a “wimp,” a “pussy,” and less than the “macho” man I should have been.
But, whether it is a bone marrow biopsy, a CT/PET scan, or an angioplasty procedure is that emptiness in one’s stomach feeling due to the unknown and uncertainty of what lies ahead. And then, once the procedure is completed, it is the waiting to see the doctor for the results. Don’t think that you can call the Radiology Department or the Lab for the results because you cannot – they have been instructed not to give those results out, unless it is to the doctor.
By the time you have finally been able to arrange a meeting with the doctor, the internet searches that you have performed about your illness or potential condition, have you tense, excited, apprehensive, scared – but mostly scared.
In 2010, I moved out of State and my first order of business was to find an Oncologist who subsequently subjected me to a very aggressive chemo treatment as the data he was reading indicated longer life if performed. Today, my cancer is gone, but the type of cancer unfortunately that I have, always returns and it is predicted that will happen to me in about 3-5 years, which is the good news; the bad news is that this aggressive treatment may have worsened my MDS blood disorder and the only way to tell for sure was to have another bone marrow biopsy.
All patients, regardless of the illness, must endure the uncertainties, indignities, and the pain of the diagnosis, the treatment, and waiting for the doctor to share a few minutes of his or her time explaining the results and the recommendations, leaving the patient emotionally paralyzed not knowing what to do. Of course, there is the “second opinion,” that one can request but that sometimes result in additional tests and additional waiting time and additional uncertainties.
Thank goodness my heart has maintained itself during this journey (not getting better or worse) as I wonder why two Oncologists had such differing opinions on how to treat my cancer; and if, the treatment I finished 6 months ago has created a worse problem inside of me. And, thank goodness, I live in a small city because I can pretty much ask and receive the procedure time that I requested otherwise I would be going without food for 12 hours or more. So today, is my last day to wait to find out the results of my bone marrow biopsy that was performed a week ago; results that will tell me I am fine or that I have blood disorder inside of me that was worsen and can only be corrected with chemo.
Whether I am in denial or not, I do not let my heart condition, my lymphoma, or my MDS influence how I live my life or the positive enthusiasm I infuse (like chemo) into the minds of my students in the classroom. No doubt I will continue to be tested and continue to wait for the results and continue to live with the uncertainties of it all. And, there will always be the wondering of how one Oncologist/Hematologist and one Cardiologist can have so many patients and remember all the subtle details of my 3 illnesses.
BYPASS SURGERY
By Victor M Adamus
Colon Cancer
by Victor M Adamus
I was told by my insurance company that men at age 55 were required to have a colonoscopy and I was five years behind that rule, one I really never read about in my policy. So I scheduled one, only to find the results were not good. A tumor, small, but not tiny, nothing the surgeon could remove during the C test, too big, he said was found and it was necessary to refer me to a general surgeon at our local hospital. A laproscopy surgery was scheduled after many invasive attempts to determine the actual area of the pimple sized tumor and once everyone settled into the feeling this would be routine the tumor pathology said differently ... it was Stage I cancer, anything but routine, considering we all thought the tumor would come back from the lab benign, meaning no Big C. I was relieved, somewhat, that we had caught it in time and my referral to a local Oncologist also showed by using the data provided by the National Cancer Institute and that of the F Lee Moffitt Cancer Center that it was safe to say the surgery was 100% successful and I was told to go on with my life. So I did.
About six months later I returned to the surgeon complaining of blood in my stools, blood on tissue after a bowel movement, and to his shock and surprise he said it could only be cancer and that even though his margins were correct during surgery, somehow he missed a cell and it came back with a vengeance. I had to have radiation treatment immediately and as scary as that is and many physical exams later, I spent the weeks of Christmas and New Years starting my radiation therapy to kill off cells in the colon area of the surgery, a ring left by the laproscopy done that was considered a cure all. I felt at that time it was now aggressive; that this was going to be an end of life struggle; and that my thoughts of living out a retirement were not so good.
I was right. Six months after radiation I was scheduled for a baseline study at F Lee Moffitt Cancer Center because if I ever had to have surgery again, it would be there. Moffitt is an incredible place with the most professional people, doctors of all cancer related studies, and the Center itself is pleasing for a patient. I wondered if this was the place I would eventually die in. Those thoughts do cross one's mind when the continued insistence of pre-maintenance for this disease is so important to the insurance provider. Almost like someone taking odds at a horse track. Well, even though I was given a huge sigh of relief, no cancer after a battery of tests, my wife and I spoke in the car coming home that it was sure to be a finality to this Stage I cancer experience. The fact was, the worst was waiting in the wings.
Two weeks after leaving Moffitt, a Hematologist there had done a general review of all my tests and found a hot spot on the left side of my liver. Realizing that this usually means the cancer has spread, he sounded the alarm and I was called by my team leader to return to Moffitt for a biopsy. That indeed, they believed the cancer had metastasized, was in my blood stream, could do extreme damage, and in Colon Cancer victims could spread quickly to my lungs. I now had Stage IV cancer. Fear of death was everywhere in my daily life. I could hardly sleep, knowing that for one brief retrieve, we were the happiest in our married life knowing we could go on with our lives and put my cancer experience behind us. Now I was facing the real battle for my life and I would find, after Chemo therapy, that even at age 62, one must live his life every day as if it was his last.
Chemo is poison. And the job of an Oncologist is to put a combination of these cocktails together to take a patient to the brink plus a tad more. It is a test of strength. Endurance you conjure up somehow to kill the cancer cells that could take your life. It was the worst experience of my life and it left me with numbness in my feet, the kind of feeling like you are wearing a pair of rubber boots as you walk and a tingling in my finger tips that prevents me from opening screwed down bottle caps and turning the pages of a book. I can't even write my name as I used to. But some cancer victims tell me I'm lucky that this is my only complaint. My real complaint, of course, is not knowing the end of this story, the end of my life, when the cancer will reject Chemo and the crazy cells will go for it all.
Today I'm on a maintenance program of 90 days clean up due to microscopic spots found in my liver from a PET scan and the Oncologists differ in opinion because none of the spots are hot and they are too tiny to do another biopsy. But this time it's a pill program, not so bad, I am tolerating it well as I do the infusion of Avastin monthly which is also a part of the program. I have three more cocktails to try if this fails. A PET scan will be scheduled every six months after this therapy and nothing is done unless it reveals yet another cell attack on my liver or lungs. I could live five years they say.
The optimists who deal with cancer victims are pleased with the steady progress of cures, like the killer T cell found which kills cancer tumors in the brain. Labs all over the world are working to clone that killer cell because cancer curing, of and in itself, is a huge profit making machine. There could be a cure for cancer right around the corner, but to me it's a race against that clock.
I cringe every time the phone rings and it's a schedule person setting me up for another test.
If you have a question about cancer a good start is with the recommendations we posted in the left margin under Medical References.
As you can see by reading Vic’s account, cancer patients must put their minds, bodies, and souls in the hands of strangers – each one of us has their own story to tell and mine is below.
Lymphoma – Non Hodgkin’s with Myeloproliferative
by Alex Hutchins
Much of my story has already been described below in an earlier article entitled Another Day, Perhaps, that you can read if you scroll down.
I had Oncologists from three different States (TN, KY, OH) tell me something different about their recommended courses of action. To make matters worse, a second opinion from an Oncologist in NY offered me even more variety from which to choose. There was, do nothing with the Lymphoma but watch and treat the blood disorder myeloproliferative; another Oncologist suggested to follow a regimen of Rituxan, every six months and needed to do a bone marrow biopsy, which I can assure you is no fun and very painful. To watch animation of the procedure, The third Oncologist suggested an aggressive approach as the data yielded better results and a longer life. This aggressive approach was a cocktail of Rituxan, Cytoxan, and Fludara for 3 days every month, for 6 months. I soon discovered that Cytoxan and Fludara were even more wicked than Rituxan and to take all three was definitely going to be interesting.
My journey through several Oncologists was due to the fact that I changed jobs and moved to northern KY for a year, first seeing an Oncologist in Ohio, then changed to one in KY who had a better reputation. However, this move came after 2 years of 18 Rituxan treatments in TN. It was the KY Oncologist who recommended the more aggressive treatment of Rituxan, Cytoxan, and Fludara.
At this point, my state of mind and level of anxiety was contingent upon the following 3 fears:
- My on-going battle with heart disease, damaged heart muscle, low ejection fraction and 5 stents, 3 of which were in my “widow maker” artery or the main heart artery called LAD.
- The stress of my new job and living alone in Northern KY.
- Uncertainty of the various opinions and the side effects of chemo infusions.
Since I experienced no adverse side effects with the Rituxan treatment, I decided to go aggressive with my treatments and on the first day of my 8 hour infusion, became violently ill after 2 hours. I was embarrassed and humiliated to be among strangers and without family. The weekends after infusions were the worst experience of my life with a sense of helplessness to stop the waves of nausea, the vomiting, and the complete exhaustion of the body, coupled with the fierce desire not to eat or for that matter move at all.
My treatments are over and my CT scan shows no signs of Cancer in my body and my heart has not sustained any additional damage that can be detected at the present time. However, for the last 5 months, severe fatigue surrounds me like an afternoon fog that from doing any work that needs concentration. While my eating has not completely returned to normal, the weight that I gained during my chemo treatments due to steroids is not easily removed because I cannot exercise because every attempt has me out-of-breath after 6-7 minutes. Waves of nausea wash over me some afternoons, prompting me to go to the bathroom and lie down on the tile floor with only my underpants to cool off which can sometimes halt the sensations.
Every time this happens, I email my best friend Vic to share the story and he says this is the side effects of coming off chemo and could last for a year or more. What else will last for a long time and perhaps for the rest of my life, is a low white blood cell count. A low white blood cell counts puts my body at risk for catching disease and for fighting off that disease once it invades my body. My cancer will return in 2-3 years, maybe in 3-5 years, no one really knows but it will return as that is its nature and when it does, I will be going through this all over again, but this time I’ll be a little older.
12 September 2011
A little ditty about depression
by Alex Hutchins
Mental disorders are common in the United States and Internationally. An estimated 22.1% of Americans ages 18 and older (about 1 in 5 adults) suffer from a diagnosable mental disorder in a given year. When applied to the 2003 U.S. Census residential population estimate, this figure translates to 46.4 million people.
In addition, 4 of the 10 leading causes of disability in the U.S. and other developed countries are mental disorders - major depression, bipolar disorder, schizophrenia, and obsessive-compulsive disorder. Many people suffer from more than one mental disorder at a given time.
Mood disorders cost U.S. employers 16 billion dollars in lost work time annually.
Over 90 percent of suicide victims have a diagnosable mental disorder.
In the U.S., mental disorders are diagnosed based on the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV). For More Information
Based on the most recent data, more than 34,500 people died by suicide in the United States in 2007.
Approximately 20 percent of those individuals — or one in five — are veterans. Is it possible that depression can lead to suicide?
Suicide is the fourth-leading cause of death in the United States for adults 18 to 65 years old and the third-leading cause of death in teens and young adults from ages 15 to 24. Currently, 67 percent of all Marines are between the ages of 17 and 25. For More Information on Military Suicide
LIVING FREE
Depression lives on my shoulder fading
In and out with my exposure…
Weekends spent in bed you see
Window shades drawn for me
Lights off and out of bed
Only when I use the head.
In the back of class I sit
Wearing black in case I sweat;
Appearing unresponsive to some
But pass the course when exams are done.
Now, when my career unfolds
The other side of me explodes
Though Jekyll & Hyde I act
Accomplishments are a fact.
Bi-polar now is my cup of tea
On a roller coaster ride I now can see,
Never knowing, Sir, who I will be
But each day, I am living free.
Bi-polar now is my cup of tea
06 September 2011
Another Day, Perhaps
by Alex Hutchins
About two years ago, I was told after complaining of lingering muscle aches on the left side of my upper chest that I had suffered a massive heart attack which had damaged the left side of my heart, reducing my ejection fraction from 50-70% down to 25-35%, and that my LAD (left anterior descending) artery was 100% blocked, and that my other two main arteries on the left side were both blocked 80%. A triple bypass was recommended. The reason I was still alive was that my body, being otherwise in such good health, had grown literally dozens of supplemental arteries to compensate for the blocked LAD. To date, I have had those three arteries cleaned out and five stents inserted, three of which are in my LAD.
I recently realized that I have been on a “spiritual” journey here on earth, let’s say, and without going into too many details, I have also come to realize that the sum total of who I am was given to me (not earned by me) by my Creator at birth. This includes my physical abilities, my mental abilities, my creative ability, my health, and my strong body. All of these were given as “gifts” (and were given to you) as we try to appreciate the natural beauty all around us. See Poem Here.
My illnesses are my legs being broken by my Creator, who is now carrying me around His neck until I heal and from whom I will never stray again. A bond of trust and protection has developed.
When I had my bone marrow biopsy, I was told I would feel about 20 seconds of extreme pain, but
by Alex Hutchins
About three years ago, I was diagnosed with “B” Cell Lymphocyte Lymphoma, low grade and slow growing, but Stage IV because it was found to be in the bone marrow. I was watched for a year, then treated for eight straight weeks with Rituxan, which appeared to keep it at bay, but six months later was put on a maintenance treatment every six months (four weekly treatments of Rituxan) for another two years, one of which has already transpired. The Lymphoma was located around my pelvic area,chest area, and under my arms.
I recently realized that I have been on a “spiritual” journey here on earth, let’s say, and without going into too many details, I have also come to realize that the sum total of who I am was given to me (not earned by me) by my Creator at birth. This includes my physical abilities, my mental abilities, my creative ability, my health, and my strong body. All of these were given as “gifts” (and were given to you) as we try to appreciate the natural beauty all around us. See Poem Here.
I recall a story told to me a few years ago about a flock of sheep and a shepherd who finally had to break the leg of one of his lambs because it too often strayed away from the others. Around his neck he carried the little one, until his leg completely healed, upon which time, on the ground he place this little lamb who quite amazingly never strayed off again.
My illnesses are my legs being broken by my Creator, who is now carrying me around His neck until I heal and from whom I will never stray again. A bond of trust and protection has developed.
When I had my bone marrow biopsy, I was told I would feel about 20 seconds of extreme pain, but
felt none because I had placed myself into His hands. That is not to say that pain will never be
experienced, because on the operating table, when I had heart surgery, the arteries in my leg were
being sutured and the anesthesia had worn off. The two minutes of pain were unbelievable.
I have just completed (4 months ago) 6 months of aggressive chemo treatment (Rituxan, Cytoxan, Fludara) with wicked side effects that have destroyed my immune system. But I know I will be protected and will endure, because there is something left in my life that He wants me to do.
I can vaguely remember the facial expressions of my Cardiologist, the Nurse, and assistants around me as the doctor gave the order to stop my stress test. “Turn off the treadmill”, he said. I was then told to relax on a nearby bench, having looked into the eyes of discontent, I knew that bad news was on the way. The nurse came back to take my blood pressure and give me a scheduling card for a Nuclear Stress test, and a booklet explaining the procedure. The doctor said he is pretty sure I have a blockage in one of my arteries.
That turned out to be an understatement.
The nuclear stress test showed two blockages, maybe 50-60% clogged. I would need a stinting procedure and the sooner the better for me because the condition could cause a heart event at any time, I was told. The surgery was set for a Wednesday morning at Holmes Regional Hospital. The procedure is not invasive as I was given some twilight and the surgeon went up through an artery in my groin to the heart to clear the blockage and replace it with two stints. The stints can last anywhere up to five full years. Most heart patients don’t even know when they have dissolved, I was told.
The doctor who specializes in this type of procedure also knows when arteries can’t be cleared of obstructions in order to insert the stints so they work. My arteries were blocked more than 85%. I had three arteries blocked from 95% to 100% and veins had wrapped around the blockages to feed a flow of blood to the other side, keeping my heart functioning while causing my blood pressure to blow sky high. The doctor did nothing and when I came to recommended immediate bypass surgery. I thought my wife was going to faint. I was like the proverbial deer blinded by the headlights. I couldn’t wait to get home. I couldn’t imagine that six weeks before I had stopped a 25 year career of smoking. And now my only choice left was a bypass operation or chance a heart event in the next six months. I had already complained of facial pains just walking a hundred feet to and from my mailbox.
So this is what getting old is all about, eh? I was 57 and had a healthy life, played Tennis, loved swimming, and enjoyed my long walks. Now I was about to enter a phase of my life where to save my life I would have to have open heart surgery, a bypass, which turned out successful but left me feeling like I was hit by a Mack Truck.
The recovery from my bypass, thought to be six weeks, turned out to be six months. This involved using a plastic home device to raise my pulmonary function. Without that little contraption I would gasp for air. My exercise was to be four times daily, I made sure I was on that thing every time I entered our bedroom. My wife was surprised that I used the devise so much, but my feeling of losing my breathing technique was life threatening to me at the time. I had to get my lungs back up to where I was before surgery.
People ask me why I am an advocate for bypass surgery. I suppose it is because the surgery made me feel young again. I could run up and down a staircase with ease; unload groceries in both arms without any stress; play basketball with my son again; take long walks, over three miles, without working up a sweat; and working in the yard was, once again, a pleasure, not a chore. In fact, my life was a hundred percent better than it was before. I lived three years feeling like I was 29 again, only to learn I had cancer which changed my life forever.
The doctor who specializes in this type of procedure also knows when arteries can’t be cleared of obstructions in order to insert the stints so they work. My arteries were blocked more than 85%. I had three arteries blocked from 95% to 100% and veins had wrapped around the blockages to feed a flow of blood to the other side, keeping my heart functioning while causing my blood pressure to blow sky high. The doctor did nothing and when I came to recommended immediate bypass surgery. I thought my wife was going to faint. I was like the proverbial deer blinded by the headlights. I couldn’t wait to get home. I couldn’t imagine that six weeks before I had stopped a 25 year career of smoking. And now my only choice left was a bypass operation or chance a heart event in the next six months. I had already complained of facial pains just walking a hundred feet to and from my mailbox.
So this is what getting old is all about, eh? I was 57 and had a healthy life, played Tennis, loved swimming, and enjoyed my long walks. Now I was about to enter a phase of my life where to save my life I would have to have open heart surgery, a bypass, which turned out successful but left me feeling like I was hit by a Mack Truck.
The recovery from my bypass, thought to be six weeks, turned out to be six months. This involved using a plastic home device to raise my pulmonary function. Without that little contraption I would gasp for air. My exercise was to be four times daily, I made sure I was on that thing every time I entered our bedroom. My wife was surprised that I used the devise so much, but my feeling of losing my breathing technique was life threatening to me at the time. I had to get my lungs back up to where I was before surgery.
People ask me why I am an advocate for bypass surgery. I suppose it is because the surgery made me feel young again. I could run up and down a staircase with ease; unload groceries in both arms without any stress; play basketball with my son again; take long walks, over three miles, without working up a sweat; and working in the yard was, once again, a pleasure, not a chore. In fact, my life was a hundred percent better than it was before. I lived three years feeling like I was 29 again, only to learn I had cancer which changed my life forever.
