The New Normal; Follow-up Colonoscopy; Las Vegas & COVID; Notable Events

It’s 650(!) days ATN. I was recently reminded that it’s been roughly six months since I last did an update, and that I should post something so that you all know I’m still alive.

At least for those of you who haven’t seen me in person – the last half year has seen three trips to Las Vegas and two to Honolulu. (No, these weren’t vacation trips…) Somehow between all those was another colonoscopy (to check up on the surgery), a CT scan, an EUS, a “minor procedure” to examine and remove an odd lump, and a handful of doctor visits. Cancer treatment is the gift that keeps on giving even after you think you’re “done.” To think before all this started my medical calendar was limited to one visit to my PCP per year. Sometimes every other year if I forgot.

This post is dedicated to my Auntie Gail Chun who passed early this year. For most of my life she was just Auntie Gail, special in her own way but one of many Aunties. Six years ago while she and my Uncle Herbert were staying with me we become fast friends, to the point she once told me she keeps forgetting I’m her nephew and talks about me as “my friend Michael.” To be honest I think of her in the same way. We benefited from the history of family but everything we shared was not out of the obligation of family but the joy of friendship. Though 2,500 miles away she was a constant presence in this journey and is sorely missed.

The New Normal

So am I “better” now? Yes and no. The latter half of 2022 was challenging with continued side-effects of the second surgery. Let’s just say I wasn’t leaving the house for extended periods until mid November.

The first post-surgery outing was to a wine and chocolate reception at one of my favorite local chocolatiers, Alegio. JT texted me that she was going to be a little late – which was fine with me since I couldn’t find a pair of pants that still fit! I hadn’t worn dress pants – or jeans – since the first surgery, both because it was summer and because it’s uncomfortable with an ostomy or when recovering from having one undone. Somehow during those months my waist had expanded by a couple inches. I knew my surgeon forgot something in me before closing up! (That’s my story and I’m sticking to it!) Fortunately I did eventually find a pair of slacks with an elastic waist band. Snug but not too uncomfortable. JT found the whole thing hilarious. My medical oncologist was thrilled. They get a kick out of people gaining weight. (I pointed out I didn’t gain weight but was just fatter. She was still thrilled.) But while she readily gave me a prescription for McDonald’s she wasn’t going to write one for new pants.

The big test of how I was recovering was the first of the five trips – a drive to Las Vegas to spend another Christmas with my brother and sister in law.

I wasn’t exactly sure I was ready for a nine hour drive to Las Vegas. (For the past eight years or so I’ve always driven to Las Vegas – when you factor in time to get to the airport, TSA line delays, flight delays, planes having to return to the gate at least once – mine always do – and other things, it doesn’t take a lot longer to drive. And you have the luxury of leaving whenever you want.) And I was driving on Christmas day, so my normal Costco pit stops weren’t going to be open. In addition to hot dogs, soda, and pizza, Costco also is a sure place to find a clean restroom, which is a Very Important consideration these days!

A non-trivial amount of planning involved figuring out how to deal with the potential lack of clean restrooms. As always Amazon (and the internet) came to the rescue: portable toilets (aka camping toilets)! Fortunately I didn’t need to use it on the trip – as it turns out most Starbucks have clean restrooms and are open on Christmas day – but it put my mind at ease to know it there for an emergency.

Follow-up Colonoscopy

The Monday after Thanksgiving was the follow-up colonoscopy. The primary purpose was to check on how the anastomosis site (the place where the plumbing got reconnected) was doing. And to check for polyps, which would determine whether I needed another colonoscopy in a year (polyps found) or three years. A suggestion to all of you: don’t schedule a colonoscopy right after Thanksgiving. You’re on a restricted diet for a week before it, something I’d conveniently forgotten. Fortunately turkey and stuffing were OK (though green beans weren’t, which frankly gave me a good excuse to not eat them.) I had asked for the same gastroenterologist who did the colonoscopy in the summer of 2021 and started the whole journey. Interestingly when she came in just before the procedure she said she remembered me and JT, and was amazed at how well I took The News. I guess some people don’t do well even when they’re still somewhat sedated.

The colonoscopy itself was fairly routine. Until I woke up. While the procedure was still going on. One of the nurses quickly noticed I was conscious and said, “Uh-oh, he’s awake” and kept asking me if I was OK. I wonder what would have happened if I’d said no? Would he have administered more anesthesia? Why not just do that? Anyway at the time I was still somewhat out of it but for reasons I don’t understand there was a monitor showing the colonoscopy probe’s images right in front of me. Hmm. That’s weird there seemed to be staples. Then I heard the GI say, “There’s the staples.” So yes, I’d been stapled back together. My surgeon did mention something about that but had something of a grin at the time so I figured he was joking. JT later commented that their last roll of duct tape was probably used in the previous surgery. That’s what I get for wanting to sleep in a little and not be the first patient of the day. My personal theory is that the surgeon had to resort to staples because I failed to bring the chewing gum which was on the Things To Bring For Your Surgery list. (Supposedly chewing gum helps to get your GI tract going again post-op. But it also makes a suitable substitute for duct tape.)

Later, while the worn-off sedative had worn off a little more, I asked the GI if I’d heard her correctly and I’d been stapled back together. She smiled and said yes. Then the smile went away and she said that she was concerned because the anastamosis site was friable (meaning it bled easily). This is apparently Not Expected (for normal people anyway). She’d taken biopsies and was going to recommend a follow-up endoscopic ultrasound to check if there was any regrowth of the tumor.

Fast-forwarding a few days, the pathology results came back as granulated tissue, which was fine and just meant that the surgery site was healing very slowly. But she still wanted the EUS, so that got scheduled for late January.

Las Vegas and COVID

All through chemo and radiation I somehow managed to avoid getting COVID. It’s somewhat ironic that nine months after completing radiation and with a restored immune system that I finally got it. My personal theory is that viruses don’t like people undergoing cancer treatment. If you were a virus, would you pick someone who’s being poisoned and blasted with radiation, or some nice fit body that’d provide a nice home for your offspring? JT doesn’t think viruses are that smart. But they’ve been around for a long time. I think they know a good host when they see one!

I’m also pretty sure I got COVID while standing in a two-hour TSA line at the Las Vegas McCarren Airport during Trip #2. They’ve got you packed into a terminal with several thousand other people, many of whom may be masked but are still hacking away. What happens in Vegas may stay in Vegas, but TSA line souvenirs will follow you home!

This also reinforces that driving is much better than flying. The only reason I had flown was a very last minute (as in day before) change in travel plans that had me flying into Honolulu to see my Auntie Gail the day I was set to drive to Las Vegas for the Consumer Electronics Show. Fortunately a colleague who was planning on crashing my hotel room was able to check in for me so at least I still had a place to stay when I eventually got to Vegas. But on the way home, we left the convention center at around 2 PM. After TSA lines, flight delays, circling back to the terminal because of a broken seat belt, and the plane for some reason not getting authorization to take off, I finally got home around 1 AM. Or two hours later than if I’d driven back!

The bout of COVID itself wasn’t too bad. In fact the only reason I had done an at-home test three days after returning from Vegas was to be sure I didn’t have it. I didn’t really believe the positive result, but that night I felt like I had the beginning of a flu and the next day had a massive headache and definitely felt ill. I think the lesson here is don’t test yourself if you feel fine, or you might get COVID. It’s what they call a Heisenbug. Or maybe the test itself gives you COVID, so you’ll go see a doctor and get more drugs like Paxlovid. Which is exactly what I did. And guess what? I felt fine a day after starting the Paxlovid regimen, but five days after completing it COVID returned with a vengeance. It’s what they call “rebound COVID”. My PCP (who wasn’t the one who prescribed the Paxlovid) later told me he generally doesn’t recommend it unless you’ve got severe symptoms or are in a high risk category.

The COVID episode ended up causing a reschedule of the EUS, which eventually happened in March. The gastroenterologist doing the procedure asked if I wanted to skip sedation since it was going to be a quick procedure. Who’s he kidding? The procedure was listed as “Sigmoidoscopy (flexible, diagnostic) with endoscopic mucosal resection.” That word “resection” seems to imply cutting and resealing things. So of course I want to be sedated! And I let them know in no uncertain terms that I wanted to remain sedated throughout the procedure.

All went well. I didn’t wake up half way through to watch the gastroenterologist image a tumor or mumble to himself about finding my surgeon’s long lost scalpel. And all the biopsies were negative. So at least for now I’m still officially in remission.

Notable Events

Happy Birthday JT! Buttercream frosting and strawberries sandwiched between two layers of moist vanilla cake and covered with more buttercream frosting and a thin layer of Rice Crispy treats. Recipe shamelessly copied from Zippy’s.

I know many of you who subscribe to the posts really do so because of the occasional food article. So here you go…

A group of friends (colloquially known as the “wine group”) got together to celebrate JT’s birthday. She requested I bring Spam musubi. So of course I made some. And something extra.

Twenty years ago when I first introduced the group to Spam musubi they prodded it with trepidation. One even called her husband to complain, “Mike’s making me eat Spam!” (Her husband, being more down to earth, asked, “Well, does it taste good?”) Let’s just say the group is now quite fond of it.

I also brought this. Believe it or not a platter like this sells for $50 in the Bay Area?!

In the 20+ years we’ve been exploring wines I don’t think we’ve considered which pair well with Spam. It seems others have. Pinot Noir gets my vote! With Beaujolais Nouveau, and Riesling as close seconds! The “dessert Spam” of course must be served with a late harvest Riesling. Mmmmm…..

Lessons Learned

  • Ask your doctor about any immediate side-effects or restrictions related to anything being prescribed, whether a minor procedure or a vaccine. Then ask the nurse.

    Case in point: My medical oncologist referred me to dermatology for a lump on my right shoulder. I’ve noticed oncologists get worked up about lumps. Even ones that are supposed to be there – like the mediport I had for a while (even though she ordered the mediport, every time she’d probe my chest she’d inevitably say “What’s that?” when she got to the mediport.)

    A clinic nurse had declared it a dermioid cyst but three months later (clearly not a “stat” referral 🤣) the dermatologist said it didn’t look like one. She recommended excising it so we could be certain what it was. She even said if I had half an hour she could do it then. Great! Or so I thought. After she had sliced open my shoulder she paused and asked, “You aren’t doing any travel soon, are you?” This was the week before Thanksgiving. I told her no, and asked why. She was worried about lifting luggage and said I can’t lift anything heavier than five pounds or so. I asked what about a turkey? She paused for a bit then asked if I had any family members who could convey the turkey to and from the oven. Her nurse who was assisting also suggested that I should also get said family members to vacuum, and while they were at it they could clean the toilet too. Because apparently cleaning the toilet involves lifting things weighing more than five pounds. Well my sister and her family were showing up for Thanksgiving, and when I relayed this bit of news she offered up my two and a half year old niece to handle the vacuuming. Needless to say I elected to haul the turkey around and do the house cleaning myself. Fortunately the stitches held.

    Oh, and that lump turned out to be a non-cancerous cyst of some sort.

    Case in point: The day before I was heading off to Las Vegas to attend the National Association of Broadcasters convention I had my annual physical. My PCP suggested I was overdue for a shingles vaccine, but when I told him I was driving to Las Vegas the next day he said it wouldn’t be a good idea to get Shingrex and we’d do it next year. For reasons he couldn’t determine the pneumococcal vaccine was also on my chart. Apparently you’re supposed to get that when you’re 65. He couldn’t figure out why it would be recommended for me, but didn’t see any harm and neither did I. And he said there’s no reaction so I said go ahead. He went off to tend to his next patient and a nurse came in to administer the vaccine. She remarked that I was young to receive it, and I responded that I have no idea why I’m getting it but as long as there aren’t any side effects I’m game. Her response, as she jabbed me with the needle: oh you might just feel like you’ve got the flu for the next couple days. What?! Didn’t I just go through with my PCP that I’m driving to Vegas and attending a conference?! Fortunately I felt fine for the next couple days (aside from having to wake up at 6 am two days in a row – I’ve let the pre-convention conference people know that registration at 8 am is Not A Good Thing.)
  • Don’t take Metamucil right before having a glass of wine.

    At the urging of my surgeon I’m taking Metamucil, which does help with the “GI tract issues.” However one thing I noticed is that if I have a glass of wine shortly after the Metamucil I don’t get that nice buzz I used to. (The wine is of course being consumed for purely medicinal reasons – the tanins are heart-healthy! That you happen to get mildly buzzed is just a pleasant side-effect. 😁). Well if I wasn’t absorbing alcohol I probably wasn’t absorbing tanins either. The label on Metamucil does suggest not taking it either immediately before or after taking medication, and since the wine is medicinal clearly it needs to be taken before the Metamucil.

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