Nine Days, or Wound Care for the Clueless

scrabble-cat

Sumi, my first Scrabble partner at last week’s tournament.  I think his name is supposed to sound Japanese, although to me it just sounds litigious.

Monday

It rained most of last night and it’s still raining.  The Cosumnes River is expected to overflow (again) by Wednesday if this keeps up.  The weather people say this will go on all week.

My second day out of work.  I am missing a big conference that I organized.  Tomorrow, I am supposed to train staff over in the Napa Valley, but I have sent a subordinate in my place.  I try not to think about work too much, instead concentrating on what I can do to help my wife.

It’s a lot easier not having to apply those bandages every couple of hours.  The disposable Depends are very convenient and I thank God for them.  Unfortunately, my wife’s feet are starting to swell.  I send an email to her doctor but receive no response.

My wife’s cousin comes to visit, bringing along larger pairs of Crocs and some slippers that make it more comfortable for my wife to walk around.  More importantly, however, she is going to help my wife learn to inject insulin.  At the hospital, they found that her diabetes is out of control and that this was the likely cause of her infection.  We’ve both been on oral blood sugar lowering medication for some time, but we had no idea it had gotten this bad.  I just had my own A1C read a few days ago and was still within a reasonable range.

Typically, my wife checks her blood sugar only once in a while.  I don’t do it at all.  Sharps of any kind freak me out.  I have had nightmares about syringes and needles since childhood.  So now we have two types of insulin on hand for my wife, slow acting for bedtime and fast acting for before meals.  Now she gets to check her blood sugar and inject insulin throughout the day.  I pinch myself but am unable to wake up from my nightmare.

While my wife is getting an injection lesson, I head out to do the errands.  Gas up the car, visit two supermarkets, pick up mail from the post office, return a large load of items to Walmart.  My nieces had gone shopping to pick up some supplies for my wife on the day she was discharged from the hospital.  Unfortunately, most of what they bought turned out to be unneeded or didn’t work for us.

The rain continues to fall and we wonder if the power will go out when the winds pick up.  Insulin, I have learned, must be refrigerated.

I drive around town with the wipers going, getting wet at every stop.  My wife usually does most of the driving, which suits me fine.  I have never enjoyed driving and have never been very good at it.  For decades, this was an embarrassment to my father, who had a long career as a driver education teacher.  My reluctance to drive was something of a family joke in my younger years.  Eventually, I got over it to some extent, even driving across country by myself on one occasion.  But when I think of the number of auto accidents I have had over the years, and the fact that my wife (who has been driving longer than I have) has never had an accident, I am glad that she does most of the driving.  So to head out in the rain, among drivers who are not used to inclement weather and are hydroplaning speed demons, is right on the very edge of my comfort zone.  My limited driving experience in the area inevitably results in a wrong turn that finds me in a part of town with which I am unfamiliar.  I turn around, stop and map every stop on my phone after that.

But I am in luck today.  My niece has called me for help in applying for a job online.  Cantaloupes are on sale for a dollar each at Sprouts.  I find a handicapped spot directly in front of the Walmart entrance, along with a conveniently located shopping cart to haul in all the returns.  I lean against the cart in the lobby, my jacket dripping, while the clerk takes forever to remove each item from the cart and then from their bags, scanning everything individually and issuing red stickers from his handheld point of sale device.  Then, of course, I still have to stand in line at the customer service counter and then wait while the clerk examines each item yet again.

Then it’s back out in the rain.

 

Sunday

8:30 am.  We wake up to the phone ringing.  It’s my wife’s doctor, calling a bit early.  We relate our woes, letting her know that we have only one bandage left, enough for one wound dressing change.  She suggests that we come into the clinic, open until 12:30 pm, no appointment necessary.  The nurse will check the incisions for signs of infection and will supply us with bandages.

Up and at ‘em.  Shower, clean and dry the incisions, apply the last bandage.  Out the door and head across town.  We’ve been to the clinic several times, as this is where I typically have my blood drawn.  We park in our usual place and start searching around for the clinic.  Most of the departments that we pass are dark and empty, befitting a Sunday morning.  We walk and walk, quite slowly, with my poor wife holding onto the wall.  We had no idea that we had parked at the wrong end of the complex.

We stop to rest on a bench, get a drink of water.  Elevator up to the third floor.  Walk some more.  We arrive at the clinic, check in, sit and wait.  Eventually, we are called, only to be told that we were supposed to have an appointment (despite what the doctor told us), that they have no supplies at that location and that there was no one to check the incisions.  Go to the emergency room, they tell us.

Understandably, my wife is angry.  We hoof it all the way back to the car.  We have a folded bedsheet in the car’s hatchback that we use as a liner.  I pull it out so that my wife has something soft to sit on.  I drive to the hospital.  Another car zips into the last available parking space in the emergency room lot.  A man relaxes in the car, cigarette dangling out of his month.  We wait for someone to leave so that we can park.  We spy a Staxi abandoned in the parking lot.  I grab it and give my wife a push across the lot and into the emergency room.  We wait in one line, then another line, then sit and wait to be called.  We contemplate a second emergency room copay in a week.

A nurse takes us in back, checks my wife’s blood pressure and send us back out to the waiting room until an exam room becomes available.  When we are finally called, I try not to be rattled by the moans and groans of the occupants of the other bays.  One woman yells out in pain every few minutes.  We are visited by a doctor, a nurse, a patient care technician.  They agree to hunt around for the bandage size we need.  Their initial search turns up empty, and they agree to check the fourth floor.  A few minutes later and, voilà, a tech shows up with a grand total of four bandages.  We could just purchase them online, we realize, at a price of $83 for eight bandages.  One such package would last us a day or so.

The nurse recounts how his wife had a similar incision and drainage due to an infection.  She used large size Depends rather than expensive bandages, he tells us.  Another alternative, he suggests, would be to use sterile gauze pads.  He asks me to glove up and try it out.  The first set of disposable gloves doesn’t begin to fit my distended hands.  He then exchanges them for a larger size that I am just barely able to pull on.  I soon realize that this exercise is for naught, as the nurse intends to apply the gauze himself.  To do so, he uses a large quantity of medical tape, crisscrossing the gauze in every direction.  This is going to be a doozy to remove later, I think, and I am right.  I found myself trying to release her from all that tape quickly when she needed to hit the toilet.  It was a painful experience for her, and I amazed that I managed to avoid pulling her skin off with the tape.

Next stop is Walgreen’s for a box of Depends.

 

Saturday night

9:30 on a Saturday night.  I’m calling around to the few pharmacies that are still open to try to find sterile bandages that are the right size to cover my wife’s surgical wound.  No one has heard of this type of bandage.  No one has another brand in this size.

At discharge this afternoon, the hospital gave my wife seven bandages to take home.  They did not tell us that this supply would not even get us through the night, never mind for the next couple of weeks.

Nor did they show me how to apply said bandages to my wife, nor did they explain how to clean the incisions.  I get to figure this out by myself.  Yay!

I call Kaiser for help, listen to inane recordings (I can now tell you quite a bit about their women’s hot flash and menopause clinic, as well as about their weight loss meal replacement program) and get transferred to three different people before I finally get disconnected while on hold.  I think:  Is this what socialized medicine is like in the rest of the world?

Kaiser calls back, apologizes for the disconnection.  Can we talk to your wife to make sure that we have permission to talk to you?  HIPAA (or “HIPAApotamus,” as one of the hospital nurses put it yesterday) has got to be one of the most annoying laws ever passed by Congress.  The nurse attempts to troubleshoot, seemingly aghast that, in all her years of service, she has never been asked such a question.  She suggests we return to the hospital floor from which my wife was discharged to ask for more.  (They had told us that we were given all the bandages they had.)  She suggests checking a medical supply store.  (On a Saturday night?)  We settle on a telephone appointment with a doctor in the morning.  By happy serendipity, it’s my wife’s regular doctor.

My wife points out that we have nothing to complain about, reminding me that we just talked to a health care professional on a Saturday night and will have a consultation with her doctor on a Sunday morning.  I step down from my high horse.

 

Thursday

My wife has been in the hospital all week.  I have been attending mandatory offsite training all week.  This turns out to be quite a combination.

I arrive at the training site across town an hour early to avoid traffic.  I dump my grits packets into my bowl and head to the break room to apply boiling hot water.  Then back to the training classroom, where I have some Earth Balance vegan margarine stashed in my bag for application to said grits.

I text a good morning to my wife.  She has had a bad night in the hospital, vomiting due to medication being pushed on her when she hadn’t eaten anything.  I can’t say that I blame her.  The so-called food there looks and smells positively disgusting.

When the trainer sends us on a break at 10:30, I check my phone and find that my wife has texted.  She has to have surgery tonight.  I try not to panic.  What kind of surgery??  She does not respond.

Lunchtime, I text my mother-in-law.  “Mom, are you coming???”  Yes, she says, along with my sister-in-law and my niece.  When class lets out at 4, I inform the trainer that I will not be present tomorrow for the last day of training due to my wife’s surgery.  She tells me I can make it up later.  I head straight for the hospital, where I learn the nature of the surgery and the plans to do it between 6 and 7 pm.  My wife’s family shows up, but when 8:00 arrives and still no surgery, they are ready to leave.  They have a 90-minute drive home and have to work tomorrow.  They disappear.  High-ho, the merry-o, the cheese stands alone.

The surgeon has been delayed, we are informed.  The previous procedure has taken much longer than expected.  The surgeon has to rest a little before performing the next one.

At 10 pm, orderlies arrive with a gurney to take my wife off to pre-op, all the way across in the other hospital building.  They walk fast and I can’t keep up with them.  It’s okay; I have a general idea of where I am going.  Turn right, turn left, turn right.  I am used to this part now.  Head outside.  Cross a bridge, then a roadway, then back inside near the emergency room.  Turn right, walk through a long ward, turn left, turn right.  Now I am lost and at the mercy of signs directing me to the appropriate elevator.  I make it to the surgical waiting room.  There is one other person there.  High overhead, near the ceiling, the TV is on.  I am unable to locate a remote to shut off the noise.

I check my phone periodically, but leave it off as much as possible, as it is quickly running out of charge.  I do not want to have a dead phone if I have to contact someone fast.  I should have had the forethought to take my niece’s phone charger, left back in the other hospital building, plugged into my wife’s IV pole.

Midnight.  I don’t know what to do with myself.  I have been up since 5:00 this morning and try not to fall asleep.  I try to ignore the idiotic drivel on the TV.  I walk down the hall, walk back.  I flip through the magazines.  TimeNational Geographic.  Most of them about a year old.

There is a cart full of books and I peruse the titles.  Mostly Reader’s Digest condensed novels (which I refuse to read as a matter of principle) and paperback romances.  I settle for one of the few other items, a legal thriller by Brad Meltzer, The First Counsel.  I move to the other side of the room and read the first couple of chapters.  Some guy is dating the president’s daughter and they go tearing up D.C. on a Saturday night in an ultimately successful effort to shake the Secret Service detail.  A lot of reckless (but not wreckless) driving is involved.  Also a visit to a gay bar and a drop-off of a big stack of cash in a manila envelope out in a remote area.  Poorly written and boring, I think.  I set the book aside.

About the time that Jimmy Kimmel appears on the tube, the phone rings at the deserted information desk in the corner of the surgery waiting room.  My sole companion rushes to pick it up.  He listens for a moment, then starts yelling.  Something about that he should have been informed earlier that they were going to transfer his wife elsewhere.  He slams down the receiver and storms off toward the elevators.

Now I am alone.  Just me and the year-old mags and the romance novels and Jimmy.  At one in the morning, I get the bright idea to use the info desk phone to call the recovery room and see if I can find out anything about what’s become of my wife.  After all, the phone number is right there, laminated for all to see.  Sure enough, they tell me my wife is in recovery and that I can come down.  They give me directions, which are either lamentably poor, or perhaps I am just a dunderhead who can’t follow directions.  I try several wrong doors and hallways before I find the right place and knock on the big double doors.  A staff member comes out to get me.  I ask why they hadn’t called the surgical waiting room and I am told that my wife just came out of surgery a few minutes before.  She looks pretty good for just having been cut, I think.  The anesthesia has not made her sick.  A doctor comes by and gives me the rundown.  My wife asks for water, and it is a while before I can get anyone to bring some.  We are told that she can be wheeled back to her hospital room in about half an hour.  It is now two in the morning and I have been up for 21 hours.  My wife tells me to go home and get some sleep.

I head back out the surgery area and down the elevator, only to realize that I am in an unfamiliar location, likely way on the opposite side of the hospital from where I am parked.  I find a hospital map that appears to confirm my suspicions.  I sit down on a bench for a few minutes before I begin my hike.

After navigating a number of corridors, I regain my bearings.  I sit down by a deserted Starbucks coffee station and call my parents.  Mom said to call and let her know how the surgery went, regardless of the hour.  I tell her all about it.  I confess that I hope I can keep my eyes open long enough to get home.

When I arrive at the final door out to the parking lot, it will not open.  “Oh, come on,” I mutter to myself.  This is supposed to be an automatic door.  Who am I going to be able to find to help me at 2 a.m.?  I notice a sign:  “In emergency, push to open.”  Oh, man, I don’t want to do that, I think.  Alarms and crap are going to go off.

But they cooperate.  I am shocked when the doors fly apart and I am outside in the damp, night air, just a few feet from my waiting vehicle.

 

Wednesday

This is my wife’s second hospital stay of our married life.  Last time was nine years ago, when we lived in Fresno and she landed at St. Agnes Hospital (referred to locally as “St. Agony” or “St. Anguish”) after contracting a virulent strain of flu.  They stuck her in the quarantine ward, fearing that it was the dreaded H1N1, which it turned out not to be.  I’m hoping that the script is more or less the same this time, complete with a prompt discharge, some pills to take home and a rapid recovery.  But I know that this time is different.  I can feel it.

The quarantine ward at Saint A’s was annoying for visitors, who were required to don a gown, hat and gloves (an outfit you can really sweat in).  For the patient, however, it was nice and quiet.  The 1 West building at Kaiser Hospital in Sacramento could be described as the diametric opposite.  Daytime and nighttime blend into a haze of 24-hour alarms, beeping IVs, patients yelling, nurses and patient care technicians coming and going.  Always someone talking and some machine going off, demanding attention.

Across the hall, a homeless man with apparent mental issues is giving every staff member a hard time.  He raises his voice, argues with everyone, complains about everything and uses the F-word in place of every comma and period.  Tonight, he is griping vociferously that the staff had promised to put a second dinner tray, cornbread chicken, aside for him.  Now he’s hungry again and he wants it.  Unfortunately, the staff can’t seem to locate it.  He makes his anger known repeatedly and loudly.  It is past dinnertime and the staff attempt to placate him by offering whatever leftover trays they can find.  No chicken, but he can have fish.  Oh, but he doesn’t want fish.  After ten minutes of arguing, he tells them to just bring him everything they have.  When his food arrives, he wants salt.  He’s not supposed to have salt.  He starts yelling, finally accepts some Mrs. Dash.  My wife informs me that, earlier in the day, he had become violent, throwing an applesauce so hard that it caromed across the corridor and into her room.

Days later, after my wife comes home and I find myself struggling to clean the incisions and apply bandages, she asks me if I’d rather that she return to the hospital.  I stutter, not knowing how to respond.  No, I do not want you to still be in that hellhole where it’s impossible to get a moment’s peace and quiet, not to mention a few hours of sleep.  Yes, I want you to go back to the hospital where there are people who know what the hell they are doing.  I am so afraid of the incisions getting infected due to my incompetence.  Maybe I’m selfish because I’m lonely here without you and I’m so glad you’re home.  Maybe I’m selfish because this is so much work and I’d rather someone else do it.  Either way, I’m a terrible husband.

Eventually, hospital staff and the home health nurse tell me I’m doing a fine job.  Talk about dumb luck.

Tuesday

The trainer starts today’s class with an ice breaker.  Everyone is supposed to stand up and tell one thing that’s happened within the past 24 hours for which he or she is grateful.  We hear stories of good news at work, good grades reported by grandchildren, sports victories.  When it’s my turn, I say “I don’t usually drive, so I’m grateful that I was able to find this place today with only one wrong turn.”

I expected that my wife was going to give me a ride all week.  I did not expect that she would end up sick in the hospital.

I leave the house at a quarter after six, having mapped the location on my phone.  I try to remember my landmarks.  Go past the 80 freeway, past Grand Avenue and turn left on Arcade.  Get on the Capitol City Expressway and stay in the far right lane.  Get off at the 160 freeway and then off again at Canterbury.  Turn right on Leisure Lane, right on Slobe, left on Commercial, right on Lathrop.  Yes, I am grateful for having found this place without getting lost.

After class, I head back to the hospital.  I have mapped it, but I find myself in the wrong lane by the mall and have to find a place to turn around.  I won’t make that mistake again, I think.

I know from yesterday’s experience that there is no place to park anywhere near the out building where my wife’s hospital bed is located.  I also know that I don’t want to have to do that big outdoor walk over the bridge again.  So I park near the medical office building, which is connected to the main hospital, but not to the building where my wife is.  It’s got to be the better part of a mile walk over there, I think.  I’ll just have to walk slowly and do the best I can.  Follow the signs.  Too bad Google Maps won’t help me with the inside of hospitals.

And then:  Just as I get out of my car, I hear my name called.  It’s the husband of my wife’s cousin.  Cousin is visiting and hubby decided to take a walk and figure out whether there’s a faster way to get from the car to my wife’s hospital room.  I tell him I need to try to walk inside as much as possible and that I was hoping to find a staff member who would give me a push over there in one of the hospital’s personal transport chairs, known as a Staxi.  “I’ll push you,” he immediately tells me.  “God is good,” I mumble.  We walk to the information desk, he installs me in a Staxi, and in five minutes he has pushed me all the way over to my wife’s room on the other side of the complex.

Late at night, when I leave my wife’s side, I am not so lucky.  There is no cousin’s husband and no staff member to help me.  I get to hoof it solo, slow and steady like the tortoise.

 

Monday

It’s my first day of a pain-in-the-neck weeklong mandatory training class.  You’re supposed to take this class as soon as you’re promoted to manager.  After two years as a manager here (and a couple of decades elsewhere), someone finally figured out that I hadn’t had the class yet.  Busted.

Actually, this is only the first half of a two-week training class.  I am scheduled for the other half at the end of the month.  To make matters worse, we have a statewide conference on the very day that I return to work.  Fortunately, I have set it all up in advance.  Then there are deadlines that I must meet and training trips that I have to take.  The timing is very bad indeed.

I don’t do much driving around town and have no idea how to get to the out-of-the-way neighborhood where the training center is located.  My wife has not been feeling too well, but she is familiar with the lay of the land (having grown up here) and drives me over.  She seemed to be feeling a bit better on Saturday, when we had a big family gathering at a restaurant in honor of my birthday.  Yesterday, she seemed tired, although she woke up with me and cooked some food for me to take to the Scrabble tournament in Berkeley.  This morning, she was upset that I had not woken up early enough and that I might be late to my first day of training due to the traffic.  We just make it in time.

Since my wife was upset with me, I paid attention to how she zigzagged from one side road and freeway to the next to get to the training center.  You know, just in case she were to decide she didn’t want to drive me anymore.  I had no idea how important this would end up being.  I had no idea that she’d be in the hospital for the next week.

When the trainer sends us on our first break of the day, my wife texts to let me know that she was able to schedule an 11 a.m. appointment with her doctor.  Same-day appointments are hard to come by, and even more so with one’s own doctor.  She asks me whether she should go.  Yes, please go, I tell her.  I’ve been telling her that the boil that’s come up on her skin looks infected and needs to be checked.

At lunch, I call her.  She tells me she vomited in the exam room and the doctor said she had a fever and needed to go to the emergency room.  She was on her way there.  I wonder to myself whether she’ll be admitted.

When I don’t hear from her for the rest of the day and she doesn’t show to pick me up, I know what has happened.  I call the hospital, endure the inevitable transfers from person to person, and eventually reach someone in the emergency room who informs me that she is still there.  “She’s on the sicker side,” I’m told, and will be admitted.  Problem:  I am in a distant part of the city with no transportation.  As bad as I am with anything technological, I manage to figure out how to download Uber on my phone.  Soon, a ride to the hospital is headed in my direction.

The driver is very kind, driving around the emergency room parking lot until I find our car.  He even helps me load my belongings into the trunk.  I give him a tip out of the few dollars in cash that I have on me.

I check in with security, receive a stick-on badge and am pointed in the direction of the bay where I find my wife.  Due to the fever and infection, she has been admitted.  They are just about to wheel her over to a hospital room in another building.  “We’re going outside,” the orderly tells her.  “Are you going to be warm enough, or do you need another blanket?”  Outside??!!  You mean these buildings are not connected?  What the heck do they do when it’s pouring down rain?  “This is California,” I’m told when I ask.  “We love the fresh air.”

“Idiots,” I think.  “This would never happen back in New York.”

I can’t keep up with the gurney, despite the fact that the orderly stops several times when I fall way behind.  This is quite a walk.  Head outside.  Down a little path, across a bridge, then into another building to wind around more corridors.  About 30 minutes later, my mother-in-law shows up with her daughter, granddaughter and little great-granddaughter.  My wife is hooked up to an IV, on heavy-duty antibiotics, fluids, insulin.  The family tells me to go home and sleep, they have it under control.

Sleep sounds good to me, but it means that I have to find my way back to the car.  I hadn’t the forethought to leave a trail of bread crumbs, Hansel and Gretl style.  I’m told that I have to go outside and walk over a big bridge to reach the emergency room parking lot where our car is.  Now, I don’t do well walking outdoors.  If there is the slightest bit of wind, I can’t breathe.  My agoraphobia kicks in and I panic.  How the heck am I going to do this???

You have to do it, kid, I tell myself.  You need to be an adult and take care of your sick wife, not make a scene.  “What’s the worst that can happen?” I think.  After all, I’m at a hospital.

I head up over the tall bridge, trying not to hyperventilate.  There’s barely a hint of a breeze, which is very much in my favor.  On the other side, I see the emergency room entrance and a large parking lot.  I wonder whether this is where the Uber driver dropped me off.  And I wonder whether I should go sit in the emergency room for a while to fortify myself for the remainder of this outdoor walk.  No, I tell myself, I must be almost there.  I see the edge of a building, and as I come around the corner, there’s the car.  I made it.

 

Sunday

Berkeley is about 80 miles west of Sacramento via Interstate 80.  Eighty on 80.  This will be my second Scrabble tournament there, my first having been just recently, on New Year’s Day.  I performed very poorly on that occasion, having lost every game.  But I’m a glutton for punishment and I’m back for more.

To me, competitive Scrabble is a lot like playing the video poker machines in Reno, another pastime I enjoy.  It’s not about winning or losing.  It’s about playing the game.

Although I’m not a very good driver and am not good with directions, this is one trip even I can pull off successfully.  The tournament is at the director’s house.  Our homes are each about a mile from the freeway.  Only the long stretch of I-80 stands between me and a good fight over a Scrabble board.

Last time, I had to lug two heavy bags up the host’s steep stairway.  One bag carries my Scrabble board and equipment, the other my food.  There is always plenty of food at a house tournament.  When you’re vegan, however (and gluten-free to boot), you know to bring your own.  I had a hard time pulling those bags up, one at a time, step by step.

I didn’t really know what to expect.  I found out about the New Year’s tournament from a bare mention in an email sent out by another director.  It was our host’s first time directing, and she didn’t publish the particulars in advance.

Now, however, she’s learned by experience.  An email went out to participants with all the details.  Last time, there were an odd number of competitors, and most of us had to have a “bye” (sit out a round).  During my bye, I made the mistake of sitting on my host’s sofa in her living room.  I sunk in and couldn’t get up.  Fortunately, our host is a personal trainer who is strong and extremely physically fit.  She grabbed my arm and pulled with all her might.  She nearly fell over backward, but she got me up.

This time, as soon as I entered, our host informed me that she had set up a playing room downstairs in addition to the upstairs tables.  Would I perhaps like to stay downstairs?  Hmm, and avoid lugging everything up that flight of stairs?  Oh, yes!

The host had warned attendees in advance that she has cats, but that they stay downstairs.  One of her feline friends, an amiable orange tabby, took a liking to me as soon as I sat down and set up my Scrabble board.  After the obligatory scratch of the belly and behind the ears, he decided that I’d do just fine as a Scrabble partner.

And so I started off the tournament with a smile, and even managed to win one game this time around.  I enjoyed munching on the soy meat and potatoes that my wife had prepared that morning.  Happy birthday to me!

I had no idea that I’d spend the rest of the week going back and forth to the hospital.

 

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Men Get Mammograms, Too

Today I experienced something that few men ever do.  I had my first mammogram.

Yes, men do get breast cancer. About one out of every thousand males is so diagnosed.  This translates to only about 1% of all breast cancer cases.  Granted, this is nothing compared to the one out of every nine women who find themselves with breast cancer at some time of their lives.  But neither does it mean that we men are exempt because of our gender.

I had been warned that getting a mammogram is uncomfortable.  For me, however, the chief source of discomfort was being a man stepping into a woman’s world.  You feel like an intruder, like you don’t belong there.  A woman in a paper gown steps out into the corridor and I instantly avert my eyes.  I remind myself:  This is a medical procedure, this has been approved by my doctor, this is for my own good.  (Shudder)

I grit my teeth and navigate the bureaucracy that is Kaiser.  I go to the location where my doctor sees patients and get my unrelated bloodwork done.  Then I step into radiology and “take a letter” (a laminated ticket marked by a letter rather than a number).  I suddenly get the feeling that I am in the wrong waiting area and walk back to check.  It appears that the outer room is the “waiting room” and the inner room the “waiting area.”  I go back and sit down.  I read work email on my phone and play a few Words with Friends turns until I hear “Letter F!”

I return to the counter in the narrow vestibule.  “What’re you here for?” asks the woman behind the cutout window.  Having been listening to other patients come and go, I know the choices are X-ray, ultrasound or mammogram.  Still, I am tempted to answer “second degree larceny and committing lewd acts with a chicken.”

“I am here for a mammogram,” I tell her.  Words I never thought would escape my mouth in all my days on earth.  Ms. Kaiser makes a face and then quickly recovers herself.  I can hear her thinking “You have got to be kidding me, son.”

“Men have to get mammograms sometimes, too,” I blurt out.  I read my medical record number off my phone, which I have now provided so many times that I should have the darned thing memorized.

She spends an inordinate amount of time studying something on her screen.  She turns around and consults with another employee.  “You’re gonna have to go to Point West.  We can’t do it here.  There has to be a radiologist present and we don’t have one here.”

Dismissed.  Welcome to the wonderful world of managed care.

“The wait is an hour to an hour and a half.  You want me to make you an appointment?”  I say yes and she calls over there, but it just rings and rings.  When she tells me that they don’t answer their phone, I reply that I’ll just go and wait.

“I need the address, please,” I tell her.  I’m still new to Kaiser and unfamiliar with their dog and pony show.  She writes something on the back of a card and I make a hasty retreat.  My wife is waiting on a bench just outside the front doors and I give her the news that we have to trek clear across town.  I decide not to mention how long we will have to wait, as she is already pissed off because she is drowning in work and should be at home on her laptop doing it.  I hand her the card.  This isn’t the first time that I’m glad she grew up in Sacramento.  I seldom drive and basically have no clue how to get from Point A to Point B.  Yes, I know, we’ve lived here for a year already and I should get off my butt and learn how to get around.

On the drive over, I decide to face the music.  “I’m probably going to have to wait a really long time,” I sheepishly admit.

“You don’t know that!” my wife snaps back.  She knows how pessimistic I tend to be about everything.  “Yes, I do,” I protest.  “They told me it might be up to 90 minutes.”

My wife drops me off at the Point West facility entrance and I hike down a long corridor to radiology.  This time I’m dealing with a male employee.  I breathe a sigh of relief and hope he’ll be more sympathetic than they were at Fair Oaks.

No such luck.  I tell him I’m there for a mammogram, which, despite assurances from my doctor, they would not do at the other location.  I tell him a radiologist has to be present and I practically throw the card at him.  He looks at me like I’m from outer space.  He consults several times with a female colleague.  Turns out he doesn’t know what code to enter in the computer.  Apparently “mammogram” is not a choice on the screens for male patients.  That’s Kaiser for you.  Thrive, my ass.

Is this an initial?  Yes.  Diagnostic?  Did you feel a lump? Do you have discomfort?  Any breast cancer in your family?

Just when I think they’re going to send me away, the two employees finally figure out how to do some kind of manual override.  “I was told I don’t have to have an appointment,” I whine.  I really don’t want to have take time off of work (and have my wife take time off from her work because I don’t know where the hell I’m going) to come back another day.  Okay, let’s be honest, I just want to get this done because I don’t want to have to go through it all over again.

Having parked the car, my wife shows up just as I arrive in the waiting room.  She is getting upset because her work isn’t getting done and she believes that I don’t respect her time, which is quite reasonable considering a stupid thing I did recently.  I have sleep apnea and have a CPAP machine to help me breathe at night.  The thing is old and decrepit and needs to be replaced.  I have an appointment for the equipment to be examined next week at yet a different Kaiser location.  I asked them if I could just send my wife with the equipment and they said no, the patient has to be present.  My wife was pissed that I would even ask such a thing and she is 100% right.  I amaze myself at the depth of my idiocy sometimes.

Just like in the other place, neither my wife nor I am quite sure that we’re in the right waiting room.  But in just a few minutes, the door to the inner sanctum opens and a technologist with a heavy eastern European accent calls my name.  She walks me to the examining room, where I find that she is as confused as everyone else.

“How long have you had Kleinfelter’s Disease?” she asks me as she looks at my medical record.  I am appalled at her ignorance, but try to be polite because, after all, this woman is about to handle my breasts.  Um, yeah, she could hurt me.  I explain that it is a syndrome, not a disease, a chromosomal disorder that one has from birth and that gynecomastia is a common symptom, often suppressed by testosterone therapy, which ironically increases the odds of breast cancer.  Some of the literature discusses the advantages of having a mastectomy.  This is something, like breast cancer, that I prefer not to think about.  Not yet, anyway.  Thoughts of chemotherapy, my hair falling out and getting sick at work in front of management flash before my eyes.  I shake it off and remind myself that this is just routine, preventative.  Pull yourself together and get this done.

The procedure itself is no big deal.  She smashes me pretty well into that machine, which is what I fully expect based on the sign on the wall announcing “We compress because we care.”  The Nick Lowe song “Cruel to be Kind” starts playing in my mind.

“I torture people all day long,” the tech reassures me.  Just where is that accent from?  Poland?  Ukraine?  Chechnya?  Just before I went in I had pulled out my phone to find that I had a missed call from someone in, of all places, Russia.  One of sadistic Ms. I Love Torture’s relations, perhaps?

“Don’t breathe,” she tells me each time she gets my breast in just the right position to take the next picture.  After repositioning me several times on one side and then repeating the exercise on the other, it is over.  She tells me to wait while she takes the pictures out to be examined by a radiologist.  Five minutes later she returns and tells me that they didn’t find anything and I don’t have to go for an ultrasound.  I put my shirt back on and prepare to get the hell out of there.

“Come back any time you want me to torture you some more,” the tech tells me as she disappears around a corner.

Men as well as women are encouraged to perform breast self-examinations on a regular basis.  Learn about the warning signs of breast cancer in men here.

 

I Don’t Need to Be Reminded

Friday night.  Just chillin’.  I just made a fresh batch of guacamole, I’m flipping through blogs and a song in Japanese wafts through my headphones from my Spotify feed.  I don’t understand a thing the singer is telling me, but her plaintive voice is lovely and the horns, bells, flute and strings backing her up send me into a state of relaxation that seems perfect for the end of a busy week.

The Net is rife with stories about comedian Garry Shandling, who died this week of a heart attack at the age of 66.  For reasons not entirely clear to me, the coverage irks me beyond all reason.  My Zen-like state is gone.

I’ve never been much of a television watcher, so the first time I ever heard of Shandling was during a visit to the old NBC Studios in Burbank back in the 1980s.  (Side note:  I found it somewhat sad to learn, while performing research for this post, that NBC’s TV broadcast operations have since moved to the roller coaster, Harry Potter schmaltz of Universal Studios.  And today’s so-called studio tour?  Its “video host” in Hollywood is Jimmy Fallon, who actually records The Tonight Show a continent away at NBC’s 30 Rockefeller Center studios in New York).

Thirty years ago, I lived in New York and was visiting California for the first time.  I stayed over a few nights with cousins who lived in a gorgeous San Fernando Valley home that was destroyed by an earthquake just a few years later.  They even lent me one of their cars, which turned out to be a comical experience.  For one thing, this was my first time driving the LA freeways.  In the days before GPS and smart phones, I depended on a road map to navigate the labyrinth of freeways that seemed to weave in and out, over and under in a tangled web.  As if that weren’t enough, I quickly realized that my cousins’ speedometer was broken!  So there I was, whizzing along with the high-speed traffic, not really knowing where I was going and trying to drive fast enough to keep up with the flow but slow enough to avoid a speeding ticket.  Somehow, the parking lots that are the Long Island and Cross Bronx Expressways seemed tame by comparison.

I made it to Burbank and participated in the NBC studio tour.  Naïve yokel that I was, I found it thrilling to sit in Studio 1 where The Tonight Show was recorded, before the famous multicolored curtain and the star on the floor where Johnny Carson stood to deliver his monologue.  The group was told that we could return at 4:00 pm to be in the studio audience for the taping, but that Carson would not be there that day.  In his place, I learned, was someone named Garry Shandling (who?).  “He’s very funny,” the tour guide assured us.

Well, excuse me, I didn’t come here from New York to see some Garry Shindig or whatever the heck his name is!  I left extremely disappointed and did not return for the taping.  Today, of course, I would have checked online in advance and determined the proper day to go.  But back then, being a tourist was largely a hit or miss proposition.

While rabid Shandling fans would undoubtedly disagree with me, he will never be on the “A list” in my book.  Yeah, yeah, I know he had a couple of shows of his own.  Call me a meanie if you will, but to me he is not in the same league with comedians such as Carson, Leno, Fallon, Robin Williams and Jerry Seinfeld.

But I digress.  Depending on which website you visit, you’ll see that Shandling was in good health or that he had medical problems.  Pick one.

One of our local television station’s news programs used his death as an opportunity to educate viewers about the dangers of being out of shape as we age.  Obesity, diabetes and high blood pressure are killers, the anchor intoned solemnly, and the average age of fatal heart attacks has now lowered to 60.  The big mistake people make, he continued, is in thinking that controlling conditions with pills is the answer instead of exercising, eating right and losing weight.  So, I guess this means that I am going to die shortly and join Garry Shandling in that great beyond.

Thank you so much for reminding me.  I’d better get my affairs in order, call a lawyer and make out my last will and testament.  Time to buy that cemetery plot.  And, by the way, shame on those nasty doctors for making me take all those pills for nothing!

Apparently, the fact that a lot of us have been fighting (and losing) uphill battles against these conditions since the days of our youth isn’t sexy enough to make it onto TV.  Believe me, we are all aware that we are ticking time bombs and that our days are numbered.  We’ve been to a million doctors, had a million tests, taken oceans of pills.  Meanwhile, we try not to dwell upon our conditions so that we can live some semblance of a normal life in whatever time remains to us.

I’m just glad that I’m not a public figure.  This way, the media circus can’t make an example of me when I’m gone in a misguided effort to educate us regarding health conditions that we are either intimately familiar with or else don’t give a damn about.

Garry, you’ve really made my day.

 

College Buddies

So I knew these three guys back in college.  You know the ones:  The easygoing, happy-go-lucky types who never bothered to go to class and always knew how to get you hooked up.  For quite a few of us, they were our best friends.  And as I wax nostalgic today, I wonder what are the chances of catching up with them again, perhaps on Facebook or Craigslist.  My best buddies from a simpler time of life.

Jim Beam.  Jack Daniels.  José Cuervo.

Whoever said three is a crowd doesn’t know what they’re talking about.  We’d even (ill-advisedly) let a fourth tag along every once in a while, a charmer named Johnny Walker who was always broke, bummed drinks off the rest of us and stole our girls.

I wonder where these fellas are today.  My guess is that one went to law school, another is still playing rock ‘n roll in dive bars for tips, and the last one was buried in a pauper’s grave somewhere.  Maybe I’ll look for them under “Missed Connections:  100 Proof.”

I try not to live in the past, so it’s not that often that I think of college days.  When I do, I don’t bother to don the rose-colored glasses.  My college experience was not what one would characterize as halcyon, really more like a pain in the ass.  I did a few things right (such as ducking and dodging the constant flood of illegal drugs in which the campus soaked like a bloody rag), but I also made a lot of mistakes, some of which proved I was dumber than a doornail.

I will never forget a college roommate who justified his drinking and drugging by insisting that the time to do it is when you’re young.  If not now, when?  When I’m a sad old man who’s a drunk in the street?

I didn’t know those were the choices.  (And this was one of my better roommates!)

My three college buddies came to mind today in connection with my first experience at Kaiser.  That place is nothing if not efficient.  It is a veritable factory, where the goal appears to be to process as many patients as possible in the shortest time possible.  The brave new world of managed care.

I like my new doctor well enough, and I appreciate that I can email her and actually receive a response.  I like the convenience of “one stop shopping” with the lab and pharmacy being onsite.  It annoys me no end, however, that I explained that I needed a particular test, was told I don’t need it, went down the hall for my bloodwork, then was called a few hours after I got home because I’ve been scheduled for that test after all.

How does that song go?  “All doctors have beans in their ears, beans in their ears, beans in their ears…”

What tops that is that I received an email from my new doctor asking me to undergo a test that I clearly don’t need.  After using a few choice four-letter words, I emailed her back to explain the situation in detail.  She emailed back again asking that I consider doing it anyway.

Jim, Jack, José — I need you guys!

 

New York State of Mind

I moved to California in 1995 after a few years in New England, but I was born and raised in New York City and environs, and will always be a New Yorker deep inside.

I’d be hard-pressed to describe what makes one a New Yorker.  Well, for one thing, we know the difference between the Bruckner and the Deegan and whether it’s better to take the Whitestone or the Throgs Neck.  We love bialies and knishes and how to navigate the subway system.  We’re jaded and take every annoying inconvenience in stride (alright, so I’m not so good at that one).

For many of us who came of age in the 1970s, being a New Yorker meant nurturing a deep and abiding affection for Billy Joel and Barry Manilow.  Now, back in college, I was on the receiving end of a lot of (not so) good-natured teasing about my appreciation of Barry’s music.  But there is something about the hits of Billy Joel that scream “Big Apple” like nothing else.  My sisters and I deconstructed the lyrics of nearly every song on The Stranger, and I managed to have the chutzpah to quote the lyrics to “Allentown” in one of my college term papers after I devoured The Nylon Curtain in all its vinyl glory on the turntable in my bedroom.

There is nothing like hearing Billy Joel croon about The New York Times and The Daily News, “don’t care if it’s in Chinatown or on Riverside” to bring it all back to me in a flood.  Among my favorites is Joel’s early recording, “Summer, Highland Falls,” not only for the melody, but also because the place referred to holds some very specific memories for me.

So it was with great delight that I recently learned that SiriusXM satellite radio has launched, for a limited time, The Billy Joel Channel on Ch. 18.  Aside from the songs sending me tripping down Memory Lane, I am enjoying the interviews in which he explains the influences and inspiration associated with many of his hits.  And I have discovered a number of tunes with which I was not familiar, such as the amazing piano instrumental “Root Beer Rag.”

The timing of this is excellent, as Billy is placing me in the right frame of mind for a cross-country road trip to New York that we are planning to take a few months hence.  (More about that in a later post.)

I will conclude by mentioning that Billy Joel being piped into my ear buds from my trusty iPhone has raised my spirits greatly in the past week or two.  Believe me, I’ve needed it.  We recently switched health care plans through my job, and tomorrow, I get the pleasure of starting all over again with a new doctor at (cough, ack, eek!) Kaiser.  Medical stuff gets me depressed, and I am quite aware that I have plenty of it ahead of me.

I don’t care if you have to do a million tests and then cut me up and put me back together, Doc, just don’t make me use up all my annual leave so we can’t go to New York.  I mean it, Doc.

I’ll sic Billy Joel on you.

 

The Measles Comes to California

My mother called a few days ago to warn me that measles is going around.  Although I initially cocked my head and squinted an eye at this information, it turns out that she’s right.  An email notice sent out to state government employees yesterday stated that there are now 75 confirmed cases of measles in California.

At least to me, measles seems terribly old-fashioned, a disease that, like polio, should long ago have been vanquished by the miracles of modern medicine.  When I was a kid, the childhood diseases were measles, mumps, rubella and chicken pox (before it became fashionable to refer to it as “varicella”).  I managed to contract the last three, but certainly not the first.  Before parents could register a child in the public schools, they had to provide immunization records showing that their kid had been vaccinated against such dread diseases as smallpox, polio, diphtheria, tetanus and, yes, measles.

I imagine that measles must continue to be a vast public health threat in underdeveloped nations in which immunization is not widespread.  But here in the United States?  I think of Cheaper by the Dozen, in which the twelve Gilbreth children all came down with measles in the 1920s after they moved from Providence, Rhode Island to Essex County, New Jersey.  But that was a good ninety years ago.  Ancient history.

Mom listens to talk radio as she putters about the kitchen, and she told me about a local talk jock who characterized measles as a thing of the past only to have a middle age listener call in to say he had it as a kid.  Mom says it’s obvious that he doesn’t know the difference between “German” measles (rubella) and the real deal.

I suppose my mother has the right to be suspicious, considering that she really did have measles as a child.  She proceeded to tell me the story of how she was eight years old when she became sick with a high fever and then the famous spots.  Her mother never allowed her to stay home from school just because she didn’t feel well, but this was different.  It was one of the very rare times in her elementary school days that she couldn’t possibly go to school.  My grandmother was working behind a sewing machine in her brother’s factory at the time, and she felt that she could not stay home from work.  Thus, my mother had to stay home in bed alone.

Remember, this was about 75 years ago.  The really scary thing about measles back then was the high fever, from which kids died or were left deaf or blind.  Fearing for my mother’s eyes, my grandmother closed all the blinds, leaving my mother in a darkened room.  After a few days of this, my grandmother told her daughter that Aunt Rose, wife of the factory owner, would be coming to visit her during the day.  Now, Aunt Rose had a reputation as a nasty, vindictive person.  As evidence of this, my mother points to the time that she fell and scraped up her knee.  Aunt Rose tended to it by pouring boric acid on the wound.  My mother claims to remember to horrible pain still.  Well, on the day that Aunt Rose came to visit her little niece with the measles, she immediately pulled opened all the blinds and curtains to fill the room with light.  Then she said she would fix my mother some soup, if only she could find a match to light the stove.  Unfortunately, my grandmother had hidden all the matches for fear that her daughter, left alone and to her own devices, would burn down the entire apartment building.  So Aunt Rose ordered my mom out of bed, measles or no, to crawl on the floor on her hands and knees to look for a match under the stove and the refrigerator.  Of course, my grandmother had hidden the matches much better than that, and, oh well, there would be no soup after all.  Aunt Rose waltzed off on her merry way, and my grandmother was livid when she returned home in the late afternoon to find light streaming into the small New York City apartment.

I only hope that the measles does not turn into an epidemic in California, instead disappearing as quickly as it arrived.  Health officials are saying that it was introduced by a sick child visiting Disneyland during Christmas week.  I can see what a public health nightmare can develop in the blink of an eye by something as virulent as the measles.  I think about my own workplace, where more than two thousand of us are packed like sardines into 34 floors of tiny cubicles.  As it is, bronchitis went around recently and every single member of my team, including their fearless leader (moi), came down with it.  It took nearly a month and two courses of antibiotics for me to get rid of that nasty bug, and now a lot of us are coming down with colds again.  And it’s just barely February.  Clearly, winter is not going to go out with a whimper.

With a little luck, we may be fortunate enough to escape a plague of measles here in California.  For the time being, however, I am glad to have had two hour-long phone conversations with my mother this week, and particularly that she was in the mood to share some of her childhood stories with me.

Priceless.

Schizo

I never heard of schizophrenia until eighth grade health class.  Along with learning about the dangers of drugs and alcohol and the obligatory, highly embarrassing sex ed curriculum (from which my parents refused to excuse me, despite my entreaties), we plodded through a unit on mental health.  When we covered neuroses, I knew right off that the teacher was talking about me.  But it was the psychoses that were really scary, and I wondered whether I could secretly have one of those.

When we arrived at a discussion of schizophrenia, I was shocked (pun intended) to learn about such strange phenomena as multiple personalities, paranoia, delusions of grandeur, catatonia and hearing voices.  Alone in bed at night, I prayed to the Lord that I would never be afflicted with any of these horrors.

Mental illness, schizophrenia included, was still on the pedagogic menu when we were once again subject to the tortures of health class as juniors in high school.  By that time, I understood that I was not psychotic and was able to relax a bit.  I went on to take two psychology classes before I graduated, one of which included a visit to the local mental hospital.  My father humored me by driving me to the Vassar College library on quite a few evenings, where I researched a term paper on schizophrenia until the librarians threw us out and locked the doors.

Even today there is stigma associated with mental illness, but it was much worse when I was a teenager back in the seventies.  This was the era of Psycho, The Exorcist and One Flew Over the Cuckoo’s Nest.  My fellow junior high and high school students were openly derisive about anyone who appeared to deviate from the norm in any way, and never more than when it came to mental illness or developmental disabilities.  If we didn’t like something that someone did, they were “retarded,” “psycho” or “schizo.”  We bandied these terms about indiscriminately in the same way that many continue to demean the sexual preferences of others by saying “that’s so gay” (sadly, still “dropped on a daily,” Macklemore and Lewis notwithstanding).

It’s good to be able to say that some things have changed in the past forty years, however.  While the causes of mental illness have by no means been locked down, advances in scientific research have made inroads in our understanding of the nature and treatment of schizophrenia.

Still, it came as a bit of a surprise to me today when I learned that bacteria, of all things, are now being implicated as one possible cause of schizophrenia.  New research estimates that about one-fifth of all cases of schizophrenia may be attributed to infection by Toxoplasma gondii.

Now, wait a minute.  I know about toxoplasmosis.  When my sisters (both of whom have always had cats as pets) were busy having babies, my mother warned them to have their husbands clean the cat box.  It was known that cat feces could contain Toxoplasma, and that if this microorganism was transmitted to the blood of the fetus, the baby could be born with horrific brain deformities.

Turns out cat boxes are just the beginning, however.  Humans can also contract toxoplasmosis long after they are born.  T. gondii can also be transmitted through eating undercooked meat or by drinking contaminated water.  It is estimated that as many as 60 million Americans may currently be infected with T. gondii, and that some of them will develop schizophrenia as a result of the protozoan’s effects on their brains.

Just think of it:  One in five schizophrenics could have avoided a lifetime of misery and incapacity by avoiding infection by Toxoplasma.

Still want that steak done rare?

Sounds to me like yet another argument in favor of the vegan life.

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