24.) Sitting Here in Limbo

Well, the news was not what I had hoped it would be.   As I walked into the hospital yesterday and headed up to nuclear medicine, I was quietly rejoicing that my battle with cancer, at least this immediate round of warfare, would be completely over with, done, resolved, finished, or as we say here in Hawai’i, “pau.”  I’m so ready to close the book on this chapter of my life and move on.  I’m ready to just sort of melt once more into the background of my family and friend’s thoughts and prayers and for them to be able to pretty much forget about me and my needs for a while.  I was looking forward to the WBS (whole body scan), expecting clean scans that would, by the end of the day, provide a sense of relief that this cancer had been conquered.  Instead, I find myself right back where virtually all cancer patients often find themselves—just sort of hanging in limbo, waiting for more information, hoping for definitive answers.

The whole RAI (radioactive iodine therapy) and WBS has been an amazing experience; like something right out of a science fiction novel.  By the Lord’s grace, I didn’t get as sick as I had feared.  Far from the dungeon that I anticipated, the accommodations at Moanalua Hospital were wonderful; especially the giant, wall-sized, plate glass window overlooking Moanalua Valley that dominated my room.

Of course, everything was covered in plastic or paper, even the floor.  I was responsible for cleaning up after every meal, rinsing everything, and sorting all my own rubbish into separate hazardous wastes bags.  I was also responsible for taking all my own vitals every four hours and calling them in to the nurses’ station—blood pressure, pulse, oxygen level, temperature—and, if I forgot or was sleeping, they didn’t send in a robot spider to punish me; rather, they would simply buzz me on the intercom to remind me. My diet was extremely restricted and I basically ate the same three meals each day for three days with only slight variations.

The hardest part was just the isolation.  Not seeing or talking to anyone, except the nurses by intercom, for three whole days.  But that was okay, too, in that it provided some great “retreat” time to just be with the Lord.  I spent a lot of time looking out over the valley and talking with God.  Plus, I was allowed to open the windows and let the strong island trade winds blow through, which was nice for sleeping.  I also did a lot of reading.

The RAI itself was a simple procedure.  There was no hazmat team, as I had imagined, only a lovely young woman who arrived with a thick, solid lead cylinder—about 4 inches high and 6 inches thick, with a half-inch hole drilled down the middle.  It looked like a large, plump, metal doughnut.  The cylinder, along with a full glass of water, was sitting on a rolling metal cart.  She pushed the cart into my room, gave me instructions, and then stepped back out into the center of the hallway to observe.  I pulled a black plastic tab which caused a glass vial to protrude up out of the hole in the middle of the cylinder.

I took the vial, opened it, and poured a little capsule into a clear, plastic cup. The capsule looked like a small, clear Tylenol capsule. It had two red rings around the middle and was filled with a white powder.  I simply poured the capsule from the cup directly into my mouth and washed it down with the glass of water; then dropped the vial back into the cylinder.  The woman approached with a measuring rod, about six feet in length, placing one end of it against my chest while holding up a Geiger counter type device at her end.

“Yup, you’re hot,” she said.

“Why, thank you,” I replied, “I haven’t been told that in quite a while.”

She smiled, “Don’t forget to take your calcium and constipation meds.”  She then quickly retrieved the table, closed the door, and, like the wind, was gone!

While the hospital stay was only three days, the isolation continued after I returned to Kona.  We rented a little condo downtown where I stayed alone for the next five days.  Rene’ came over for a little while each evening, being sure to always keep at least six feet away from me, and prepared my supper.  It was good to be with somebody each day, even if it was just for a few minutes. But it was definitely “look, don’t touch!”

Then, yesterday, I had to fly back to Honolulu for the whole body scan. That, too, was in interesting experience. I was placed in a comfortable, cocoon-shaped, half-cylinder like bed, wrapped up tight with Velcro strapping—like a straight jacket—covered with a thin blanket, and told to try not to squirm.

The bed, mounted to a track, then moved, ever so slowly, through a long, body-length tube.  The “camera” itself, was less than an eighth-inch from my nose while I was down in the tube; which was a little disconcerting.  I couldn’t stand it for long; I had to close my eyes and just try to go somewhere else in my mind. But, as my head emerged from the tube, I was able to open them and watch the rest of the scan on a screen directly above me. The whole thing took a little over an hour.

The nuclear techies allowed me to view the scans both during and after the tests.  The scans looked like star fields—like looking at a distant galaxy—with all these tiny pinpoints of light scattered throughout the dark silhouette of my body.  What was most amazing, though, was the region of the thyroid bed in my throat.  It was a brilliant glow with, what appeared to be, sort of foggy, shimmering rays streaming forth, terminating in tiny lines of light, straight as arrows, in all directions—like a star-burst.  I asked if that was just some kind of glare, like you might see in your windshield when headlights are coming at you on the highway at night.  They said, no, that what we were seeing were the actual beams of beta-particle radiation streaming forth as detected by the camera.

I couldn’t help but reach for my throat and swallow hard.  It made me mindful of the Holy Spirit who dwells within every child of God (I Corinthians 3:16) and, though we cannot detect His presence with the naked eye, or any mechanical device, His power and presence is very much there.

And then, we noticed what we all didn’t want to see.  A brightly lit cluster of stars emerged on the left side of my chest.  There had been some kind of substantial uptake of the I-131 in that region.  Was it in the lungs?  Was it a lymph node?  The nuclear technicians, of course, couldn’t tell me anything; but their moods turned somber.  I was told that only the radiologist, in consultation with my endocrinologist, would be able to interpret the readings accurately and determine what was going on.

My endocrinologist called only one day after the WBS to tell me that she had already received the report and that they were concerned enough about this cluster of stars that she was ordering up an ultrasound for me right away.  She said they thought that the cancer may have spread to my liver.

While it is unusual that thyroid cancer would metastasize to the liver—usually it goes to the lungs or bones—it is not impossible.  She has already scheduled the ultrasound for the coming week and said that she would have the results, along with the full report from radiology and a possible prognosis, by our next consultation; which is still about two weeks away.

She said that, if the ultrasound reveals a nodule in the liver, they’ll have to go in and get it right away.  However, she was quick to reassure me that it is probably nothing, just an area where some radioactivity may have pooled before being strained and eliminated from the body; it could even be a spot on the skin due to sweating or some other bodily fluid.  I remember shedding a few radioactive tears that morning on the way to the hospital, and wiping them on my shirt in that general area, because an old friend had called to check on me.

Furthermore, even if it is metastasis—wherein the cancer cells have spread—it may not be a growing nodule and the radioactivity may very well do its job of tracking down and ablating the cancer cells once and for all.  But, for now, something is definitely showing up on the scans and I would very much like to know why.

This is yet another example of how my Kaiser Permanente team has responded to this whole ordeal.  I’ve never had to wait for approval for anything.  The medical staff quickly jumps on every little concern that arises, orders up tests, makes my appointments for me, and keeps the ball rolling.  I guess it is in their corporate interests, as well as their patient’s best interest, for them to try to nip every problem in the bud as quickly as possible and keep each client as healthy as possible for as long as possible.

Anyway, so I guess I will now be getting an ultrasound of my liver.  So goes the many twists and turns of battling cancer.  I will know more about these readings and, hopefully, finally receive an official staging of the cancer, along with a prognosis, when I visit with my endocrinologist in a couple of weeks. In the meantime, I’m sitting here in the eye of the storm—not knowing, for sure, what to expect next; something every cancer patient just has to get used to, I guess.

But, hey, you can’t let cancer dictate your life for you.  Starting today, I’m back on my hormone replacement therapy and, already, feeling much better.  The head nurse in the endocrinology department in Honolulu, Annie, called to check on me today.  I told her that I can feel myself emerging from that sad and sorry state of hypothyroidism and getting stronger hour-by-hour.  I also apologized for anything I may have said to her while in “hypo-stupor.”  She just laughed and said, “It’s okay, I’m used to it!”  She’s an amazing person—like a “life-line” for me.

Just finally getting off the LID (low iodine diet) is a huge relief.  I can finally eat whatever I want and, I’ve got to tell you, I’ll never look at a simple hotdog the same ever again; not that I plan to eat a lot of hotdogs—ha!  But, not being allowed to eat one really made me relish (no pun intended) the thought of eating one. It reminds me of what the Apostle Paul said:

I would not have come to know sin except through the Law; for I would not have known about coveting if the Law had not said, ‘You shall not covet.’  But sin, taking opportunity through the commandment, produced in me coveting of every kind. (Romans 7:7-9, NASB)

I’m so glad that we don’t have to worry ourselves sick with guilt, fear, and anxiety in our struggle to live lives of decency that bring honor and glory to God; and that make Him smile.  Why not?  Because, here again, the Biblical principle of freedom in Christ comes into play. Paul, in that same letter to the Christians at Rome, goes on to say:

I find then the principle that evil is present in me, the one who wants to do good.  For I joyfully concur with the law of God in the inner man[hotdogs are not good for me], but I see a different law in the members of my body [I know I shouldn’t have a hotdog, therefore I want one], waging war against the law of my mind and making me a prisoner of the law of sin which is in my members[stolen water is sweeter, so I’m going to eat this hotdog]. Wretched man that I am! Who will set me free from the body of this death?  Thanks be to God through Jesus Christ our Lord! (Romans 7:21-25, NASB)

This goes hand-in-hand, I believe, with what the Apostle John said:

My little children, I am writing these things to you so that you may not sin [hey, don’t eat that hotdog, it’s not good for you].  And if anyone sins [if you do what you know you shouldn’t and eat that hotdog], we have an Advocate with the Father, Jesus Christ the righteous; and He Himself is the propitiation for our sins; and not for ours only, but also for those of the whole world [WHAT?  You ATE the hotdog?  God is NOT smiling!!!  >>> siiiigh <<< Good thing you’re covered by the blood of Christ]. (I John 2:1-2, NASB)

Does all that sound a little too “liberal” for you; like maybe we’re just excusing sin, or something?  humph…

But here’s what’s really interesting:  that being the case, now that off the LID—free from the law—I really don’t find hotdogs all that attractive anymore.  My desires seem to have changed.  There are plenty of others good things to eat that are far more enjoyable and much better for me. Funny how freedom from sin and its consequences, and the freedom to serve Christ out of love rather than being strictly regulated by law, greatly diminishes the desire to sin.

Of course, we must be careful with this concept.  God’s grace is not a license to sin.  The scriptures condemn those “ungodly persons who turn the grace of our God into licentiousness” (Jude 1:4, NASB).  We must still, “Pursue peace with all men, and the sanctification without which no one will see the Lord (Hebrews 12:14, NASB).  But that sanctification does not rest upon some single moment of weakness [OMGoodness, I’ve broken down and eaten that hotdog]; but, rather, it’s a matter of the heart—a walk of life!

How on earth did I get so carried away with hotdogs?  Anyway, while I’m sitting here in limbo with regard to the cancer, I’ve no intention of simply letting life slip by me.  Yes, anything could happen.  But, anything could happen to any one of us on any given day.  Nobody is  assured of tomorrow.  I was reminded of this yesterday when, following the ordeal with the scans, I was sitting in the hospital waiting for a prescription to be filled and I noticed a plaque up on the wall which read, “Yesterday is HISTORY, Tomorrow is a MYSTERY, Today is a GIFT.”

When you think about it, today is all we really have.  No wonder the scripture says, “This is the day which the Lord has made; Let us rejoice and be glad in it!” (Psalm 118:24, NASB).  This is where “faith” comes into play.  The Apostle Paul also exhorts us, saying, “Therefore, being always of good courage, and knowing that while we are at home in the body we are absent from the Lord—for we walk by faith, not by sight—we are of good courage, I say, and prefer rather to be absent from the body and to be at home with the Lord.  Therefore we also have as our ambition, whether at home or absent, to be pleasing to Him” (2 Corinthians 5:6-9, NASB).

I’ve got things to do, people to love, opportunities to reach and teach, a life to live, and a God to serve.  I refuse to allow what “might happen” to get in the way of all of that!

23.) I’m Radioactive, Radioactive!

It’s a strange world in which we’re living today.  When once humanity seemed bound by the common, everyday processes we see going on all around us, now it seems we are limited only by our imagination.  Traditional healing with herbs, and plants, and available local remedies has given way to a plethora of complicated chemical compositions and high-tech solutions to what ails us.  We’ve even mastered, or have begun to the master, we think, the atom and to manipulate the gene.  I think of young Miranda when, upon the thought of, perchance, leaving her desert island home and returning to civilization, cried, Oh, brave new world that has such people in’t (Shakespeare, Tempest, 5.1.181-184).  I also can’t help but think about the Tower of Babel, “and now nothing which they purpose to do will be impossible for them” (Genesis 11:6, NASB)—Yikes!

I don’t know about you, but I’ve often wondered to myself “how far is too far?”  How far are we willing to go in the name of, and in behalf of, humanity’s health and healing—if it really is “healing?”  Are we actually heading for something like Huxley’s (1932) Brave New World, or will things begin to deteriorate into something more akin to Well’s (1896) Island of Doctor Moreau? Maybe both?

It seems as if, ever since man discovered the atom, he’s been imagining how to manipulate it—you know our propensity for trying to “control” absolutely everything—and all the cool stuff and he can do with it.  The first idea that popped into his head, of course, was how to make it go “boom” or, rather, “BOOM!”—shall we say, “BOOOOOOOOOM!!!”   But, as blowing stuff up with atoms gradually began to predict the potential for a rather bleak future for humanity, he soon began to wonder what else he could do with it.

“Darn, we have to stop destroying things with this stuff!  Soooooo what else can we do with it?”  “Anybody? Anybody?”

“Hummmmmmm… well, we could, I guess, see if, perhaps, we can use it for some good?”  “Perhaps it would be useful for some kind of healing?”

“Dooouuuggghhhhh!  Anybody else?”

But, eventually, nuclear medicine was born.  The good news—technically, we still get to destroy things; just on a much tinier scale.

So, early tomorrow morning, I’ll jump yet another plane bound for Honolulu, this time with only a “one-way ticket” – yikes! I’m being sent up to, what I’ve affectionately come to call, “The Big House”—Moanalua Medical Center—Kaiser Permanente’s central hospital facility for the State of Hawai’i; the same place I recently did a five-day stint.

A prison, I, I mean, hospital bus will pick me up at the airport for transport to the facility.  Once there, they’ll take me to a little white room called MOA NUC MED INJ ROOM 3 where I will be forced to drink a lethal dose of poison—well, not lethal to me, prayerfully, but to a lot of things inside me.

The radioactive isotope—iodine-131—is supposed to track down and obliterate any remaining thyroid cells or miscreant cancer cells within my body.  I’m imagining tiny, microscopic, atomic explosions going on all throughout my system as, cell-by-cell, the radioactive iodine is carelessly absorbed by the renegade troublemakers and then “BAMMM—got you!”  It’s kind of the medical community’s idea of a high-tech video game—“Grand Theft Auto”—at the cellular level.

I’m not sure just what all other kinds of unsuspecting cells will also end up being obliterated but, supposedly, we only use 3% of our brain cells to navigate through life anyway so, perhaps, I’ll be alright in that department.

After they strip me of all my clothing and belongings, and make me drink the deadly poison, I imagine men in HazMat suits escorting me, by way of a hidden passage with lead laden walls, down to the Big House dungeon, where they have really super-thick concrete walls; and, there, they will lock me away in solitary confinement—an old, dusty supply closet that the janitor cleaned out a few years back, I presume—for a period of three to five days.

They will do this for at least two reasons.  The main reason is because, ever since they took away my T3 hormone replacement and forced me into this goofy state of hypothyroidism, I’ve been getting grouchier every day and, I suppose, people are getting pretty fed up with me.  Furthermore, after ingesting the nuclear explosives, I’m REALLY not going to feel very well, and nobody wants to have to deal with that.  So, upon my wife’s request, no doubt,  “best to just lock him away and forget about him for a while!”

Oh, and the other reason is because, at the dosage they’re giving me, I’ll be considered a radioactive contaminate for several days; and people just seem to have this “thing” about being around others who are constantly bombarding them with waves of beta particles.  I know, hunh? Still so much prejudice in the world; go figure!

While in lock-up, not even the nurses will be allowed in my room.  I’ll have to take my own vitals every four hours and clean up my own vomit; as well as any other messes that I make.  I think the janitor will come by once or twice a day, if he happens to remember, with some kind of mashed up low-iodine organic compound baked into a kind of bread, along with a little water, and shove it through a slot in the lead-lined door.  If I want anything more than that, I suppose I can always scout for cockroaches, as they can apparently survive anything, even radioactivity.

I’ve been told that “everything” that goes into that room will become radioactive waste and will have to be bagged for HazMat and permanently disposed of. However the room will be nicely furnished in the new and stylish “Stark” motif. Everything, even the floor, will be lined with disposable plastic; the sheets, pillow cases, and bedding, as well as my hospital gowns, will all be made of disposable paper. Well, we can’t get more “contemporary” than that, now can we?!?

I have already been ordered to shower and scrub at least four times a day while in lockdown; and there will, no doubt, be some kind of hidden, Owellian (1949) camera to make sure that I follow those orders sufficiently. And, if I don’t properly follow all instructions to a “t”, I fear there will be some kind of a dystopian, Bradbury (1953), spider-looking, robot thing sent in to do the job for me. I’m pretty sure that a CIA Predator Drone probably circles high above the “Big House” should I, at any point, renege on any of this and try to make a break for it—for all I know, they’ve already got one watching me now!

After several days, if the nursing staff hasn’t forgotten where they stored me, I will be scanned with a magic wand for discernible levels of any remnant danger that I may pose to the general public.  If I pass the radioactivity test and, it has been emphasized, “if” I’ve cleaned up my act and display a fairly reasonable attitude toward others, they say they “might” let me out.

Only then will Kaiser Permanente secure a returning one-way ticket, put me back on the prison bus to the airport, and have me transported back home; probably inside a leaden case in the underbelly of a cargo transport.  That is, if my family is quite ready to have me back and gives their consent.  I’m under no illusions, though—I remember the little poem by Kessinger (1959):

“Indispensable Man”

Sometime when you’re feeling important;

Sometime when your ego’s in bloom

Sometime when you take it for granted

You’re the best qualified in the room,

Sometime when you feel that your going

Would leave an unfillable hole,

Just follow these simple instructions

And see how they humble your soul;

Take a bucket and fill it with water,

Put your hand in it up to the wrist,

Pull it out and the hole that’s remaining

Is a measure of how you will be missed.

You can splash all you wish when you enter,

You may stir up the water galore,

But stop and you’ll find that in no time

It looks quite the same as before.

The moral of this quaint example

Is do just the best that you can,

Be proud of yourself but remember,

There’s no indispensable man.

I don’t know why I’m so “freaked” about all of this.  It’s a very simple procedure, really.  Just drink the poison, get really sick, and then get a whole lot better.  Most people survive it just fine.  But, for some reason, I’m more nervous about this than I was either one of the two thyroid surgeries—both of which came at me pretty quickly.

It’s probably just the hypothyroidism, yeah?  Or, maybe I’m just in the same boat as Wyatt Earp when he said to Doc Holiday in the Cosmatos (1993) film, Tombstone, as he nervously contemplated his final showdown with the outlaw killer, Johnny Ringo, “It all happened so fast with Curly Bill… I didn’t really have time to think about it.  But I’ve had plenty of time to think about this.”

They’re not even going to put me under, or anything like that.  Still, I don’t know, something about it just feels creepy!  It’s kind of like taking the “red pill” in the Wachowski (1999) movie, The Matrix, remember these classic lines:

Morpheus: Unfortunately, no one can be told what the Matrix is. You have to see it for yourself. This is your last chance. After this, there is no turning back. You take the blue pill, the story ends, you wake up in your bed and believe whatever you want to believe. You take the red pill, you stay in Wonderland, and I show you how deep the rabbit hole goes. Remember: all I’m offering is the truth. Nothing more.

The truth, and nothing more? Eh, eh, eh—yeah, but what Neo doesn’t seem to remember is that “truth,” like virtually everything else in life, ALWAYS comes with a whole lot more than one initially contemplates. Later in the movie, after Neo’s entire existence has been absolutely, completely, and utterly altered beyond all imagination, we find another classic line:

Cypher: You know, I know what you’re thinking, because right now I’m thinking the same thing… Actually, I’ve been thinking about it ever since I got here… (he raises his glass and drinks) Why, oh why, didn’t I take the blue pill !?!?!

Am I going to regret all this?  Probably!  But, I mean, I’m already fighting cancer, right?  It’s not like this is some kind of rosy picture to begin with.  And this is just another weapon in my arsenal—it just happens to be a weapon of mass destruction at the cellular scale; and a nuclear weapon at that.

One thing every cancer patient learns early on is that, despite all the rhetoric about “taking charge” of our your own healing, for the most part, you just do what your told; you just try to keep moving along from day-to-day, trying to take it all in, trying to make sense of it all, trying to find the little rainbows wherever you can; but also realizing that it’s all pretty much out of your hands.  And that often leaves one feeling uncomfortably vulnerable.

Just because you’re paranoid doesn’t mean they’re NOT out to get you!

__O.O__

I’m trying to remain completely rational about all this.  You all know how much I despise hyperbole and would never participate in such literary indulgence.  But I can’t seem to shake this feeling that, in today’s world, we’re messing with some really dangerous stuff that, perhaps, we were never intended to mess with. Or, I don’t know, maybe we were.  But one thing I do know for sure is that God knows and, either way, He’s got this!

Best video of this song: