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!

18.) Hospital Antics

Wow! – the second surgery pretty much kicked the stuffing out of me! I was in no way prepared for it to the degree I thought I was. I guess I was taking too much for granted. I figured it would just go pretty much the same as the first one; after all, wasn’t the whole thing simply the completion of the first surgery? They had taken out half of my thyroid, now they just had to go back in and finish the job—same song, second verse—right? I was feeling pretty confident and had it in my mind that this was only another “out-patient” procedure, like the first. I even had everything timed this time, right down to the minute: check-in at 7:30AM, a couple of hours prep-time and then surgery at 9:30AM, back in recovery by 11:00AM, and then released two hours later. I figured Ne’ and I would be back in our hotel room by 3:00PM at the latest. Then, after a simple post-op consultation the next day, we would be on an afternoon flight back to Kona. Whole episode, less than 36 hours—start to finish. Well, that’s what I figured, anyway.

Five days—four nights—later, after finally being released from the hospital, I crawled out of a wheelchair and into the airport shuttle feeling like I had been put through a meat grinder and wondering to myself, “What was I thinking?” I mean, I should have known better than to be so presumptuous. Surely I have learned by now that every time I get up on my high-horse and get to thinking to myself, “I’ve got this,” I get knocked off again. While it’s okay, I guess, to look confidently toward the future and to try to put a positive spin on things, how dare I get so cocky about it and make such bold assumptions all the time. When will I ever learn?

I first knew I was in a little trouble when the doctor came to me in the recovery room and said something about how well the surgery had gone, with the exception—“Wait! What? There’s an exception?”—that they had to use a much larger trachea tube, the largest they had, for the intubation (please, save the preacher jokes till I’m feeling a little better). He also said that the anesthesiology team had problems inserting the tube due to residual swelling from the first surgery. He said that only their clinically administered pain control measures would spare me the kind of suffering inevitably heading my way. The other unsettling news was that my calcium level was exceedingly low due to trauma to the parathyroid glands during surgery; and he could not release me until it leveled out. He then described possible symptoms of low calcium levels for which they would be monitoring me, including: facial tingling, tightening, and lack of control; severe muscle cramps and seizures; even interference with my cardio rhythm; and, well, death. Okaaayyyy—so, yeah, I’m staying!

The first night in the hospital was frightening. Not only was I suffering with the “sore throat from hell,” which the 4mg of morphine every two hours didn’t seem to faze, but my semi-private roommate, Uncle Miguel, kept me spooked all night. He was 83 years old and recovering from gall bladder surgery. He was an old, proud, fiercely independent “paniolo” (Hawaiian cowboy). And, of course, they would put “me” with Uncle Miguel, right? I mean, who better to bunk with the old salty than another old salty?

I didn’t realize it at first, but soon discovered that Uncle’s one goal was to break out of that joint that very night. Furthermore, he was determined to fight anybody that stood between him and his goal. And, as my luck would have it, my bed was right between his and the door. His wife, Aunty Margarita, was of no help at all. While she was the only one who could control him, keeping him on a pretty short leash while she was awake, still, she slept deeply and soundly; and, I might add, she snored like a Harley Davidson—I kid you not, even the nurses were amazed! So, Uncle would lay there, biding his time, waiting until the Harley was really revving, then he’d attempt an escape.

His first attempt came about 11:00PM. I’m lying there, trying to doze off and on between the Aunty’s rumblings, when I see the divider curtain swing back and there stands Uncle ready to fight. Now, I don’t care who you are, or how weak and feeble he is, the first sight of a crazy, old, angry and determined—not to mention, virtually naked—paniolo swaying back and forth in his flimsy hospital gown in the middle of the night, eyes as wide as silver dollars, is enough to send a shiver down anybody’s spine. It might as well have been an angry pit bull coming after me. What could I do?

There was only one thing to do—scream! I pushed the button on the call gadget and screamed into the microphone, “Uncle’s up, Uncle’s up, he’s wandering around the room!” To which I received a response that sounded vaguely like laughter. Well, they didn’t laugh long because Uncle, being sufficiently discombobulated by my screams no doubt, began to lose his balance and bounce this way and that off the various items around the room, much like a pinball. Finally, he hit the wall, bounced off, spun around and fell backwards over an aluminum tray stand, scattering debris of all kinds in all directions. It sounded like a train wreck.

Finally, people arrived—rushing in the door like it was a code blue “stat” or something. I’m sitting up in bed, in searing pain, all hooked up to the IV lines and quite under the influence, crying out, “Where were you, I called for help, nobody came? Where were you?” But I also found myself profusely apologizing for not being a quick thinker and hopping out of bed to try to catch uncle before he fell.

The nurses quietly reassured me that I did the right thing, that it was not my responsibility to catch uncle, that doing so might have been worse, and that, since he landed on his butt, nothing was hurt except maybe the floor. Aunty gradually awoke from her slumber, asking the nurses what had happened.

Uncle tried to escape four or five more times that night; however, they now had him hooked to some kind of monitor that sounded an alarm each time his feet hit the floor. Needless to say, between the pain, the alarms, the Harley next door, the regular hospital hubbub—the room was right across the hall from the nurses’ station—and visions of a skinny, pit bull, attack ghost threatening me in the night, I didn’t get much rest. In fact, I went more than 36 hours without sleep—not a situation conducive to healing. The next morning I was profusely thanked by the nursing team for helping “save” Uncle the night before. I modestly, and a bit shamefully, accepted their praise. Later that day, as a reward for my heroism I presume—or maybe to silence any potential formal complaint (not that I was planning one, but how would they know)—I was moved to my own, private room—yesssssssss!!!

But, while life in my private room was peaceful enough, somehow, it seemed a bit boring; despite the vampires who kept coming to draw my blood every four hours around the clock for four solid days.  Actually, I found myself rather missing the entertainment value of bunking with Uncle.  I think I’m going to have to add him to my collection of “rainbows.”

The day after surgery, things began to progress from bad to worse. Because my calcium level was going down, rather than improving, and because of the blistering pain in my throat, all the meds were increased. The oral calcium dosage was doubled and they began giving me calcium glutamate intravenously. In addition to the morphine every two hours, I was also given an oral dose of liquid acetaminophen and codeine elixir every four hours.

The combined effect of these meds produced the predictable outcome of assailing me with the absolute worst case of constipation one could ever fathom. I mean, I’m serious when I tell you that I now think I’ve come as close as any man ever wants to come to experiencing what it must be like to give birth. I had never imagined myself begging for a suppository; and then sooooo regretting it when the thing finally went to work. I’m telling you, I nearly passed out!

After that second night, I made the commitment to quickly wean myself off of the pain meds. The way I figured it, at least I’d only have grueling pain at one end, rather than both. A couple of nurses warned me about putting off the pain medication, rather than taking it at regularly scheduled intervals, but they couldn’t “make” me take it. I was kind of proud of myself for being so rebellious and tough. I even dared to envision myself as a younger version of Uncle Miguel; that is, until the pain in my neck and throat really got to raging and I began to realize how much good those meds really had been doing all along. I soon found myself again the beggar. It did nothing for my ego when the nurse finally showed up with the morphine; and with a haughty, little Filipina “I told you so” look in her eye.

I do want to pause and say a word to, and about, my sweet wife. While they wouldn’t allow her to stay with me in the hospital that first night, she was determined to stay every night thereafter, even though I tried to send her back home to the Big Island. But she was having none of that; choosing, instead, to sleep night-after-night on three old, hard chairs that she lined up under the window beside my bed. This was against hospital policy, of course—she wasn’t supposed to stay overnight—but the nurses soon figured out that this cute little gal was virtually as tough as any old paniolo; and that no one would be sending her anywhere. So they decided that they might just as well go ahead and bring her a blanket and pillow.

As far too many of us already know, battling cancer is quite an ordeal—filled with all too subtle “ups” and way too obvious, and often crushing, “downs.” It’s easy, I think, to focus on the hardships, the pain, the fear, the setbacks, and the disappointments. But even in the middle of all that, there can still be found a deep and profound joy; a particular joy that, perhaps, cannot be experienced in any other context. Throughout this whole ordeal, while in the hospital and after returning home to recover, there have been those people—near and far—who have checked in on me, encouraged me, prayed for me, and who have gone out of their way to minister to me in a variety of ways. I know I’m not always the easiest person to get along with, even under the best of circumstances. And so, for that reason, I’m all the more grateful, beyond words, to be the recipient of such undeserved and unconditional love—yet another rainbow!

cowboy sillouette