Oct 25, 2012

Elliptical Timeline

There's an old joke: Call me anything, but please don't call me late for dinner. And please don't call me a hypocrite, either. Three days a week, I have done physical therapy at Rehab X, twelve times so far.

If you read my book, "The Tales of a Stroke Patient," though I said horrific things about my stay there for seven weeks, I didn't say one bad word about the physical therapists. So I was not being a hypocrite when I returned to Rehab X for physical therapy. That's a roundabout way of saying the physical therapists were the best, at least according to the sign they have plastered in the therapy window for winning the local newspaper's award.

Anyway, there were three parts to the routine that lasted for about an hour and was the same every time. First, I got stretched on the mat with the physical therapist helping me lift, spread, and bend my legs. My hamstrings, quadriceps, and ankles were challenged, and though it hurt, it was a good hurt. Next, I went on the elliptical, a cardio training machine that mirrors walking up the stairs and running, working large muscle groups, in my legs and one functional arm in a continuous movement.Finally, I used the parallel bars, with exercises like side-stepping and lifting my leg on the affected side as high as it would go.  My therapist gave me all her time, but occasionally, when the therapy center was crazy busy, the therapist at most had two patients.

I don't know how long she stretched me, but I got up off the mat and attempted to sit until my balance was restored. After about a minute, I walked over to the elliptical machine, taking a minute more. I noticed a pale, elderly man with plush, white hair sitting in a waiting-room-type chair with arms, next to me in the therapy room. His head was down as if he was sleeping. With the therapist's help, I sat down on the elliptical and I cycled for 14 minutes. I know it was 14 minutes because the elliptical machine had a timer.

I was unclear who noticed it first as I was getting off the elliptical and going to the parallel bars, the third part of my routine, but the elderly man was still sleeping, or so it seemed. I also don't know how long he was that way because he was upright in his chair. 

Two therapists went over to him and screamed his name to no avail.  My anxiety level went through the roof. Four doctors, three paramedics, the two therapists, and one nurse appeared which reminded me of the song, "The Twelve Days of Christmas." Four calling birds, three French hens, two turtle doves, and a partridge in a pear tree. Tra la la. That's how my mind works now, three and a half later. I'm all over the place.

Anyway, the therapist made a comment. "This happens way more times than it should," said my therapist, talking to me as if I was a confidante. Then catching herself, which I considered over-sharing, she said, "Let's concentrate on the parallel bars." But it was too late. My interest was piqued.

"How often does it happen? Once a week, once a month?" I asked. "And why does it happen 'way more times than it should,'" quoting the therapist. I was interrogating her as if she spilled the beans, which she had.

But that was all she said. She clammed up and started to lift her legs, demonstrating what she wanted me to do on the parallel bars.

The National Institute on Disability and Rehabilitation Research funded an article, written by Mark Sherer, Ph.D. and others, that said that unconscious people with no eye opening could be in a comatose state. Complete unconsciousness with some eye opening and wakefulness as well as sleep is called a vegetative state. So, according to that article, I was in a coma for 8 days when I had my stroke. Characteristics of someone in a coma include no eye-opening, unable to follow instructions, no speech or other forms of communication, and no purposeful movement. That was me.

"Mr. Smith" didn't look conscious, either, and I had no clue whether he was in a coma or had turned vegetative, but I didn't see his eyes open as long as he was in the room which was at least 14 minutes from the time he was noticed. Fortunately for him, Rehab X is connected to a hospital which is on the other side.

But I have questions. Did he a brain hemorrhage? A heart attack? Did he take more--or less--medication than he should? Wasn't anybody watching him? It was at least 14 minutes from the time I sat down on the elliptical that he was alone. Maybe the therapists all thought he was sleeping. But in light of the activity in the therapy room, that didn't seem logical. The paramedics transferred him to the gurney and "Mr. Smith" and the entourage left.

What if it was me with another stroke? Would anybody notice? For at least 14 minutes, he was there. The elliptical had timed it. But I had gone too far in my recovery to go backwards now. So I did the exercises that the therapist requested while concentrating on my anxiety which could be somewhat controlled if I set my mind to it.

When I returned to therapy the next time, with my mind working in a strange way again, I saw the empty chair, and I thought of Clint Eastwood.

For all those who didn't see the event when Mitt Romney was nominated by the Republican Party with accompanying hoopla,  Eastwood addressed an empty chair which was occupied, though not virtually, by Barack Obama, criticizing the President. Eastwood is a Republican. It was not his finest moment. Neither was it for "Mr. Smith."

Oct 9, 2012

The Cancer Scare

I was scared of anything medical, even way before the stroke. I waited 8 years to get a sinus operation, 10 years to get a colonoscopy, and 11 years to get hearing aids. Then I broke my shoulder in December, but my upper arm was still swollen five months later. And, of course, I was worried. Could it be blood clots again, this time in my arm, closer to my heart? So I decided, at last, to take action. Five months. I'm improving with age.

I went to the local imaging center in May, a chain that specializes in mostly MRIs, CT scans, ultrasounds, and X-rays. The technician scanned my arm with an ultrasound and told me that I didn't have clots. The doctor verified the result in a letter. But what no one told me was the technician went up too far and scanned my thyroid, too. A few weeks later, I got another letter, recommending a biopsy because my thyroid had eight nodules, seven of them too small to worry about. The eighth one gave the doctor concern. I made another appointment as soon as possible which translated into three weeks, but a little background first on cancer and biopsies.

Nodule. Carcinoma. Tumor. Malignancy. Lesion. I call it the "C word." But no matter what you call it, cancer is cancer. I thought I had it from all the X-rays and CT scans over the last three, stroke-related years. Today, after the smoking PSAs and warnings on the cigarette packs, and a lot of pink depicting Breast Cancer Awareness, more than a million cancer deaths have been avoided in two decades. Even so, there is still cancer.

The American Cancer Society says that cancer deaths in the U.S. continue to go down for lung, colon, breast,  and prostate cancers, which are responsible for most cancer deaths. However, some of the less common cancers have been on the increase in the past decade, including pancreas, liver, kidney, and thyroid cancer.

A biopsy, a sample of tissue taken from the suspected site, is done in order to scrutinize it more carefully. Biopsies are done when an initial reading suggests an area of tissue looks suspicious on an imaging test. Lest you think I am straying from the issue at hand, here's the reality: most often, biopsies are done to look for cancer.

So there I was, an uncomfortable stroke survivor, lying prone on a table and staring up at the ceiling, waiting for the biopsy to begin. I started to count the square tiles, count the lights, count the square tiles again. When the radiologist came into the examining room, as I was silently planning my funeral and after-party, the doctor showed me the needle (most commonly used on all biopsies) he would use to remove a small amount of thyroid tissue with the assistance of numbing medication and an ultrasound to identify the nodule.

"You will probably be sore after the biopsy, but the soreness should just last for a few days. Use an ice pack initially, 20 minutes on, 20 minutes off, and take Tylenol, and if the site becomes swollen and/or hot, you can call us at any time. A doctor is always on call," the radiologist said. "There will be three samples taken, one at  a time." I started planning the inheritance for each of the kids.

The biopsy was over in a few minutes and I took a nap when I arrived home. The pain that would "last a few days" lasted a week, with the intensity getting weaker every day. Mostly, I had a sore throat.

The radiologist sent me a report of the findings in another two weeks, and all it said was "abnormal tissue." The report also recommended a biopsy again in three months. So, of course, I wanted a second opinion. A doctor friend recommended an otolaryngologist who specialized in thyroids. So I went to see him. The "oto" recommended Veracyte, a thyroid testing company, that goes the extra mile to test the sample completely. The sample was sent to San Francisco where Veracyte is based, the land of the "Big One," (referring to an earthquake forecast recently for the San Andreas fault that could end up being bigger than earthquake experts previously thought).

According to the Veracyte literature, the test "measures the amount of activity of 142 genes in the thyroid nodule...to be performed only when cytopathology (the examination of cells used to diagnose nodules) is indeterminate." "Abnormal cells," the diagnosis on the first report, was about to get a re-do.

Three months later, I went to get another biopsy, this time with four samples, and again one at a time. The biopsy, like the other one, took a few minutes. I knew the drill by now. Ice pack on and off, Tylenol, nap, and the sore throat for a week. The results letter arrived two weeks later. I was glad the "Big One" didn't hit yet. The letter said that no evidence of cancer was found because the nodule was benign.

Look at all the time I wasted, worrying about thyroid cancer. Three weeks to the first biopsy, then three months to the second biopsy, and then two weeks longer for the results to come. I couldn't get the time back, but once again, a lesson learned: don't worry until you know.

I think I need a root canal. No more delaying, I decided. I'm going in four months--tops.

Oct 1, 2012

Where the heck is the blog, "The Tales of a Stroke Patient"?

By now, the thought has probably occurred to you: Where the heck is the blog, "The Tales of a Stroke Patient"? I mean, what's going on here? Permit me to tell you about the last 3 weeks.

I turned the posts into a book. There were so many corrections, book cover design requests, and layout questions, it felt like I was on deadline every day. It felt that way because it was true, and being on deadline took me back to when I was working for the newspaper, to my television news writing job, and everybody who said, "I want it now!" For so long, I wished for work and that wish finally came true.

Thank you, Xlibris, for doing such a great job on my book. And thanks for the deadlines. I'll resume writing the blog shortly.
You can buy the paperback version at http://bookstore.xlibris.com/Products/SKU-0115053049/The-Tales-of-a-Stroke-Patient.aspx

You can buy the Kindle (Amazon) version at http://www.amazon.com/The-Tales-Stroke-Patient-ebook/dp/B009J9QC64/ref=sr_1_2?ie=UTF8&qid=1349018197&sr=8-2&keywords=the+tales+of+a+stroke+Patient