Lose 7 Pounds in 30 Hours–Without Boring Exercise!

As soon as I’d clambered into the house, I waddled into the bathroom and weighed myself. Two pounds heavier than when I’d entered the hospital.

I put a tape measure around the belly That in itself took effort. Almost forty-eight inches. Wow!

Given the five or six cups of hospital food ingested in the past week, these statistics made no sense. What was going on? Was it the types of food? The lack of deep sleep? The constipating meds?

I took the meds anyway. What if the pain got worse? I slept seven or eight hours straight for the first time in a week The nurse did call, poor dear, around midnight, doubtless very glad to find that I’d kidnapped myself. I would have liked to apologise for fleeing on her shift, but was already in dreamland. I awoke so grateful for that sleep. And then the fun began.

It was a good thing I’d left the hospital. Had I stayed, the morning staff would have discovered me in a pool of nasty-smelling stuff from top and bottom orifices, somewhere between bed and sink.

At our hojme hospital, Kay had put my wonderful mattress atop our library guest bed, which is a hard, unaccommodating fold-out thing (probably designed to discourage long visits). Unlike the $26K hospital bed, it did not rise, but it was also a lot closer to the ground, which meant I could if need be sort of roll out of bed and fall onto the floor without damaging anything except my dignity–not that I had much of that stuff clinging to my unwieldy bod by this point. From the bed, I could peruse the spines of several thousand books. My head lay nearest the god-bothering books, floor to ceiling–very appropriate for the occasion, I thought. One look to the left brought back Rumi’s poems, Sogyal Rinpoche’s Tibetan Book of Living and Dying, A Pace of Grace by BC’s own Linda Papov, the lovely face of Peace Pilgrim striding along her path, and The Idiot’s Guide to the Bible. I could let my eyes bounce along the shelves, up at the classic and then the upstart philosophers, human thought in all its luxurious, even excessive, variety. Then education, another collection of upstarts, of whom I am one–or was, until this happened. Then, books on the wonders of the body–you don’t realise how much has been written about what we humans are and how we work until you get sick. Some titles were too apropos: Who Dies? What Survives? I figured I could answer the latter title in one word–sure as heck didn’t need a whole book to tell me death is a synonym for THE END. But the book spine that blinked at me like a neon sign was Life without Pain. Imagine: someone believed strongly enough in that possibility to put out a whole book on it. That’s where I was going–to a life without pain. But not quite yet, apparently.

The home hospital had safety features in addition to ambience and a strong nurse in Kay, who proved able to lift me almost painlessly from the bed until I could retrain my muscles. A clock with a second hand allowed me to keep tract of my own pulse. A beautiful glass with a steel straw in it offered me water from the nearest shelf. For a call button, we set a large steel bowl and the steel wok lid beside the bed–the only items sure to wake Kay in case of emergency. We coaxed one of our ancient thermometers back into working mode, but left the far more expensive blood-pressure reader in its lonely exile in the bathroom, as it invariable reads the BP some thirty points higher than Walmart does. Instead, a six-weeks-old gray kitten agreed to snuggle with me and lower my BP–what could be better than that?

That first day was hard. The action began as soon as I woke up and wouldn’t stop. There was plenty of exercise for both of us–just not the boring kind one does in a gym. Kay was kept running, lifting, cleaning, as the gastric experiences of an entire week decamped. Even water wouldn’t stay down, but a human being has to have water; so it was sip, sip, sip all day, just to stay hydrated. The body temperature began to rise and Kay threatened me with Emergency or even 911, but somehow, after twenty-four hours, we’d beaten it back.

Thirty hours after coming home, I weighed seven pounds less and measured four inches less around. I took my first shower, a plastic bag taped over the incision site. I felt incredibly clean, both in and out, ready to build up this body again. There is nothing like the face of death, I thought, to prepare you for living.

Borborygmi Theater

A left-behind stethoscope was our ticket into the Borborygmi Theater.

A nurse or doctor had momentarily forgotten the thing. With a conspiratorial glance, Kay and I began listening through it, the way kids play with a doctor kit. Fun’s hard to come by in a hospital room, after all, and I hadn’t had any fun for quite a while.

First I passed the stethoscope over the four quadrants of my burgeoninig belly, just as the nurse had, and then Kay had a listen.

Have you ever done this? Omigawd, as Mother would say. Rumbles like a truck. Squeaks, gurgles, skitters, bubbles. The occasional squeal or roar. How can anything be so loud and yet not audible all the way down the hall?

Horrifying. Humbling. At the same time, magical: if all this ickiness is operating properly, mind and soul can also operate.

Kay declined to try her own innards.

There is a word for this flesh symphony: boborygmi. It is derived from Greek, like all English words that look as if they need an h or two inserted in them. The origin seems obscure, but I would not be surprised if it were linked to the ancient Greek word for stranger: barbaros. That was the generic word for foreigners because the Greeks thought their speech all sounded like Bar-bar-bar-bar, and yes, English gets the word barbarian from it. (Apologies to all the Barbaras in the world: yes, one interpretation of your name’s meaning is "Lady Barbarian".)

I learned this wonderful word in a funny place–the annual medical Revue many years ago at U of Alberta. Onstage clumped four zombie-faced med students, dressed in scrubs–the Chorus. Then there came a silly song about abdominal matters that literally had us falling out of the seats, bent double with laughter. After every verse, the zombie chorus intoned in deep voices, "Borborygmi, borborygmi…." After all these years, I could still feel how my guts hurt from laughing that night.

My expanded belly could be thought of as Borborygmi Theater now. I’d been on my back five days–that was the stage, a rake stage, yet, slightly elevated upstage, where the pillows began. The omentum (a thing I didn’t even know I had until this month) fell like a curtain from stomach to the bottom of the abdomen. Stage Left, the colon began inching Upstage along the perimeter, before crossing to Upstage Right, sneaking along under the back wall of the diaphragm, only to inch down Stage Right to disappear in the orchestra pit. Overhead, the dome of my belly rose higher by the hour, which might, who knows, be adding to the acoustic values in the theater and deafen the holder of the stethoscope. And in the middle of the stage, meter after meter of small intestine writhed its way through the play of Peristalsis, whining and crying and wailing. Talk about overacting!

Peristalsis, the process of forcing whatever food falls into the stomach to take the lower exit leaving only nutrients behind, was not going well. There had been no production for some time–by Day 6, nothing impressive had happened for three days, while pain ran up and down the scales like a piano student who’d lost her mind, despite two kinds of painkiller which should have shut her up.

I thought, This is what happens when all you have is a bunch of directors and no Stage Manager. This production should have been blocked out as soon as we started rehearsals! Somebody should have thought about what was supposed to happen where, how, and when on the stage of Borborygmi Theater even before the surgery.

By the time the night nurse came on shift and brought me meds, I was miserable, without much hope of getting better. Couldn’t keep my mind on anything much beyond the horror story of my belly. I folded the three pills into their little white top hat and called Kay. "Come visit," I said, the visiting hours in ICU being 24/7.

I could hear she wasn’t enthused about another outing that time of night but she came, Scrabble game in hand. I motioned to her to close the doors; I hadn’t turned on a light.

"We’re leaving," I said, motioning to my packed bags. "You take those; I’ll follow in two minutes."

Kay protested. Only that morning she had insisted strenuously that I was anything but ready for home care.

I wasn’t getting any care anyway, I pointed out, beyond pills that were not working and the occasional taking of blood pressure.

"But don’t you have to be discharged?"

"It’s Saturday. No doctor to do it."

With a "My crazy mother" shrug, Kay picked up the bags and left. I peered down the hall for a minute or two. I was sorry to inflict my unseemly departure on this particular nurse, who was the one who had listened and then gone the extra mile to get me a substance called fruitlax, the apparently only useful solid to have slid down my throat for an entire week. But I also knew I couldn’t stay there any longer.

It was just after nine. No one had checked on me since seven. I walked across the hall, banging my shoulder on the door in my post-op clumsiness, but no one noticed. Out through emergency, where the car waited with a nervous Kay at the wheel. First fresh air in six days–delicious!

"Let’s go home," I said.

The Overnight Pariah

Take your journal to the hospital, and a couple of pens. You never know when its seems wisest to stay awake by scribbling your way through the dark.

I was becoming desperate for the four-hours-straight stretch of sleep that is essential to steering clear of fibromyalgia pain. I could sense it hovering out there, ready to pounce on some or all of my anatomy. So, I had soldiered on until 12:30 a.m., the time appointed for the nightly meds, in hopes of getting those precious hours for the first time since entering hospital three days earlier. What an effort! Pain is exhausting.

The new medication worried me. The nurses had more or less left the decision to take 2 or 4 micrograms of the stuff with me. But what did I know about Dilaudid? A morphine substitute. Okay, that tells a person who almost never downs so much as an aspirin, nothing. So far, all I knew was that 2 mcg. wasn’t doing much for pain. I was to have 4 mcg. plus Tylenol tonight, and I was desperate enough for sleep to try the full dose.

Exiting the bed without incurring high levels of pain wasn’t possible yet. Kay had visited late that night to help with the mundane nursing tasks of toilet, teeth, a fresh undersheet in the bed, ice water to sip from. Little did she know as she padded out the door at 12:25 that she herself would not get a long sleep.

Five minutes later the night nurse arrived and wordlessly handed me the little white top hat in which meds are served. No small talk from her tonight. I asked whether she had anything for the maddening itch in the middle of my back, where the epidural had sat for three days. She indicated no. I asked if perhaps the skin lotion I had noticed parked by the sink would be helpful, and, evidently put out, she plunked the container down on the bedside table. Two days earlier, she would have been solicitous, rubbing the stuff in herself or, more likely, detailing an LPN to do it. I wondered how she thought I would reach the spine with a thorax and abdomen as sore as mine, not to mention with my gimpy right arm, which still periodically roared about a previous injury.

A cool wind had blown from this nurse since she started her shift at seven. Maybe she realised I had by now heard her own tale of her more difficult left hemicolectomy–making her suffering greater than mine, you understand–about half a dozen times? Hardly. I had listened attentively and was quite prepared to tap her experience and wisdom on the topic. Wow! A caregiver who actually knew what patients like me go through! On my arrival, she couldn’t have been friendlier. We had some nice talks.

It must have been the dressing change the previous day that turned the tide. There had been a lot of blood collecting under the nifty transparent bandage over the hug incision. At first the nurse shrugged it off, but then returned to apply a fresh dressing, perhaps having received direction from someone. She put on a fresh dressing, but it didn’t seal at the bottom; so she patched it with what she called a "two-by-four", both of us laughing and joking the way well intentioned patients and their caregivers do sometimes.

Then I took my evening stroll around the ward and trailed blood all over the floor. Oops.

The next morning my surgeon changed the dressing himself. Guess what? No leaks. He seemed a little testy, sticking the date of his dressing onto my tummy above the incision, as if someone would need a reminder.

Tempest in a teapot, knot in the bandage, typhoon in the toilet…whatever. Maybe the nurse thought I had complained? It dawned on me that the LPNs were carrying the load of the many mundane duties involved in nursing. Maybe there were ways to be a good patient, and ways to be bad.

I pulled myself together, took the pills and bedded down. Come hither, Morpheus. It should have been a quiet night. Only two of the four ICU beds were occupied. Unless the world’s biggest accident occurred in our sleepy town, the nurse, accompanied by a male nurse and an LPN, should have very little to do.

One and a quarter hours later, I was jerked out of my darling sleep by a man’s voice loudly delivering what sounded like a punch line. Loud voices were having a good time down the hall. No going back to sleep with that going on. I decided the best solution would be a stealthy closure of the glass doors of my room.

I did it. Groggily I raised the bed and sort of fell out of it, slid the doors together, used the "facility" and with the aid of a little stool and some fancy legwork, re-entered the bed. Someone must have noticed the closing door, for the sounds did abate somewhat. Maybe I could pick up the threads of sleep?

I drowsed, but kept waking in a panic, trying to find my breath. I’d never breathed like this before. What was in that drug? If I fell asleep, could breathing stop?

I wasn’t hooked up to the monitor, I realised. It had been turned off. Since 12:30, no one but me had the slightest idea of this body’s vital signs.

It seemed a little overconfident not to monitor a patient who never takes so much as a tylenol but who was now on powerful narcotics new to her, three days after surgery. If that constituted over-reaction, I sure wished someone had told me what to expect.

I was scared to sleep. Again I forced the body out of the bed and, by dint of shoving my bag close to the cute little toilet with one foot and lowering myself to the throne, rummaged around for my EmWave. This palm-sized instrument tells the holder when the heart is "in coherence" and when it is merrrily jerking along as usual. You can control your cardiac system to a large extent with a breathing technique and a thought technique. This "Hearthmath" technique has saved lives in the past, and it sure wouldn’t do me any harm now. At least it would let me know something about what the heart is doing, since I couldn’t very well turn on the monitor again by myself.

I would call Kay as soon as decent to do so, and ask her to research this stuff, this Dilaudid, and to call the GP to make me part of her morning rounds, please. Maybe I could get moved upstairs.

It was minutes to five a.m. The next dose of tylenol was an hour late, although surely the staff, if they had noticed the closing of the doors, must have known I was awake. The next load of Dilaudid was half an hour late–mercifully. But no one came until I dropped the phone, when the LPN popped a head in–but no pills came with her.

The EmWave told me I was in blue or green zone ninety per cent of the time, which I sure the hell was not. I kept up with the measured breathing, sitting up in the dark until the dawn crept through the windows. Seven o’clock and change of shift couldn’t come soon enough.

Somehow I’d made enemies. Stage Two of recovery was not going well, but I could see no exit from this familiar game. I was supposed to accept whatever staff did, without question. No rocking the boat. If I did not react to their failure to provide painkillers on schedule by screaming for more narcotics and tylenol, however, I must be faking the pain. Bad Patient.

I became Badder. The day nurse came to lecture me on taking my pills and all I could come up with was, "After I talk with the doctor, I’ll decide." That was definitely not the right reply.

On my trundles through the back of the ward, I’d noticed a poster about patient autonomy, specifically for seniors. It was a pretty impressive piece of work (although once could still see, under the tape, the title ABUSE, which was the situation the protocol had evidently originally been developed for). Hey, there’s been training going on. That’s great. Fifteen years ago, during my last big involvement with the medical community, such training had been scarce. Patient autonomy was a big topic in the new, burgeoning field of medical ethics.It was good to see the discussion migrating to all care facilities.

In those days, the concept of Patient-Centered Therapy or the Patient-Centered Approach, meaning the patient retains the authority to hire and fire members of one’s team of caregivers,was blisteringly new even in the US. I liked the idea. Obviously it patients were respected as the heads of their teams, as they were, presumably, still the owners of their bodies, they would be more knowledgeable and therefore more compliant, not less. More compliant patients, as everyone knows, result in better medical outcomes.

I’d had similar thoughts about legal clients. If only our clients understood what we lawyers were trying to accomplish, I thought, wouldn’t they shoot themselves in the foot less often? Wouldn’t that result in a reduction in the number of trials? Well, that’s another story, It’ll be a cold day in hell before most lawyers turn the fiction of "taking instructions" from a client into reality.

I was about to make the mistake of thinking the concept of patient autonomy had grown vigorous enough to be of help in fixing little problems like my medication and care.

Shortly before eight Kay, the GP, the day nurse, and my surgeon’s partner (the surgeon had left town for ten days) were gathered at the bed. I ewxplained my fear of the Dilaudid unless I was hooked up to the monitor, as the stuff was new to me. I also asked my GP if I could have some continuance to physiotherapy with the right shoulder, to help me get out of bed by myself. There seemed a satisfactory solution: there would be physio, there would be morphine, which I’d had before, and tylenol, and I would be moved upstairs.

As my surgeon’s partner moved down the hall with the day nurse, Kay and I heard her say, "Did you know the patient refused her narcotics?"

At that point a truly patient-centered approach would have dictated a return to the patient to clear up the dissonance in communication. That didn’t happen. As the weary day stretched on, neither did the morphine, the monitor, the physio, or the move upstairs.

Next morning, the same cast re-assembled at the same bed over a patient in more pain and distress after 24 hours of ibuprofen and tylenol. Could I please go home? they said. Wasn’t I ready?

I thought Kay would explode. I couldn’t sit up by myself yet, let alone get out of bed or do anything much besides read by myself. And our home was hardly fitted to be a hospital.

Again, the decisions to move me, to send a physio. Neither happened. Every several hours someone came to take blood pressure, which soared and dipped with the vagaries of pain.

The day nurse arrived for that duty about five to take blood pressure and administer an informative lecture on the subjectivity of pain. She looked to be in her twenties. I’m in my sixties. I wondered what she thought I didn’t know about pain, especially since my master’s thesis had dealt with the subject in some detail and I have forgotten more about dolorimeters than most folks, medical or not, will ever know. But hey, she was trying. And, I reflected, ICU doesn’t often have to deal with patient-autonomy issues, because people in crisis or in surgery have already given up a great deal of that autonomy for the sake of having their lives saved. Otherwise, the system wouldn’t work, and there is much to be grateful for in the way our society responds to medical crisis.. Heaven knew, I wouldn’t have survived this far without at least three life-saving surgeries. So I just shut up and practised friendliness.

She was interrupted before she could write down the BP and scurried away, saying she’d be back in five. As the end of her shift approached without her return, it occurred to me it might be a kindness to remind her. I pressed the call button.

An LPN entered, the one who never introduced herself or smiled. She deprogrammed the call button. "Why?" I asked as she cut my last communication with the desk.

"Because you don’t need it," she snapped.

She might as well have said, Because you’re a faker. Don’t call us; we’ll call you."

Fools of the Gods

The first breakfast that arrived at my hospital bedside astonished me.

In one corner of the large tray sat a big cup of a dark brown liquid probably meant to be coffee, topped with a plastic cap to prevent spillage. Next to it sat a "milker", which is not a miniature Swiss miss leaning her forehead against a contented cow while pulling the teats, but another piece of plastic containing high-fat milk. Then a white-sugar baggie. Next to that, another plastic, mass-produced milk container with white stuff I haven’t drunk for years, since I learned about all the messing around with hormones and chemicals in the so called dairy industry. Across the tray leftwards stood a small plasticised-cardboard tub of ice cream, its contents, including chemicals and carcinogens, neatly printed on its cover in a font designed for ants. Finally, the piece de resistance: a large, unadorned brick of dark green jello.

Have you ever read the contents on a jello box? (Bring your extra-strength reading glasses if you’re new to the fine art of ingredient-watching.)

Good morning, Cancer Patient! Want to have another go?

Every meal arrived on trays with niches for cups, bowls, and plates, make of a durable brown plastic, the kind that will not betray the iniquity of a lazy dishwasher and assures us that it will probably last about 10,000 years beyond the last human. The double-walled bowls and cups were made of the same stuff, and although the plates were ceramic, they came covered with lids of the stuff. I began to wonder whether anyone connected to the hospital had studied the effects of all that plastic on hot food. Were the lids dripping minute particles of themselves into the coffee, tea, soup and entrees? What about those liquids spending half an hour in their stay-warm containers?

Buon Appetito, Cancer Patient! Helping you restore your levels of carcinogenic intake!

Good thing, I had no appetite. For someone whose theory is that we’re getting cancer in droves because the world is full of carcinogens which we can’t help but ingest, the presentation of such a breakfast makes it plain that the gods are laughing at our frantic attempts to curb the results of our own excesses.

A cynic could consider cancer a natural form of population control. Only problem is, it’s non-selective. I may agree with the principle that we should curb our population, but when it comes to being one of those culled by cancer, I blurt, "Oh, but I didn’t mean me!"

Those first breakfasts returned intact to the kitchen. Later I saw that "return to the kitchen" did not actually happen: all uneaten food was scraped off into a large bucket. In six days, my presence contributed a lot to that bucket.

The same headliners appeared daily, only varying the dark brown liquid with a harsh-smelling black tea which seemed likely to have been brewed from the cheapest possible bags,made from floor scrapings. Only the jello bricks transformed themselves into, of all things, chocolate cake. If you’ve ever had a belly incision, you’ll remember viewing toast, croutons, and cake-y things with distrust, lest they make you cough. All three arrived in those first five post-op days, along with roast potatoes that, according to my visitor, tasted like playdough, cheese-fried steak, half-cooked tasteless spinach, spicy navy-bean soup, raw salad, uncooked prunes, and packaged waffles, among other things.

Huh? Red meat is supposedly one of the bad guys in instigating colon cancer. I’ve read research results indicate that dairy is one of the best media for growing cancers.And if you google post-hemicolectomy diet (which I foolishly did not do before entering hospital), you see that raw foods and fruit are to be avoided after surgery, along with anything that might move with difficulty through your highly tender and swollen plumbing.

In six days I swallowed perhaps five to six cups of food, including some tasty cream soups, cream of wheat, and most of a quite delicious chicken dinner. It’s not that the kitchen can’t cook, not at all. It’s that there appears to be no intelligent connection between the kitchen and the hospital at large.

Obviously the great edifice of cancer expertise would not exist without patients–but must I get cancer again? Isn’t it okay to get well now?

What fools these mortals be!

“Talking Stones,” a winner

Happy homecoming in more than one way–my poem “Talking Stones”, which I wrote with poet friends on retreat in Maui two years ago, has placed in Little Red Tree Press’ competition and will be published in its anthology late this summer. Not only that, I get a cheque.

Don’t quit your day job for poetry, though–it’s fifty US$. That’s the way of it in poetry. One of the most important human activities, and there’s no money in it.

“Blind Bison Jump” was also selected for inclusion in the anthology.

Here is the poem. Be sure to check out Little Red Tree Press, too.

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My daughter said I look like a cyborg.

A many-pronged thingy fits into my back, dead center, keeping my mind clear and my bod foggy. An IV feed perces my left hand, flowing in electrolytes and mysterious clear liquids. My torso is adored with about eight sticky, soft-plastic circles armed with metal nipples, and numerous thin colored cords wrap themselves around the body. A clear tube protrudes from my sanctum sanctorum, loops itself around my legs and wanders over to a plastic bag that seems to be filling nicely with a beautifully colored chardonnay, or, if I swill cranberry juice, zinfandel.

"Taking a walk," which all patients are encouraged to accomplish after surgery by shuttling around the ward several times, is an operation for Cylons like me. The chardonnay and various bits of equipment must be unclipped from the $26,000 bed and re-hung somewhere on the wheelies. Somehow I must be hauled upright, have shoes jessed on, and then off we go the great adventure: arround and around the ward, all eight beds of it.

I’m a star patient–yes, someone on the nursing team actually used that term. I write two blog entries, engage everyone on staff in conversation, entertain visitors, and, most miraculous of all, produce a little product indicative of the bowel’s resumption of function.

The epidural in my back anaesthetises everything in the torso that is lower than it. Never before have I awakened from surgery feeling this good, this competent, this positive. What I don’t comprehend, of course, is how I would feel on the regular post-op goof–narcotics, lots of them.

On the third day, the Eppy is removed. I’m a little apprehensive, since it hurt so much going in (apparently unusual), but removal doesn’t hurt at all.But suddenly, I’m not half the patient I used to be. I can’t sit up without help; can’t cough or blow my nose. The prospect of sneezing is terrifying. Getting out of bed has become an ordeal. Food repels me. My sweat stinks. The blood pressure rises to heights never before seen on my screen. I can’t bend forward, lie on my side, or walk without hanging onto my increasingly protuberant belly for dear life, lest it fall off. The entire abdominal cavity, front and back, has become a theater of pain, racing impetuously up and down the scale from 2 to 8.

The mountain of belly rising before me as I lie in the bed reminds me we are only flesh and blood. How can a body cope with all that we inflict on it?

Oh, yes, I whimper. Once you’ve been a Cylon, it’s hard to go back.

The Knife

Naturally, far from everything was finished as planned before surgery morning dawned. I had contemplated going over useful information with my daughter, such as where my will is kept, or how to ward off various slings and arrows of outrageous fortune which might reasonably be expected to fling themselves our way in the near future. In the interests of not freaking her out any more than she already appeared to be, however, I kept my mouth shut, gave her a hundred-dollar bill in walking-around money, and threw some books and night things into a bag.

I drove. She didn’t even ask. Probably too tired—seven a.m. is too early for her. As soon as we arrived, hospital staff shooed her away, with just a moment to hug me. “Take care of my life, now,” I said, handing her the keys and the aforementioned bag of stuff, thinking that this was her first taste of what it will be like when I do die, and suddenly she’ll this have stuff and activity to manage. “Stop worrying,” I said. “Remember what my mother said about me? ‘Born nine days late and never caught up’? Well, there’s this rule at the heavenly gates: if you didn’t finish your homework, you can’t come in. Just think of all the homework I have to catch up on!” I got a weak smile, and she was gone.

Then the real work began. Clothes off and into a plastic bag, along with the reading material the hospital instructions had suggested I bring, heaven knows why. On with the ugly cotton gown. So far,so familiar. A nurse handed me pills for pain—that was different, but I guess she’d seen an epidural put in before. Because that, indeed, proved a little bit of hell. But before that, something new: thigh-high stockings, so tight you squiggled your mouth around behind one ear in your concentration to get the danged things on (No, they are not designed for the plump patient).

Supposedly, this epidural was going to make a large positive difference in post-operative pain control and let me get away with less narcotic substances cluttering the system, but there is a price to be paid in the negative difference in pre-operative pain. I sat with my naked back toward the Ghostmaker doc, my head and shoulders hung down to afford him a better spine curvature to find his way, a nurse standing in front of me to prevent me from bolting or perhaps falling off the gurney with pain. And oh my heavenly silver socklets, was there ever pain! I cried like a little kid—couldn’t help it.

And then it was over and the Ghostmaker or somebody suggested I “lie yourself down”–I kid you not: apparent medical or nursing degrees do not a grammarian make. I corrected the speaker twice, because a grammar nazi with that much goof in her can’t help herself, but I was gentle about it—do unto others as you would have them do unto you. And that, as I lay spread out like the proverbial patient etherised upon a table, was all I knew until I opened an eye to see my daughter looking for a spot to put some flowers.

The Last Supper

My daughter is distraught at the thought of her mother being cut into—or perhaps it’s simply fear of losing the one rock in her life. She insists on cooking dinner for me. Tomorrow, no food is allowed, and at four p.m. the purgation starts. That means tonight is my last bit of gustatory fun—for a bit, in my mind; possibly forever, in her mind.

She’s terrified I won’t get through the surgery, although that part is not nearly so scary for me. I’ve had surgeries before. Admittedly, this is my biggest: a hemicolectomy, an appendectomy, and a hernia fix. Then there’s the added fun of an epidural. But no, what bothers me most is the prospect of the doctors’ finding a gut full of cancer—that’ll put a monkey wrench into my works, all right.

I’m still getting used to the feel of the word “cancer” in my mouth. I’m not ready to have that word there permanently. It would mean vast changes in diet, a curtailed life, and a short horizon of time. So perhaps this is indeed my last supper free in a possibly cancer-free life.

I remember my three-year-old serving her parents tea in bed, her face screwed up tight with concentration as she balanced a huge tray down the hall. I prepare myself for anything.

Prawns in garlic and ginger, fresh greens, mashed potatoes with the skins, and a nice white wine. A little dark chocolate., all served with filial love. Who could ask for more?

Tomorrow morning’s the last time for pure, smooth, French-pressed coffee. No food, all day.

If you must get cancer, make it colon cancer. Coffee, chocolate, wine—they all supply butyrates and will join those from all that miso and yogurt you’ve been swilling. Run, glucuronidase, run!

Food served with love is the best medicine.

Breakfast of Champions

I out-pilled my mother.

About two years ago, when my nonagenarian mother was in a health crisis so severe doctors and family all thought she would die within hours, I got the bright idea of running her meds through a conflict-checker online.

For a lawyer, that verges on smart thinking. Lawyers check for conflicts in the office all the time, usually by thinking about the past or by having a secretary check ratty files and time cards, or maybe, if the law office has been dragged kicking and screaming into the twenty-first century, a computerised client list. Applying that template to a medical scenario? Hey, pure genius!

Stodgy thinking or pure genius, it worked. One of my mother’s prescriptions was fighting with three or four others, driving her nuts and causing enormous pain. As soon as the conflicting meds were withdrawn, bingo! the same old feisty, sharp-tongued champion of the sharp-elbows competition roared back into play, handicap of IQ 165.

Did I say four or five prescription meds? Those were just the main actors. She had bit players, too–about fifteen prescriptions all told, eating away the family estate to the tune of several thousands annually, benefitting my mother in their convincing array with an assurance of the best medical care.

"This will never happen to me," I would mutter sotto voce. But, of course, you never know what will happen to you once you have fallen into the Old Sod category. I think of the day that looms in my future, when I will not be able to walk out the door and into the woods with a beloved dog, and hope I end before that day.

Mum knew I didn’t fully approve of that cabinet full of prescriptions, especially as they were tricked out with "OTCs"–over-the-counter helpers, mostly to do with the business of excretion or the difficulties thereof. Last week, therefore, she viewed my pill collection on her counter with astonished dismay. Was her daughter so terribly ill as to qualify for sixteen prescriptions? One more than herself?

"They must be carefully taken," I warned her. "Breakfast takes forever nowadays." She blanched, and I almost relented. ”Watch," I advised, taking up the aerobic oxygen and letting twenty drops fall into a glass, followed by the passion-flower stuff (which smells just like oregon grape, by the way). "I drink this stuff against infection, with a glass of water. Then I wait."

We waited. "Now the modified pectin, to make the surgeon’s work easier." Another glass of water with those. "We wait again."

"These are not from the doctor," she pounced.

"Nope," I admitted readily. "They are for the doctor. They’ll make the surgery go better." She might have left then, but the next set of pills consisted of three yellow monsters. "Chelation," I said. "Where’s the yogurt? Don’t you have any yogurt that isn’t made of starch?"

She didn’t. I thought of the fridge in 2001: A Space Odyssey, which holds the same mush in variously labeled cans, but used her yogurt anyway to drop the vitamin-and-mineral stash into the system along with at least some good bugs. "In colon cancer there’s apparently too much glucuronidase," I explained. "So I eat plenty of fermented foods to put butyrates into the system. Butyrates happen when foods ferment. As in yogurt. Miso. That kind of thing."

As each type of preparation was used, I replaced it into my black bag. Twelve little bottles still squatted on the counter, threatening to encroach on her medical space. "What about those?"

"We wait half an hour," I informed her. "Don’t want to overwhelm the system."

Thirty minutes later, she ventured back into her kitchen, wanting to hear about my miracle drugs. "I need a chair," she said.

I hauled one in from the dining room.

"With arms," she reminded me.

I hauled in a better chair.

"Show me," she demanded. Hawthorn, for the heart Magnesium and calcium. Cocky Ten, more correctly called CoQ10.. Most important, because everyone is deficient in this one in these sunless days, Vitamin D. Astaxanthin, the super free-radical scavenger.Cayenne to thin the blood–this is the last day before surgery I can have this baby. A vision supplement, for aging eyes. Colloidal silver…. I downed the goodies with a swallow of the world’s best coffee, pure black, french-pressed, and a bit of very dark chocolate. Next: free-range eggs with fruit salsa and perhaps some creme fraiche on naan bread.

"When are you going to get some real medicine?" she burst out. "And shouldn’t you stop drinking coffee and eating chocolate?"

"Mom," I said, handing her a tissue for the fourth time that day, "if you ever get cancer, get colon cancer. No symptoms, and on top of that, coffee, chocolate, and wine all contain butyrates–just what the doctor ordered!"

"You have more pills than I have," she said wonderingly. "How do you know they will save you?"

"I don’t. But I do know they make me feel stronger, and that’s what’s needed now."

"When do you get some real medicine?"

"Hopefully, never," I said. "We don’t need to think about that question now, Mum. The important thing is to get through the surgery as strong as possible."

Tears threatened. She was thinking about the prospect of losing her last child–me–for no reason her formidable intellect could ascertain. "You eat so healthy…and so little. Look at us–we eat normal." She waved a hand at the twin buckets of medications for her and for my step-dad. "A few real medicines, and we are in the nineties."

I didn’t have the heart to point out that her generation had grown up before pollution put a stranglehold on Earth. No medicine yet invented will likely stem the tsunami of illness that may well overcome us older humans. Remembering how, as a child, I was detailed to the task of poisoning the "weeds"–the dandelions, thistles, and indigenous plants–and the "bugs" in our vegetable garden with a wand of DDT or a spray gun of the latest murderous chemical, I judge it a miracle to be alive at all today.

Mum’s fridge is a desert. I can’t bring myself to eat a single item in it. Everything is chock full of stiffeners or softeners, sugar in all its disguises, screwed-up oils, artificial this and that. No fresh greens or fruit–not a leaf or segment. For protein, a pan of what passes for gravy, with several bits of boneless chicken drowned in it. The wonder of it all is that this horrible diet seems to be survivable for Mum and Dad as it certainly would not be for me–two days of it and I’m so sick, I need a week to recover..

I take Mum in my arms. "Don’t worry," I say, stoking the sparse hair that once was so fiercely abundant. "I’m fine. I’m strong. The docs know what they’re doing. Everything’s going to be fine."

And if not, I think, you’ll be the last one to know.

The Ghostmaker

The booking clerk at the OR called: the anaesthetist wanted to meet with me.

It dawned on me then that this promises to be a serious surgery. I’ve never met with an anaesthetist before. Most of us can hardly spell the word, although, by my age, most humans have had occasion to fall under his spell.

Dr. M has no office–just a well-organised desk in a corner of the surgery area.There’s a binder on the desk which turns out to be totally focused on the body I walk around in. He lets me read it. This is good, since I own the body which is the subject of the book and I also believe in patient autonomy. These reports belong to me, whether I paid for them personally or not.

This discussion is about what is going to happen to the body on Monday, and about how to keep the pain under control afterwards. It turns out our understandings about the colon re-section differ quite a bit. I think Dr. P is going to chop out just a few inches, but Dr. M expects a foot or more will have to go. The nice thing about being in a small town which has a biggish hospital is that doctors can actually get hold on one another quickly. So off toddles Dr. M, to talk with Dr. P. While he’s gone, I peruse the binder…and discover the answer to a long-held question.

Fifteen years ago, when I was suffering the indignities and agonies of full-fledged FMS while simultaneously being the butt of approximately 40 lawsuits, I was sent for several IMEs. An Independent Medical Examination is a procedure that supposedly gives the court an independent professional insight into the litigant’s medical condition, to help the court (i.e., judge) decide what factors caused it. But IMEs are often boilerplate, biased garbage. Every lawyer knows that there’s a stable of plaintiffs’ doctors, and a stable of defense doctors, and seldom the twain do meet.

I was sent to the defense doctors, of course, the guys whose job it is to opine that one’s symptoms are all in one’s head. My examiner was doubtless chosen for his cleverness; the defense needed someone who could trap me, the lawyer who just had to be faking her symptoms, into betraying her expertise with the situation. So, as he was feeling me up, which is, after all, his duty, he said provocative things, as if talking to himself, hoping for a reaction. The comment I remember most clearly was his observation that he found hepatomegaly.

That word means the liver is enlarged. A cross-examining lawyer would seize on that word as implying the patient is an alcoholic or some other kind of addict. Hepatomegaly was an invitation to spar with the good doctor. I might argue with him and thereby give him material for the defense theory that I was a malingerer and also, perhaps, release a few facts about me. At the least, if I reacted, it demonstrated my "unhealthy" interest in studying my own case.

I said nothing. No reply. But I worried. As the treatment plant of the human body, livers are tremendously important, and we each have only one. Was mine really in trouble? I’ve worried about the poor thing since 1995.

The binder reported the results of the x-rays and scans I’ve had lately. Not a damned thing wrong with any organ besides the colon. The liver was stated to be normal.

That doctor lied to me. He lied, for the sake of a lousy lawsuit. For an insurance company that paid his bill. Remember this if you ever are forced to submit to an IME. The examining doctor is not your friend. Keep your mouth shut.

Law tries. It tries to be good; tries to help people. Yet it simply cannot understand that the profit motive poisons its systems.

My current doctors have no axe to grind. They are totally on my team–what a relief! Dr. M returned and cheerfully described the choices in pain control. We chatted about ancient history–his childhood and mine–when each of us underwent a tonsillectomy while we were put out like lights by a sweet-smelling snootful of ether. (The stuff is still used, apparently, where more sophisticated substances are not available.) Nowadays, there’s a choice between patient-operated narcotic administration and an epidaural administration of anaesthetic, with maybe a little painkiller to boot.

Here’s the scary bit: the epidaural is a lot like a spinal tap. I think the docs even refer to the procedure as such. As a law student, I had to do research on an almighty thick case where a patient who underwent a spinal tap became a permanent paraplegic. I learned a lot of medicine from that case, but I also learned I never wanted a spinal tap, or a lawsuit.

The time has come to add the spinal tap to the lawsuits that have bludgeoned me. Times have changed: instruments and remedies have improved. Narcotics, on the other hand, are as nasty as ever–if you’ve ever wondered what it feels like to be dropped on a sidewalk like a sack of concrete, try pulling a morphine feed out of your arm sometime. Aughh!

I think I’m going to opt for the epidaural. But it’s frightening.

I think of all the moments in my body’s life when what I understand to be me was not in that body. Never mind the tonsillectomy–what about the times I’ve fainted or been knocked out, and the half-dozen surgeries? Where was "I" in those moments?

Either I did not exist, or "I" was a ghost. That’s what this man does for a living–turn people into ghosts, and then back into people.

Everything will be fine, and the surgery will give up answers otherwise unobtainable. But for several hours on Monday, I will be a ghost. This time, I plan to ask my spirit to pay attention to its whereabouts. Just for once, I’d like to know what the hell is going on.