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A Simple Irony
A cigarette smoking, ten cup a day coffee funnel, computer programmer -- overweight with high blood pressure. At age 49 I decided it was time for some life-style changes.
I knew that exercise was essential to my plan for the rest of my life, but bone spurs around my big toe joint made walking difficult and running very painful. Being on an HMO it is not always easy to get a referral to a specialist. I had been trying for a couple of years but the doc's concern was with my blood pressure. She had been after me the entire time I have been her patient to get it under control and even convinced me to take daily doses of medication; something I had vowed I would never do.
This time I went to the doc with the intention of striking a bargain. She would give me the referral to orthopedics to fix my toe and I would get into an exercise routine to get my weight down to somewhere near ideal for my height. It was easy, she bought it immediately... But, she said, "You have to quit smoking." I was not expecting a counter offer. I stuttered for a moment then argued that that would be counter productive. To give up smoking would surely cause me to gain more weight than I could lose, and the blood pressure would probably go up instead of down. She was ready for me! The Center for Health Promotion right down the street had a program with doctors who could prescribe whatever drugs were necessary, and group sessions to give the support needed to ensure success. I am hoist to my own petard. She had the better of me and I had to agree.
Cigarettes had been my best friend for so long that I was already feeling a sense of loss. But I began to uphold my part of the bargain. With the referral to "Ortho" secure, and the appointment made, I contacted the "no smoking folks" and set up a January start date.
Well, the January date came and went. I think I was waiting for some blood work up or something so it was rescheduled for February. As it turned out the surgery on my toe, (Remember the toe? That’s how we got here.) was subsequently scheduled for the same day as the starting February session. So it was rescheduled again for March.
Finally, March 6 1997. My toe has healed almost to the point where I can start to get some exercise and today is the first meeting for my smoking cessation group. I have had quite a bit of time to get accustomed to the idea of quitting smoking, but I must admit some apprehension going to the group. When I stepped inside the room, I knew! I had smoked my last cigarette! I crushed the half pack of Kools which were in my pocket and tossed them in the dustbin. I called my wife, Kay, at home and asked her to sanitize the house for me. You know, get rid of all of the old butts laying around, and wash my clothes from earlier in the week. I was really feeling good about the decision to quit and for the first time in my life I knew that I could and would be a NON-SMOKER for the rest of my life.
Of the many times which I have attempted to quit during my 37 years as a smoker this is the only time that I have had no second thoughts or fear of life without my cigarette friends. The credit for this is probably due in equal parts to a drug, bupropion, and my months of preparation to quit. The only real rocky part so far was on day three, while working on a program. I was having difficulty with an algorithm and became angry. I searched the house high and low for a smoke but Kay really did a good job. The place was clean... but way in the back of the closet, in the pocket of an old jacket - I found it. A butt. Three quarters of a cigarette. Pre Smoked.
I smelled it. I fondled it. I coveted it. I walked to the kitchen to get a match. But what is this? No matches in the drawer? Ok, I don't want to stink up the house anyway, so I'll just light a candle and carry it outside to light the cigarette. Then it hit me. This is not an activity which a NON-SMOKER would engage in. I crumbled and flushed that butt and had a glass of water instead. Did I mention that I also gave up my coffee habit when I became a NON-SMOKER? I figured why go through it twice, so I just kicked it. Now my hot beverage is water with a dash of lemon.
Week one is done and the second group session is as good and informative as the first one. Now into week two. Day eleven was the first day I didn't even have an itch. The war is won. But I have been having this nagging pain in the middle of my back. I can't remember doing anything to strain it, but none the less it smarts. My Doc can't see me for fifteen days, so I went to urgent care. They prescribed some pain medication and a muscle relaxant. That worked through the weekend, but on Monday it was back to urgent care. This time they took a little more time. X-ray, stethoscope, push and probe. The diagnoses this time is pleurisy. A course of antibiotics and some more pain pills and I should be as good as new. Tuesday I feel great. No back pain for the first time in about ten days, and a good productive day at the office.
Things changed a few hours later. Have you ever had to wake up your spouse at 4 AM and say "Honey, will you take me to emergency?" Kay took it well. She didn't panic or go hyper. Once I am up and around the back pain is not so bad, so I drove to emergency. I figured that would calm Kay some. So, more poking and prodding, but this time they are thinking HEART. More X-rays, Nitro under the tongue, EKG, Etc... They have concluded pleurisy and pneumonia, and had just about decided to release me to go home when Kay pointed out that some pain I was having in my jaw went away after the second nitro tab. That perked them all up! That was my ticket to the cardiac intensive care unit.
How does anyone get well in the hospital? I went a full 24 hours without any food. Just water. I was suppose to undergo some tests but they didn't get coordinated and I got starved instead. When dinner finally was allowed it was an hour late, re-heated and totally gross. I think I ate most of the warm salad and called it a night.
Thursday morning The cardiologist gives me the program: A full day of various tests --starting now. I told him It was VERY important that I am discharged before 6:00 PM, because tonight is my third smoking cessation group. He said that probably would not be a problem. So first thing on the agenda is the "at rest" part of the cardiac stress test. Easy enough. These guys have the coolest toys! Gamma ray cameras that build 3D images on a computer. A heat mapping camera that makes almost motion pictures of the heart at work as they inject ice-water into your veins. Way Cool.
Next, on to the CT body scanner. This is a huge square block with a hole in the center and a movable tray where the patient (me) lies and is transported into the hole. It seems there should be a legend that says "Insert Patient Here." Hold your breath. OK breathe. In and out of the hole. Stuff internally spinning in the huge block. About twenty minutes and done.
Back to the ward where I get to watch everyone else eat. Then on to the "STRESS" part of the cardiac stress test. This one is not so easy. It is the same cool toys as the first time through except this time I am running on a tread mill and am suppose to tell them two minutes before I expect to collapse. I guess I gave a reasonable performance for a 49- year-old-recently declared-NON-SMOKER.
At last, some food, or at least the institutional facsimile thereof. Time is getting short. Hopefully the cardiologist will get back here and discharge me so I can make my group. The Doc-in-training stops by and asks if I can get Kay over here so they can discuss the results of the tests with us. I told him it would take about 15 minutes. Finally, we are going to find out what is going on. I was not expecting the bomb. He said, "The CT scan showed a mass in your lung, and the lymph nodes around the heart seem to be involved."
There really is no logical response to that statement. Asking questions only made it clear that these are cardiologists, and the answers had to come from oncologists. "Well, can I get discharged so I can get to my group session?"
"No. We need to know what the mass is so you are scheduled for a needle biopsy NOW, and you won’t be released until tomorrow."
The biopsy is done but the results won’t be available for five days. For the first time in my life I took a sleeping pill to get to sleep. I have no idea how Kay made it through the night.
The next five days are filled with family, prayer, tears, hope, a resolve to get well and the realization that my life has touched many people, and many of those people are now reaching out for me. I have always been tough, but it's a relief that so many others are ready to be tough for me while I catch my breath and get my bearings.
The oncologist said this is the fastest growing of the lung cancers. "It has probably only been with you for a month or two. The tumor will respond to chemo-therapy which will start tomorrow and you will probably be feeling some relief within a few days."
So what is the probability of a cure for me? Will the chemo do the job? Only one or two percent of the patients whose cancer is not localized to the chest area will be cured... How Long? One year, two years, three years. Who knows?
As grim as that may sound, it was really a relief to me. With the full understanding that this is the logical result of the choices I have made during my life I was expecting to hear "Too far advanced, No treatment is available." With my family, my support network, some of it newly discovered, some of them praying to God, some praying to Allah -- that one or two percent sounds pretty good to me. It is time to get tough again, to focus on the battle and live one day at a time. When one day is too tough then we will live for the minute. I wanted life style changes, but this is not what I had in mind. Who was it that said "Be careful what you wish for. Your wishes may be granted?"
I will survive!
Don F. Bruno