by Randolph T. Holhut
Chief of AR Correspondents
April 9, 2013
IT'S TIME FOR CONGRESS TO FOCUS ON JOBS AND GROWTH
HARMONY CROSSING, Ga., April 5, 2013 -- When I decided on the spur of the moment last month to get surgery for a tumor in my colon, the last thing I thought about - actually, I never thought about it - was pain. I've thought about little else since.
When they cut you nearly in half to "re-section" a few inches of your lower colon, there are two awful moments: the first, when you are transferred newly awake after surgery from the OR platform to a gurney that will be pushed to your hospital room, and second, when they transfer you from the gurney to your new bed.
Frankly, I screamed out loud in agony on both of those occasions, and perhaps a dozen times later as I learned the things my body was prepared to do and the things it was not.
Part of that second stage of pain involved the naso-gastrointestinal ("NG") tubes that are thick white pipes threaded down one nostril into your gut right after surgery to pump bile and other ghastly-looking green fluids from your wound into a large plastic box that rests near your bedside.
In my case, there was also a two-pronged oxygen tube that competed with the NG tube for one nostril and half-filled the other. Another tube went into my stomach from my right side, but that one didn't create any notable discomfort. The oxygen tubes promote healing, physicians believe, by providing oxygen more directly to the surgical wound. There was also a bandage on my stomach where a laparascopy was started and abandoned, and IV tubes feeding drugs and nutrition into my system.
Despite the best efforts of a team of nurses, the IV stand’s computerized monitor kept setting off alarms, often requiring a reinsertion of the IV tubes somewhere else in my left or right hands or forearms - thery were all used at some point, sometimes morre than once. Every two hours I was awakened if asleep for a blood sugar check (I have Type I diabetes, controlled by pills), a new blood draw or a blood pressure check. Real sleep was virtually impossible.
The problem with the NG tube, beside being a painful intrusion into my nose, was that it stirred up sputum deep in my throat that it took me days to clear out. That was because even trying to cough revived the agony of the stomach wound. When would thy take it out? "We're waiting for a fart," Dr. Erbella told me. That would signal that everything was working as it should.
I was so paralyzed by the initial pain of the gurney transfers that for two solid days I lay flat on my back and never even tilted my head left or right. I just kept perfectly still for those two days and prayed endless Hail Marys for healing. That seemed to work: when I did finally move, I could feel the healing that had occurred, at least in much-reduced pain.
Three or four days after surgery, I finally cleared my throat for the first time. As I coughed into a Kleenex, I saw the thick green rope of sputum that had bedeviled me for days. It was so ugly-looking I twice started to retch, but thankfully was spared the agony that would have entailed.
My surgery had occurred on the morning of Friday, March 1, after a discussion with my magnificent surgeon, Dr. Jose Erbella. At the suggestion of my proposed surgeon, Dr. Richard Karl, and a urologist, Dr. Spiess, at the Moffitt Comprehensive Cancer Center in Tampa, a federal facility devoted to treating and curing cancer, the plan was to try to preserve my current lifestyle by first trying to shrink the tumor - discovered during a colonoscopy on Dec. 13 - with three months of chemotherapy. They hoped they could prevent my having to wear a colostomy bag to collect feces from my resectioned colon, or an an ileectomy to collect waste from my small intestine; they believed my bladder had been "perforated" by the cancer.
Dr. Erbella had installed a "port" for chemotherapy on Feb. 28, and I was pursuing Dr. Karl's plan until I got into a brief conversation with Dr. Erbella on March 1, the morning of my proposed colon biopsy. He pointed out that chemotherapy doesn't always work, and that delaying surgery might give my cancer a chance to spread.
Up to this point, I had taken my cancer with a great deal of equanimity. I didn't think a lot about it, and wasn't very worried at all. As I lay on my back talking to Dr. Erbella, though, I saw that I had two distinct options: I could delay the surgery and risk that the damage the cancer did would grow worse, or get it now and get the chemo after, when the cancer was at least mostly gone and presumably would not spread as fast.
I have to add that were it not for my chemotherapist. Dr. Robert Whorf of the Florida Cancer Specialists location in Bradenton, Fla. A stylish graduate of Harvard and Yale, I would not have had the surgery when I did except for him. He declined to provide chemo to me until he had seen the results of a biopsy, which the colonoscopist was unable to perform because of worrisome bleeding in my "friable" tumor when he tried.
Dr. Whorf, who wore a blue blazer, checked green, bLue and orange checked Madras-style shirt and creamy yellow slacks at our first meeting, said he knew a very hard-working surgeon at Manatee Memorial Hospital, a man who often worked past midnight and might be able to make time to give me a biopsy and chemo port fairly soon. Meanwhile, he would see me again on April 2. The alternative was waiting for months for a biopsy at Moffitt. I didn't want to wait.
I gripped Dr. Erbella's left arm as I lay there and asked him if he was a "religious man."
"Yes," he said. I asked him to pray with me, and began praying aloud to God to guide his hands and help him heal me. Seconds after my fervent 20-second prayer ended, I was out cold and on my way into surgery to remove the tumor.
I thank almighty God and Our Lord Jesus Christ for the circumstances that led me to surgery that morning. It turned out that as soon as Dr. Erbella opened me up, with a nine-inch vertical incision right through my belly button, he spotted the tumor and an abcess inside it. The abcess had broken through the wall of my colon and through that hole the cancer had started to attack my bladder.
During a painful cystoscopy at Moffitt a few weeks earlier, when I had a chance to look real-time into my own bladder and see the deformation the tumor had already caused, I was never clear about what I was seeing. There were white finger-like things that I understood to be from the anesthetic cream on the catheter, and what looked like snow - "debris," the urologist called it - in the fluid inside. I was amazed to see the actual urinary sphincter; I had never even realized there was one, looking much like the anal sphincter.
Dr. Phillippe Spiess, the urologist, tried to point out the actual deformation of my bladder caused by the growth of the tumor pushing it from my colon, but I was unable to distinguish it. Later, he told me that even though he had not seen it, he also believed the cancer had "invaded" my bladder - i.e., broken a hole in it. My brother Johnny died of bladder cancer just a few years ago, so that did worry me. But I insisted that since he had not seen the perforation he shouldn't recommend an cystectomy based upon his belief; he agreed, but insisted back that a perforation was probably there.
Another worrisome finding was from the MRI that was done; that showed that the immunoreactive iodine had lit up some of my lymph glands, which can often be a pathway to the widespread development of cancer. Once it's in the lymph glands, I knew, it can go almost anywhere in my body.
Dr. Erbella, though, did not see a hole in my bladder. Instead, he said, he had done an instant "frozen" biopsy during surgery of the scrapings from my bladder wall; there was cancer in the scrapings, a pathologist's report said, and the pathologist also argued later for the presence of an unseen perforation. I'm with Dr. Erbella on that. Whatever the truth, I don't have to pee every two hours, day and night, anymore. And with the abcess, my diverticulitis was also removed.
The best news of all was that while the number of lymph glands harvested during the biopsy was small, 10 of the 10 glands Dr. Erbella captured were negative for cancer. That was an enormous relief to me, even though Dr. Erbella made it clear that there might well be cancer cells remaining adhered to my bladder wall, and that months of chemo are needed to be sure we've killed those.
Dr. Erbella was clearly optimistic. He told me he believed he had gotten all of the cancer, possibly including those adjacent to the perforation, and that my immune system had limited the spread of cancer cells in the space between the colon wall and the bladder. Later, he told me that having chemo for months before surgery might have "blown away” my immune system, allowing it to spread.
Frankly, I was overjoyed by the results but in too much pain to show it. I did ask him two questions about the surgery.
"Was it hard?" I asked.
"Yes," he said.
"Was it complicated?"
"Yes," he said.
That kind of honesty was unexpected, deeply appreciated, and built my confidence.
It had been a hard, complicated, two-hour surgery that successfully removed all of the cancer cells and the 1.5-inch, 1.2-ounce sarcoma (tumor) that were apparent. I was free.
"You beat the Reaper a second time!" my friend and AR Correspondent Randall Holhut cheered. For me, though, beating cancer was not something I had done at all.
As I trace the peculiar set of circumstances that led to getting surgery in time to keep my bladder, I could clearly see the hand of the Lord in the series of events. I am a moderately religious person, but I think my experience made me much more so. There were two critical "interventions" by family and strangers that make me feel that way.
One occurred when my niece Theresa's husband, Cronin Connell, called me from his home in Alabama after learning I had cancer - about two weeks before my unplanned surgery. I don't think I had ever asked anyone to pray for me, but I did ask Cronin - a former Catholic and now a devoted Christian - to do so. I was overwhelmed with gratitude for the intense, fervent, hopeful prayer he offered as I heard the words coming from deep inside him. I felt that those words and the Lord’s response helped shape the sequence of events that led to my timely surgery.
The second occurred at the Golden Corral in Bradenton, of all places, at a free seminar on health plans and buffet attended by about 20 people, including two black women who sat not far from me. They were Mrs. Jones and Sister Dee.
I told them about my experience with Humana, my insurer, which has been almost entirely positive (they need to monitor their free transportation delivery more carefully). Thanks to Medicare and Medicaid and Humana, I had $242,499 worth of health services at Manatee Memorial at no expense to me. I learned after my release that the sequester cuts President Obama has adopted have curtailed some cancer treatment for thousands of clinic patients; the clinics say the cuts in reimbursements made the treatments too expensive.
I told Mrs. Jones and Sister Dee about my friend Cronin praying for me on the phone. Sister Dee, it turned out, had also contracted colon cancer a long time ago and felt she had been healed by prayer alone. At my request, she began to pray aloud for me there in the restaurant.
It, too, was a long, intense prayer, with Sister Dee shaking with emotion as she spoke to God, and Mrs. Jones and I responding "Amen!" through the peaks and valleys of her prayer. I believe God listens to those who ask Him with all their hearts for what we need, and armed with the prayers of Cronin and Sister Dee - and my own - I have survived. It was prayer, indeed, that "beat the Reaper," Randy.
I was in the hospital for 13 days. On Tuesday, March 5, after having once passed gas that morning, at 8:30 p.m. the NG tube was finally removed by my nurse, Christina. It felt like it had been folded in dozen-odd sections before it wass inserted, because as it came out it repeatedly bumped against the back of my septum every inch or so as it was withdrawn. On about the twentieth bump, it was finally out.
The tube from my stomach stayed about a week longer, and when she started to pull that out, it seemed to get stuck somewhere inside. Overcoming her sense of compassion with the firm grip of authority, she pulled harder and out it came. The pain was like the NG pull, a little painful but nothing like being cut in half. I was released from the IV drip only when I left Manatee Memorial.
I spent another 12 days at a skilled nursing facility called Greenbriar in Bradenton, and a friend, Tony De Pinto, came from my building to pick me up on March 25. Tony had been through three hip replacements and extensive heart surgery and had no illusions about my impaired ability to walk and function.
He had known a little about my issues after we spoke briefly when he helped me jump my car battery before my first appointment with Dr. Worth, and ended up actually giving me a ride there. Tony was the first person outside my family to discover why I was missing from the building for days.
There had been no time to inform my family that I would get surgery, but Dr. Erbella called my brother Pat immediately afterwards and told him all about it, and he let the rest of the family know. But Tony had seen that my car was in our El Conquistador parking lot but noticed that there were no lights on at night in my apartment. On his own, he called Blake General, a local hospital that had seen me last year for diverticulitis, and they'd told him I wasn't there.
Then Tony called Manatee Memorial, a beautiful, modern hospital with a magnificent view overlooking the new Bradenton Riverwalk and the broad, blue Manatee River over US 41, going north over the river into Palmetto. He became the first visitor to my hospital room, coming to wish me a swift recovery. I wasn't sure anyone would visit me, so I was delighted to see him.
The next visitor was someone I’d never met but ioften read about: Mark Flanagan, the former chair of the Manatee County Republican Party, who is a friend of my brother Pat. Mark had offered to visit me when he and Pat, by chance, talked one day. He brought me a Rosary prayer wheel and prayed for me; he even crossed himself when I told him I was Parliamentarian of the Manatee County Democratic Party.
Next was my closest friend in Bradenton, Harry Williams, who had just broken his ankle and hurt several vertebrae when he'd been hit by a car on his bicycle. Harry had to "hop” for more than a mile on crutches to get there. We talked and prayed together, and he left me a Rosary.
Then, like a pair of saints from the far beyond, came my brother Billy and his wife, Claudette, who'd driven 500 miles down from Monroe, Ga., to be with me. They stayed at my place and even cleaned it up for me; the refrigerator alone was a task comparable to the cleaning of the Augean Stables by Ulysses; they made my homecoming to a neat, clean, quiet, beautiful home a moment of joy.
While they were there, I was overjoyed to get a call from my beloved sister, Mary Ann, who just a month earlier lost her second husband to lymphoma, and who last year helped save the American Reporter from extinction. My great fisherman cousin, Richard Roberts, a wildlife guide and chairman of the Snook Foundation, and the great love of my early childhood, my cousin Patty, also called and sent me their prayers and love. I was delighted to hear, too, from my dear Aunt Rita, who has showered me with kindnesses for years.
My last caller was Richard O'Brien, the former chair of the Manatee Democratic Party and an associate professor at the University of South Florida; sadly, he has just lost his mother. Now he's moving to Washington to work for the State Department, and I hope he will soon be writing for us on foreign affairs.
Beside the beautiful red and white roses my brother and Claudette got me, there were half a dozen cards from other well-wishers at the DEC and family arrayed on my windowsill. They gave me a quiet happiness and silent joy that lasts to this day.
Back in 1980, the L.A. Weekly assigned me to write an article, which I called "The Gift of Cancer." In it, I wrote about techniques like Dr. Eugene Gendlin's psychotherapeutic "focusing," a practice he’d developed to help burned-out anti-war activists during the Vietnam War, and other advances to help cancer victims at The Wellness Center in West L.A. deal with the pain and fear it generates so often. The editor, though, rejected the piece; he said it was "too depressing."
But 20 years later, in 2013, I learned something from the gift of my cancer that is really profound. I learned that we can trust God to help, yes, but much more. I learned that out there at the margins of your life, or sometimes even at the center of it, there are people who care more deeply for you than you would ever think or dare to hope.
They may be relative strangers, like Dr. Erbella, Dr. Worth and Deacon Ron Dains of Sacred Heart Church in Bradenton, my friend and colleague from the Beverly Hills Goldbook, Josie Briones, Tony De Pinto, Carol Greaves, Mark Flanagan, Mrs. Jones and Sister Dee, close friends like Harry and AR Correspondent Ted Manna, my wonderful ex-wife Mireya, who called from Peru; family like Pat, Billy, Claudette, Mary Ann, Cronin, Richard and Patty, or great acquaintances like Pat Benson and Richard O'Brien. Whomever they are, they, too, have their challenges; they, too, have lost people, been hurt, been through the pain of illness, and from their experience have become able to open their hearts to someone like me.
I can only hope and pray that because of this ordeal, I can open my own heart to be more like them. That kind of compassion has never been my style, but now I know that I can change.
Joe Shea is a founder and Editor-in-Chief of The American Reporter. Write him at firstname.lastname@example.org.