The "Extra" Summer Vacation

We concluded that 1998 featured two summer vacations.

First was the "real" one - from June 16-29, when we really broke in the new car we had purchased about two months earlier. This vacation included The National Advanced & Challenge Square Dance Convention in Louisville, Kentucky; followed by The National Square Dance Convention in Charlotte, North Carolina. It was a pleasant two weeks away from home, work, and the "medical madness;" filled with lots of fun memories that would surely help us get through the uncertainty that was ahead.

And then there was the "enforced" vacation, which included my fourth lung surgery and all that went with it. After all, this operation would feature a change of scenery and a different cast of medical characters...

I took myself to Fox Chase for pre-admission testing on July 1, 1998. It was the first time that I made the 90-minute drive from home alone. For the most part, the tests went well. In addition, I was able to take advantage of the time to explore those parts of the hospital that I knew family members would need to know about for The Big Day (such as the waiting area and the cafeteria). For once, I showed up with a list of questions - and managed to get nearly all of them answered.

Surgery was scheduled for 8:30 a.m. on July 7. (My 7th operation - on July 7th. Lucky 7s indeed!) We arrived at Fox Chase at the appointed time of 6:30 a.m. I was taken to the OR at 8 a.m. The last thing I recall was being positioned to receive an epidural at 8:14 a.m. (Since I never had children, I was somewhat apprehensive of getting this - given the description of the procedure, I was only too happy to be "out" at that point.) I awoke in the Recovery Room around 12:30 p.m. or so and was moved to the ICU around 2 p.m. The ICU nurses told Ken that I looked better than most patients who've had this type of surgery. I guess I must've been doing something right!

Boy, these folks were right on the money as far as timing went! We had been told that it would be about 6 hours from the time Ken said good-bye to me as they took me to the OR until the time he could see me in the ICU. You do the math!

So, what happened? Looks like it was more than we bargained for: Dr. Goldberg told Ken he removed about 20 nodules from the area surrounding the left lung, the lung surface, and the interior of the lung. He also discovered that the cancer had migrated to the diaphragm, and he would up taking out a piece about the size of a quarter - that was a surprise! Although the doctor explained that he had removed as much of the disease as he could, he pointed out that there were probably still some microscopic cells left that he couldn't find and remove.

In addition, Dr. Goldberg told Ken that the right lung "has just about as much disease." So I guess we know what we have to look forward to in January '99.

One of the things Fox Chase prides itself on is pain management. My experience in the ICU was quite different from any of my previous surgeries. For one thing, I was in much less pain - that epidural seemed to work wonders for me. The moment I had dreaded from my previous surgeries - turning onto my side so the nurse could check my dressing - turned out to be a breeze. ("Hey, I did it!")

One thing didn't change: the need to begin breathing exercises immediately. This time, the respiratory therapist had an updated version of the machine with all the lights that I had used back in Round 1 at Bayshore. But this time, the pillow that I was supposed to use for my coughing was replaced by something much more fun: a small teddy bear named Sir Koff-A-Lot (later to be affectionately known as "Koffee"). Either way, these exercises seemed to go much more easily than I remembered.

I was also trying be extra careful about my intake of ice chips, after the unpleasant experience I had at Mt. Sinai five years earlier. Needless to say, I was surprised when my request for a refill on Wednesday morning was met with a response of "How about something more nutritious - like juice and crackers?" Imagine my glee when these stayed down with no problem! And to top things off, this little bit of progress was accompanied by my first escape from the bed onto a nearby chair.

Another difference in this hospital experience is that visiting hours in ICU are the same as in the rest of the hospital - and not restricted to family members. So, I was pleasantly surprised at lunchtime on Wednesday when my friend Barbara came to see me. And since she worked only a few minutes away from the hospital, she was able to visit me nearly every weekday at that time. Later that evening, my friend Arleen also came by; which enabled Ken to leave for home just a little earlier.

I was moved into a regular room on Thursday - just in time for the Jewish chaplain's weekly rounds. (I was greeted the next day by a volunteer representing the Philadelphia Board of Rabbis, which has a program of distributing challah and Kedem Grape Juice to all Jewish patients for Shabbos on Fridays.) Ken promptly brought the laptop and figured out how to connect it so I could access my America On Line account. The needlework bag arrived the next day.

Most of the tubes were removed on Friday - and by midnight, I was finally untethered and could make my first trip to the bathroom.

And I settled into a routine that I'm sure must have amused the medical staff, given all the "fun" stuff I had in the room: The stitching, the newspapers and magazines (My copy of People magazine that featured Barbra Streisand's wedding to James Brolin was especially popular with the night nurses.), and especially the laptop computer.

Unfortunately, not everything went that smoothly. One area in the upper lobe was stubborn to heal, causing a small air leak near the incision. On Tuesday, the doctors rolled in a more powerful suction device (affectionately known as "the little green monster") in an effort to speed up the healing. As I had told one of the residents, I really wanted to get out by the end of the week - I had plans; specifically my 25th high school class reunion.

Dr. Goldberg literally bounced in on Wednesday, having gotten wind of this conversation. His first words to me were, "Why didn't you tell me? We have ways..." Well, I really didn't think it was going to be an issue...

I was finally discharged on Friday, July 17, with a little "appendage" called a Heimlich Valve dangling from my left side. This was a 7-inch piece of rubber tubing that's flattened at one end and enclosed in a hard, clear plastic case. (It "flutters" when it's working, hence its alternate name of "flutter valve.") It's designed to remove air or drainage from the space bewteen the lungs and the chest wall. Yes, this was developed by the same man who gave us the Heimlich Maneuver - I eventually learned that he came up with this device after inventing the Maneuver.

I was also ordered to have a visiting nurse for two "instructional visits" - to show Ken how to change my dressing. She made her first appearance the next morning to demonstrate - then made Ken do it himself two days later. Given how much Ken hates the mere sight of blood this was no easy thing for him to stomach!

But I managed to make it down to Toms River for my high school reunion. The top of my 2-piece outfit just managed to cover the "appendage," and I simply placed a plastic bag over the valve to catch the drainage so I wouldn't leave a "trail" behind. Although this was probably not one of my saner moves, I figured it was feasible: The party was being held only a few minutes away from the nearest hospital. We were only going to be no more than 5 or 10 minutes away from the parents. And, I knew there would be at least one nurse among my classmates in attendance. (As it turned out, there were two nurses and a doctor in attendance.) So, if I wasn't going to be stuck in the hospital, how couldn't I have gone???

We spent the night at Ken's parents' home in Toms River, and visited my mother in Lakewood on the way home the next day, so she could change my dressing (and Ken wouldn't have to!).

I had my first post-op checkup the following Thursday. At that time Dr. Goldberg removed the valve, leaving Ken ecstatic at the thought of no longer having to change that dressing. We were also surprised to learn that the doctor didn't want to see us again for three months. When I asked the fateful question, "When can I go back to work?" he replied, "Whenever you feel you're ready." Gee...

Now came the "fun" of recuperating- a pretty lonely process, as it turned out. It was difficult for me to accept the fact that since the surgery was more extensive than any of my previous ones, it would take that much longer to recover. (Let alone the fact that I was now five years older than I was the last time I underwent surgery.) I became tired much more easily. The effect of the surgery on my diaphragm became apparent whenever I yawned or sneezed (and once when I laughed much too hard!). Because I was on percoset for pain, I wasn't allowed to drive. I finally got behind the wheel about a month after the operation - and even a short trip to the store left me exhausted by the time I came home.

As it turned out, I wound up going back to work a little later than planned. I had decided I didn't want to return until I had my summer checkup at Mt. Sinai - Dr. Urken had said I could wait a month or two after the surgery to see him. (I'd been seeing him in July.) Since Dr. Urken was going to be out of the office the week I wanted to see him, I decided (for once) to err on the side of caution and see him later rather than sooner.

I returned to work on August 31, 1998. The folks in AT&T's Disability Management group had penciled me in for two weeks of 4-hour days, followed by two weeks of 6-hour days. It didn't take long for me to realize I needed to be serious about these hours - my body still needed its rest.

However, returning to work featured some additional "challenges" I hadn't expected. The parking lot nearest the building had been redesigned two weeks before I got back - with more spaces opened to everyone, that were often filled by 7 a.m. Although I had spoken to the folks in Security before leaving for surgery about obtaining permission to park in the "executive" section, I returned to find far fewer spaces in that section and that they'd been moved to a location that was much too far for me to walk comfortably on a warm summer's morning. I was often exhausted by the time I reached my desk on the third floor. And to add insult to injury, the elevators in my area of the building were being "modernized" - and there were more than a few moments when the elevator not being worked on was also out of order. It was no fun begging the folks in Security to kindly operate the frieght elevator for me to return to my desk from the cafeteria - and yes, there were several times when I was unsuccessful (and endured a few inedible lunches as a result of meals getting cold by the time I finally got back to my desk). Suddenly that half-mile hike to the cafeteria in Basking Ridge (aka my source of "exercise" following my previous lung surgeries in 1992-93) seemed so much easier to deal with...

In the end, I tried to arrive at the office in time for the overnight guard to go off-duty - so I could get his close parking space. (Sometimes this worked, sometimes, it didn't.) And after speaking to a representative from Human Resources, I finally broke down and requested the appropriate forms from the Division of Motor Vehicles to apply for a Disabled Person tag for the car. If nothing else, I'd be prepared for the next surgery come winter...

But when I reviewed the requirements for specifying the disability, I feared I might be considered "too good" for the description listed for lung disease. Rather than simply mailing the form to Fox Chase with a cover letter, I decided to wait until October and my next checkup with Dr. Goldberg - that way, I could plead my case in person.

After breathing a sigh of relief at the news of a good chest x-ray, the doctor signed my form with no questions asked. And we left to make an appointment for my next visit, at which time we'd set the exact date for the next lung operation.

Little did we know what else we had to look forward to...