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Posts Tagged ‘Autumn’

 

A. POOKIE’S ADVENTURES IN THE BIG ENDIVE BY THE BAY:
On Tuesday morning, Naida, Boo-boo and I left the Enchanted Forest for the Big Endive by the Bay and my meeting with the surgeon. Upon crossing the Bay Bridge, we drove directly to Peter and Barrie’s house where we unloaded and dropped off Boo-boo. We then proceeded to Mission Bay and my appointment. The night before, we had received a call informing us that the appointment time had been changed from 2:15 PM to 2 PM and insisting we be on time. We waited in the waiting area for over an hour before we were admitted into the examining room where we waited another hour before the surgeon showed up. During that second hour, we were first visited by a young woman who introduced herself as a “swallowing technician.” Yes, she did.

Interspersed between the happy talk and questioning me about the state of my swallowing, I was asked to make funny faces such as blowing out my cheeks while sticking out my tongue. I was also asked to make growling noises for some reason. Finally, a balloon was placed in my mouth and I was directed to press it with my tongue against the roof of my mouth three times. The only reason I could come up with for why I was subject to this silly but not particularly unpleasant activity was that I surmised it allowed the hospital to submit additional charges to Medicare. On the other hand, it could have been intended as entertainment in an effort to cheer me up for what was to come later.

The swallowing technician was followed by another young woman who introduced herself as the doctor’s assistant. Strangely, her first question was to ask me why I was there today. I responded, “Because I wanted to know whether I was a dead man walking or not.”  She seemed confused and stuttered a bit. She then busied herself looking up my records on the computer and informed us that there was a growth on both sides of my throat that had been there since my first CT scan way back in September. “O,” I said, “that’s interesting, no-one ever mentioned that before. Why is that?” She did not know and became even more confused and said she would have to ask the doctor. She then busied herself with administering me a sonogram on my neck and left.

Eventually, the surgeon arrived and his message sounded far less encouraging than I had hoped. Basically, he said that in his opinion it would be unsafe to operate at this time, and implied that at my age it would always be dangerous because my arteries were brittle from age and the effects of my radiation treatment. After musing about altering my chemotherapy regime, he advised me that I should enjoy myself as much as possible now. I did not take that advice as a positive comment on the state of my health. He then said, “I will see you in three months.” That seemed a bit more positive. At least he seemed to expect I would still be around three months from now.

That evening we had dinner back at Peter and Barrie’s. Barrie had cooked a very nice spaghetti carbonara for us. We were joined by a delightful friend of theirs from across the street who also happens to be my most responsive Facebook friend although I had never met her until that evening. She told us she was the daughter of a wealthy family in Orange County and that she had been kicked out of every college she attended until she ended up at some college in Mexico City before migrating to San Francisco at the height of its reign as the capital of hippiedom. There she was involved with people like Chet Helms and other leaders of the movement during those brief but wonderfully bizarre times.

The following morning we returned to the Enchanted Forest.

 

B. BACK IN THE ENCHANTED FOREST:
As I age, like many Vecchi, my short term memory seems to be…. well, a vague memory. If I do not write here every day, I often forget what has happened.

It is Friday evening. We returned on Wednesday. I recall little of what occurred in between. We walked the dog several times. I visited EDH a few times and drove HRM and Jake to Dick’s house. Susan McCabe called to see how I was doing. That made me happy. So did the Good/Bad David today. He was calling from the doctor’s office. It seems he is having blood-clot problems. That did not make me happy.

Today, I picked up Hayden, Jake, Caleb, and Hamza and drove them all to Dick’s house. I asked them how they were doing in school. Jake said his marks were improving because he was studying more. Hayden said his were also. I asked him why that was. He said that Dick promised he would be allowed to move from his small bedroom to the large family room downstairs if he gets certain grades on his final report.

I left them off at the house. There would be no adult supervision there (Hayden is a latch key kid now) because I was returning directly to the Enchanted Forest. I made them promise they would get into only a little bit of trouble. I worry about him. I know how distressing loneliness can be for an adolescent.

On Saturday, Naida and I exercised in the gym at the Nepenthe club-house. On Sunday, we sat in the studio, Naida editing her memoir in hopes of having it published before the State Fair opens in July while I passed the time writing this and trying to find something interesting enough on the internet to banish the pit of ennui into which I seem have fallen. I am not unhappy, in fact, I am as happy as I have ever been. It is just that I find this much sedentary living unsettling. Usually, whenever I have had this little to do, I take a nap. For some strange reason, I am both napping less and doing less. I will think more about this tomorrow, or the next day and perhaps understand it better.

It is now Tuesday afternoon. Tomorrow I leave for The Big Endive by the Bay and my infusion appointment. As usual, I will stay at Peter and Barrie’s house for two evenings before returning here on Friday.

 

C. OFF FOR TWO DAYS IN THE BIG ENDIVE WITH QUESTIONS OF MORTALITY.
So, three weeks have passed since my last Chemotherapy infusion and we are off again to San Francisco for what may be my final Chemo infusion and hopefully to find out more about my prognosis. As usual, we spent the night a Peter and Barrie’s home. My grandson Anthony arrived and joined us for dinner along with a friend of Peter and Barrie. She, suffering from incurable ovarian cancer, has lived for four years so far on immunotherapy alone. She has spent those four years happily traveling around the world. Hiromi and my granddaughter Amanda joined us a little later but Amanda was suffering from a bad cold and since I was told by my doctors to avoid such contacts they left after a brief meet and greet.

Barrie prepared a great meal that featured excellent polenta. During the meal, we told stories and played “small world.” You know, recalling the famous and near famous we may have run into in our long lives. Sometimes, I feel a bit like Zelig that mysterious character played by Woody Allen in the film of the same name who appears in the background of photographs of significant historical events. If I can be excused for name dropping and I can (this is my Journal after all) let me list the US president’s I have met and known — Reagan, Bill Clinton and Jimmy Carter — and presidential candidates, Fred Harris, Mike Dukakis, and Hillary Clinton. I assume most of us as we age have brushed shoulders with the so-called great and near great and experienced at least a passing contact with significant events. I guess we are all Zeligs to some extent.

The next morning I met with my oncologist, he told us that this was to be my last chemotherapy treatment and that surgery to remove the tumor was off the table because of my age and the fragility of my carotid artery. This opinion was devastating to me since it was essentially a death sentence. However, he also told us that the chemo has stabilized the tumor and it appears to have been effective in preventing cancer from spreading to other parts of my body. He informed us he was putting me on a two-year immunotherapy regime and advised me to enjoy life to the fullest. He appears quite confident that an early onset of death would be delayed to sometime beyond the two years and perhaps held in check long after that. This cheered me up — but only a bit.

That evening back at Peter and Barrie’s during dinner we had to break up a contretemps between Ramsey and Boo-boo over possession of a well-chewed tennis ball.
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Boo-boo Hiding Out at Peter and Barrie’s House after Misbehaving.

 

The next morning we returned to Sacramento.

 

D. BACK IN THE ENCHANTED FOREST AND A BRIEF TRIP INTO THE FOOTHILLS.
After dropping Naida and Boo-boo off at our house in the Enchanted Forest, I drove up to the Golden Hills and Picked up HRM and the gang and drove them to Dick’s house. H and I discussed the possibility of making a trip to Portland, Idaho, and Montana during his spring break. I then returned home and wrote this while watching Ray Milland and Grace Kelly in Dial M for Murder. We then walked the dog. I feel good.

It is now Sunday. Spring seems to have slipped into the Great Valley and taken hold, bringing with it sunny days, warm weather, flowers of every color and hay fever (It’s always something —Rosanna Rosannadanna.) It being such a beautiful day, I decided to walk the dog along the meandering pathways of the Enchanted Forest. The new leaves of the ground cover ivy were a bright almost iridescent green in the bright sun.

On Tuesday at about 2PM, I went to bed. Not for a nap, I knew I would not get up until the following morning. The side-effects of the Chemo infusion, depression, and general fatigue had exhausted me. I woke up periodically during that afternoon and evening. During those brief periods, I would read a chapter of Elena Ferrante’s Novel, “My Brilliant Friend,” or check up on Facebook and then return to sleep.

Ferrante’s book is marvelous and its translation extraordinary. The translation often preserves the Italian language’s ability to express itself in long (at times a page or more) complex sentences encompassing vast emotions and multiple events that in English must be broken up into many separate sentences.

At some point during the evening, I finally came to terms with the fact that I was going to die, sooner rather than later. It is clear that an operation is infeasible and any potential chemical cure has run its course unsuccessfully. I recalled when Bill Yeates’ wife in a similar situation had had enough of the suffering from attempts to prolong her life and the courage to chose to take advantage of the new law to end it humanely. I do not believe I will choose that approach. Primarily because I am, in fact, happier than I have ever been in my life. At night, every night, I lie entwined in Naida’s arms ( sometimes so entwined we giggle over our inability to easily identify whose arms and legs belong to whom). There is a peace and happiness I never experienced before. Yes, I always had hoped I would find that, but there was always something else to do, something more to explore. Perhaps happiness needed accomplishment and experience. And, it did — but only for the stories with which to pass the time and perhaps a bit of justification for one’s life. But enough of this. I woke up on Tuesday. It is another day. When I awoke she was in my arms and that is all that matters now.

Damn, I cannot connect to the internet today. I cannot figure out how to fix the problem. Naida’s computer is connected. My smart-phone after a brief problem connected, but my computer remains— stubbornly unresponsive. What to do? What to do? Is interruption of internet service a modern form of Death? I sit in my chair typing this and feeling a strange form of fear. What happens should I not be able to re-connect here, am I doomed to trundling off to Starbucks every day to access the internet and confirm my existence? Is my life so bereft of meaning that I am reduced to depending on the friendship of people on Facebook many of whom I have never met? Is social media simply an updated version of those two-way radios long-distance truck drivers used to use to avoid the boredom and loneliness of their working lives? Have we become the physical and emotional slaves of our machines? Are we needed for anything beyond self-indulgence? Am I so bored that I need to ask these questions even in jest? Is anyone laughing? If I were connected to the internet I could find out.

Ha, one of our medical student borders just came downstairs and said her internet connection was down also. She promptly marched over to the modem that I had fiddled with for a very frustrating hour or so, pressed a button on top and the internet connection popped right up again. I feel like an idiot. Now if she can do the same with my failed medical treatments I would call today a very good day.

This morning, Hayden called to ask me to pick him up after school. It was unusual for him to call like that, so despite not being completely over with the side-effects of the infusion, I drove into the Golden Hills. I met HRM and Caleb at the skatepark. They were planning to go to the Wednesday church youth get together. He said that his mom appears to have relaxed her opposition to him attending. She had wanted him to become a Buddhist and not a Christian. He felt Buddhism was a way of life and not a religion. “Besides,” he said, “it’s boring for teenagers.” She seemed to concede by responding “Whatever makes you happy.” So I dropped them off at Caleb’s home where they would spend the afternoon until it was time to go to the teenage get-together. I left them with my advice that they should be kind to all as much as they can but to be fair to everyone and drove back to the Enchanted Forest where I was met by a happily yapping little dog and a hug from Naida.

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It is autumn in the Enchanted Forest — Time to change from Hawaiian shirts to flannel; for hearing the fallen leaves crackle beneath our feet as we walk by; for golden sunlight in the afternoons and early sunsets; for the yellow pollen from the Deodar Cedar trees coating the cars and the sidewalks; and a time for sleeping late in the morning and for reflection.

On Tuesday, I went for my appointment at the office of the surgeon selected to operate on my neck. A very young doctor followed by a female medical student entered the examination room where I had been placed. He appeared to be of South Asian heritage. He examined me briefly and answered my questions. He was thin with limpid sympathetic eyes. He then left with the student trailing in his wake.

After a while, the surgeon himself entered with the young doctor and medical student in tow. He was a small man in a grey-brown suit and sporting a bright blue bow tie. For some reason, his appearance made me recall that I had read somewhere that surgeons have the highest percentage of psychopaths of any profession. Also, again for some unknown reason, I tended to associate bow-ties with psychopathology.

.

He felt around my neck, had the young doctor stick a camera down my nose and into my neck and watched whatever it was he saw on the monitor behind me. He then announced that the proposed operation was dangerous and I would probably die. He followed-up that good news with the observation that almost two months have elapsed since my last PET scan and his examination showed that during that time the tumor had grown substantially and now pressed too close to my carteroid artery to be safely removed by surgery. He then railed about the unwillingness of my health-care group to allow his health-care group to use their follow up organizations thereby limiting his activities only to the surgery. He ordered his assistant to schedule another CT scan. If it confirms his diagnosis, I may be in deep trouble.

A few days before that my oncologist told me that if surgery were unavailable then we may try immunotherapy. At best, immunotherapy, he said, slows the growth and spread of cancer cells. If it does not work, then it is goodbye time for Joey.

I had woken up that morning in reasonably good spirits. By 3PM I may have become a dead man walking. Life is funny sometimes.

For the next day or two, I was very depressed. That little voice in my head, the one that talks all the time and tells you how good you are or how bad you are matters as though your goodness or badness is the most significant goodness or badness of anyone in the world, was worried.

“What does it mean to me for you to die?” it said in that same youthful voice it always had? “I mean, it’s not like sleep,” it added. “When you sleep you anticipate you will wake up in the morning. Isn’t that consciousness? You anticipate something is going to happen next even if you cannot know what.”

I was getting annoyed, even depressed with its musings. “That’s it,” it continued. “You close your eyes like you’re are going to sleep and you never wake .”

“That’s very profound, you idiot,” I said.

“No, you Don’t understand,” it went on. “Without anticipation, there is no life, no consciousness.”

“And this insight is supposed to help me how?” I enquired. It was silent. Perhaps for the first time in my life, I could not hear It. I was afraid, very afraid.

By Thursday I felt a little better — a good dose of valium and a nights sleep allowed me to begin to get things in order. First, I thought, “Write a will” — a wasted gesture. I always wanted to die with nothing. I am pretty close to that — both dying and money. I probably need someone to take my collection of Hawaiian shirts, however. I would rather not send them to Goodwill. Pookies last will and testament: “I leave to______ my Hawaiian shirts. End.”

So here I am typing at my computer, watching MSNBC and CNN and reading Tana French’s latest novel. It is a mystery novel, but so far I am not sure about the mystery. I have read about 1/3 of the book and all that’s happened so far is that the narrator gets beat up and spends a long long time in the hospital worrying about everything except who beat him up and why.

The weekend trundled by. I arranged for the CT scan on Monday that will indicate whether an operation is feasible. On Tuesday, I will watch the election returns. If the Democrats do not retake at least one house of Congress with a substantial majority, then — then what? I am too close to the end for it to make much of a difference to my welfare, but I may be sad for everyone else.

Perhaps, this is where it all may begin to end — in some ways, life has always been, little more than a scramble for scarce resources (money and sex — ok, not so scarce) ending in death.

A computer simulation by Jeremy England and colleagues at MIT showed that a system of particles confined inside a viscous fluid in which the particles are driven by an oscillating force, over time, triggers the formation of more bonds among the particles. In other words, shine enough light and apply enough heat long enough you eventually get life. In general, the function of life is to more efficiently convert matter (resources) to energy (movement). Humans have gotten very good at converting resources to energy and leaving waste and destruction behind — perhaps too good. Maybe the answer to Marconi’s query, “Where are they?” regarding alien civilizations of 40 billion planets in the Milky Way capable of sustaining life, is simply that advanced life-forms a become so efficient in converting resources to waste they destroy the planet before ever making an effective foray into space searching for others.

On Saturday, we had a barbecue and fresh oysters at Naida’s daughter’s home nearby. Sarah’s husband is a nurse. One of his colleagues, another male nurse, was there also. I asked them why they became nurses. Besides liking to help people, they agreed that employment opportunities were a major draw. One said, “I could be fired at my current job and before arriving home I would have a new one.”

Between medical appointments and various episodes of depression, I have not seen HRM all week. That makes me sad. On the other hand, autumn is a pleasant time to walk the dog and stand on the levee watching the river flow by.

The second third of the Tana French book focused on Hugo, the narrator’s beloved uncle, who is dying from inoperable cancer. Hugo surprisingly confesses to the murder and promptly dies the next morning while in police custody. In fact, the murder had been committed by others.

On Sunday Terry, the Cannabis King of the Siskiyou’s dropped by. It was good to see him. He had been looking into some alternative therapies for me. It is good to have friends. I have had some very good friends along the way. When I was very young, in grammar school, I had no friends so I used to pretend that I was sick so I could stay home in bed and read the encyclopedia. That is where I get my fondness for melodrama —pretending I am sick almost to death. Once I recall, I successfully persuaded my parents I was as sick as I had ever been in my life, so they let me stay home. After they both left for work and I was alone, I began to persuade myself that I was, in fact, very sick. I was sure I was going to need help or I was a goner. I slipped out of bed and crawled because I was too weak walk through the apartment to the door where, if I were able to open it, I could call for help and one of my neighbors would undoubtedly save me. I reached for the doorknob but I was too weak to grasp it and I fell motionless to the floor.

After an appropriate amount of time. I got up off the floor and walked back to the bedroom, climbed back into bed and resumed my reading.


On Monday I had my CT scan. More needles stuck into my body and radioactive substances injected into my bloodstream. After that, I drove up to the Golden Hills, ate lunch and walked a bit around the CCD park.

I finished the Tana French book today. Despite everything I found out previously and the resolution, more or less, of the murder that occupied most of the book, it ends with a twist as surprising as any I have read in detective fiction.

Today I have my appointment with the surgeon to review the results of the CT scan and determine if I am dead or not.

Well, the surgeon informed me today that if they operate there is a 90% chance I would die on the operating table. I do not know if that was an evaluation of his abilities or the complexity of my tumor’s location. He followed up that news with the opinion that, absent successful alternative therapies, my remaining lifespan would be somewhere between three and six months. Unfortunately, the only alternative therapy available to me appears to be immunotherapy which the surgeon explained to me would have about a 20% chance of success.

If the situation is as dire as he indicates, I intend to fully indulge myself of whatever unorthodox alternative treatment approach that I may enjoy — mushrooms, cannabis, of course, acupuncture, mood-altering drugs and the like. One of the good things about knowing your days are limited but you are otherwise in good health is that you have few restrictions on pandering to yourself.

In the evening, my sister joined us for dinner. She is down from Mendocino to attend an economic development conference. After dinner we watched the returns come in. I had hoped for better.

That night, I was afraid I would not be able to sleep. I tried all of my little tricks to help me fall asleep including counting my breaths backward from 99 and contemplating the SF 49’s starting lineup all to no avail. So I turned to Naida and said, “I can’t sleep. I am going downstairs so that my twisting and turning will not keep you awake.” She responded, “What are you talking about? It is 5:30 in the morning. You’ve been sleeping peacefully all night.”

The next day, my radiology physician confirmed the surgeon’s diagnosis and opined that under these circumstances immunotherapy was the best alternative — “Sometimes it works,” he added. I said, “It is odd feeling as well as I do but knowing I’m as good as dead.” “Yes,” he responded. “It is like that for cancer patients.” That got me wondering how many people I pass each day with similar problems to mine, that go about their days without complaint. Almost every day I meet someone who asks me how I am doing. As is my want, I tell them. They often tell me that they had gone through similar treatments two or three times already. It always makes me feel worse when I am unable to wallow in the uniqueness of my imagined misery.

I left his office with him promising to think about the possibility of additional radiation therapy should the immunotherapy treatment falter and traveled into the Golden Hills to pick up the Scooter Gang. I dropped them off at Dick’s house. They promised not to get in trouble (follow my rules — don’t hurt yourselves, don’t spill anything on the floor and don’t break anything) while in the house but begged to be able to get into a little trouble when they traveled to Town Center later. While I was leaving, Hayden walked up to the window of the car and said, “Remember Pookie you have got to believe.”

I guess there are no more adventures for Pookie — unless dying itself is an adventure — Pookies last adventure. Dylan Thomas wrote, “Do not go quietly into that dark night.” Well, I am pretty sure I will not go quietly. But instead of “railing against the darkening of the light,” it will be more like bitching and complaining (see my screed on bitching: https://trenzpruca.wordpress.com/2018/02/12/petrillos-commentary-on-bitching/). My mother always said I screamed constantly from shortly after birth until I began to talk and then I complained of everything until I became a teenager and then thankfully I only sulked.

My sister came by again yesterday evening. We laughed a lot. Planned for Thanksgiving and reminisced.

The leaf-fall of autumn has increased since the air has cooled and the Fall breezes grown stronger. They are falling too fast for the ground-keepers with their leaf-blowers to keep up so the Enchanted Forest’s paths and lawns are covered with yellow and brown leaves that in the sunlight look like spilled paint. While walking the dog I like stomping through the leaves, kicking them into the air and watching them fall back again like a 79-year-old child.

Today, we visited my chemotherapist expecting to set the schedule for my immunotherapy. We were surprised. Apparently, he spoke last night with the various doctors involved in my case. He said the radiologist changed his mind and now thought radiation might be possible. Also, my regular oncologist told him he was setting up an appointment for a second opinion at UCSF. He then laid out my treatment schedule. First, I get the second opinion. If that supports the first surgeon’s judgment, then we will begin a new round of radiation therapy, followed by Chemo and if necessary immunotherapy. Although this might appear to be more positive than the other recent medical opinions I have received, it actually seems to me to be simply a change in a treatment plan and not in prognosis. I think they are just trying to make me feel better. Despite their attempts to humor me I intend to continue bitching and wailing, “The end is nigh. Woe is me.” I do so like melodrama.

Yesterday evening, I picked up HRM from his mountain bike team practice. On the way home, after asking me how I felt, he mentioned that at the church youth meeting he attends every Wednesday all the eighth-grade boys, many of whom I know, prayed for Pookie. I may not be someone particularly optimistic about the power of prayer, but I cried nevertheless at the thought of the Scooter Gang praying for me.

On Friday, before returning to Mendocino, my sister came by to take us to a Japanese grocery store to hunt for mushrooms for my new diet. Later we had lunch at the Freeport Inn in the Delta. Following my sister’s departure back to Mendocino, Naida sautéed some of the mushrooms for dinner. They were delicious.

Saturday, we attended the weekly coffee at the Nepenthe clubhouse. It is the season when everyone there was involved in the various charity drives and party planning undertaken by the community. On the way back home while I was busy kicking the leaves about, Naida noticed a sign for a meeting at the small clubhouse of something called “Conscious Community.” We decided to find out what it was all about. We discovered they considered themselves a consciousness-raising group like those of the late ’60s except without the dope.

During the walk, we noticed a mysterious cement ball had appeared in the street in front of our house. It remains there today. Nothing like it exists anywhere else in the neighborhood. What can it be? A portent of something? Alien scat? A hairball from a giant cat?

Pookie with the mysterious orb.

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