Remembering Jon. Remembering me.

My nephew died yesterday.

Jon had been, as far as I knew, in all-but-perfect health. He was large, friendly, pleasant, and always eager to help anyone in any way he could. He was a varsity wrestler in high school and had competed for -- and nearly won -- the Virginia Sate Championship in the Unlimited weight group. He was clever and thoughtful and he was very good with his hands: auto repairs, plumbing, carpentry, electrical work -- Jon could do it all.

He was also 24 years old -- and engaged to be married. A first-timer.

He was a wonderful young man with enormous potential.

Jon had some difficulty "getting traction" in his life after high school, but recently had seemed to be putting pieces in their proper place. And I looked forward to hearing which of his many career opportunities he would decide to follow.

I only met his fiancee once, but I remember thinking, "Yes, this is a life partner with whom Jon can flourish." I couldn't make it to his engagement party -- which took place last weekend. That's right: last weekend.

Y'know, sometimes death can seem just unimaginably cruel. That such a splendid young man should be killed at such an early age. And that we should all be deprived of his gifts. His presence.

(I'm fairly sure I have the following story right, but all these events are so recent... And I will correct the story as I learn more.)

My brother-in-law checked Jon's Facebook page after he heard of Jon's death. And he found out that, the morning of the day he died, Jon wrote that he felt a cramp in his leg that wouldn't release and that he had some trouble breathing.

Classic symptoms of a pulmonary embolism: a blood clot that had broken loose and travelled towards his heart and lungs. But who would expect a robust young man like Jon to have such a condition? And who of you out there reading this would have recognized these symptoms?

Now, I know the first of these two symptoms because I had that "cramp-that-won't-go-away" feeling twice: I felt it once last year in association with the blood clot in my right leg and once again six or seven weeks ago associated with the clot in my left leg. But there's no reason on earth that Jon would have known this...

(If you've been reading this blog since its inception, you may recall the following story from the July 1, 2009 posting titled "Me and My Blood Clot." I'll give you a capsule summary:)

In late June of last year, I felt a cramp in my lower right leg, but it didn't concern me much and I didn't think much about it. (Being in the middle of radiation and chemotherapy, I had other physical issues to hold my attention.) But it kept getting worse, and I wound up going to one of my radiation treatments on crutches. The nurse on duty saw me hobble into the treatment center and she got very alert, very quickly and started asking very specific questions. Questions that started with "Why?" and "How?" and "When?" She then notified the doctor on duty.

The doc followed up by asking more questions, then saying, "Randy, we're going to give you your radiation treatment today and then send you immediately to the hospital. Don't waste time by going home and then to the hospital! By the time you're done here, I will have given the hospital staff their 'stat' instructions. Just drive immediately there and tell them your name. They'll be waiting for you." And things unfolded just that way.

I was processed through the hospital admission procedures at high speed and wound up with a Heparin drip and inflatable "stockings" that gently squeezed both right and left legs with a gentle pulsing motion. I stayed at the hospital overnight, with an hourly checking on my situation. (Yup, being awakened every hour to make sure I way okay.)

And up until yesterday, that the entire incident seemed unnecessarily dramatic. And it seemed so even after I came across the on-line statistic that 200,000 people a year die from pulmonary embolism.

But today I understand. While all this was happening last year, I had no idea that my life could literally be "hanging by a thread" -- that is, the "thread" that was keeping the blood clot in place in my leg. Now I can see that the rush to get me admitted to the hospital and into treatment, that the Heparin and follow-up Lovenox and Coumadin and the compression stockings -- all this was thoroughly justified.

Two very different stories. But I find the irony in juxtaposing them to be both frightening and humbling: if I had not been receiving radiation treatment, I would not have been swept into the hospital so quickly and I would simply have waited for the cramping to go away. And quite possibly, I would have died from a pulmonary embolism while I waited for my leg to heal itself. And if I had died, Jon would probably have heard my story from his folks, and maybe would have recognized his symptoms as matching mine and maybe then he would have sought treatment. And then maybe he wouldn't have died yesterday.

When the blood clot showed up in my left leg a couple of weeks ago, I recognized the symptoms quickly and got treatment as soon as I could. As a result, this new clot was not nearly as advanced as last year's when treatment started -- and there was no rushing around, no Heparin, no inflatable stockings, no overnight stay in the hospital. And as a result, the residual swelling was not and is not nearly as noticeable. And I was off crutches in two days rather than ten.

Over the course of my cancer treatment, I have been constantly amazed at how tough and durable life can be -- not only in my situation but in the treatment of dozens of other cancer patients I've met along the way. Our bodies want very much to stay alive and heal.

But Jon's death tells a different story -- one that doesn't necessarily contradict the "tough-and-durable" story, but one that adds an important caveat: Life can also be fragile and easily lost. Lost sometimes by what we do, sometimes by what we don't do, and sometimes independently of anything we might or might not do.

And what I've learned is that now is a time to celebrate who and what we are. And a time to be grateful for life in all its glory.

And for those of us who knew Jon, it is especially time to be grateful for having had his presence in our lives.

Health Update: 5/2/10

I wanted to hold off on saying anything about my health until today, because I had an appointment with my E/N/T guy this morning. Which I'll explain in a bit. But first:

"What was that all about?" revisited:
Last Tuesday, the 25th (at least we think it was Tuesday...) I had a follow-up appointment with Nurse Vicki at our family doctor's practice. (We think Vicki is wonderful!) Over the weekend, a nurse friend of ours had suggested that the non-appendicitis episode I'd had the previous week was due to the aforementioned -- and newly discovered -- gallstones. Like, when you pass a gallstone, it can be painful. So we made that suggestion to Vicki.

She was not crazy about that idea, because the symptoms did not sound like passing a gallstone. But she didn't have any better idea, and told us to consult with a surgeon, who would have a more informed opinion.

And wouldn't you know that the guy she recommended was the fellow who installed (and later removed) my food tube. Small world is medicine in the West Chester community. But she did recommend him very highly, and I really can't complain about him yanking the food tube out of my tummy with no warning. As described in gruesome detail in a posting from last year. I mean, he told me exactly what he was going to do. Yanking the tube out and all. And I was just shocked that he was telling me the unvarnished truth. I thought he was kidding. More fool me.

Anyway, we made the appointment, and the surgeon could not have been more understanding and supportive. He had me lay back on an examination table as he probed and prodded and poked. He told me that he had found a small hernia -- something else I was unaware of. I mean geez, what else is going to show up? And when? Gallstones. Hernias. Where does it end??

Anyway, he also said everything else felt normal and he seemed genuinely pleased that his probing and prodding and poking had not caused me any pain whatsoever.

After I described the "non-appendicitis" episode at the Hospital the previous Friday, he said that it was an "unusual presentation" of a gallstone attack. Meaning he wasn't at all convinced that the stones were any part of the problem.

Medical jargon, I guess. "Presentation." Geez.

Then he said that removing the gall bladder would not be difficult -- that the procedure was "laparoscopic," which meant several small incisions, an overnight stay in the hospital, and a quick recovery. But he also said that there was no immediate need for the procedure, except that, without the operation, there was a minor chance that the gallstones might cause some serious difficulty in the future. Further, that any future pain like I had felt on Friday would dictate the immediate removal of the gall bladder. "Presentation" or no.

And then he said, "While I'm in there, I can fix that hernia." He sounded, for that moment, much more like an automobile mechanic than a doctor. Like "While I'm replacing the head gasket, I can clean the jets in your fuel injectors and check the valve clearance." That kind of stuff. An amusing moment, I guess, if you have some psychological distance from the procedure...

Anyway, I decided not to go ahead with the gall bladder operation at this time, and told him so.

And we shook hands. And he wished us a good summer. And we parted friends.

So, in answer to the question, "What was that all about?" there still is no resolution. Sigh...


Today's Visit with the E/N/T Guy
I guess my feelings leading up to this visit will be a common phenomenon for the next couple of years. I mean, I feel fine. People tell me I look fine. But then, I felt fine just before the initial diagnosis of cancer. So what good did that do me?

I hadn't seen my E/N/T guy in months. What had my body been doing since the last visit?

There is this post-cancer syndrome. Perfectly understandable. As the days dwindle down towards an appointment like this, the anxiety level subtly ratchets up. And that comes to a head on the morning of the appointment: What will I do if he finds something? What will he say? How will I feel? Will I break down in tears in his office? What treatment options are left after the "full-court press" of treatments last year?

But my E/N/T guy is so comfortable to be around. Comfortable in his own skin. Comfortable with the job he's doing. Thirty seconds with him and you're just plain... comfortable. And you become cognizant of the truth -- that your anxiety won't help the situation at all, but might make it worse by stressing your mind and body unnecessarily.

So he probed and prodded and poked my head and neck. Inside and outside my right cheek. Then my left cheek. Up and down my neck. He peered into my nose, my ears, down my throat.

And declared that there was no sign of anything unusual. Then he told me that I looked great.

And we shook hands. And he wished me a good summer. And we parted friends.


And, oh by the way, in regards to the Friday at the Hospital episode reported previously, I forgot to mention something really important: the area of interest that day was my abdomen. Of course. But this was an area that had never been scanned since the start of my treatment. And every now and then over the last 8 or 9 months, an irksome little voice that inhabits in my paranoia would suggest that, if the cancer had metasticized to my liver or any other organ down there, no one would know it. Because no one had checked in on that area.

So the entire episode had, for me, been a big success. I had been scanned with sophisticated medical equipment; not once but twice (the CAT scan and the sonogram) and had come out clean.

And so, dear friends, I continue to get the best of all possible reports from my medical team. And it such a pleasure to share this information with all of you.

I am well.

Shall I Lichen Thee to a Summer's Day?

Or in this case, a Day in Spring?

(Apologies may be in order to Bill Shakespeare, but he seems to have appreciated puns as much as anyone!)

Blanche -- the orchid given to us by my wonderful sister last year -- is doing quite well, thank you.

Rather than putting out two or three blossoms almost simultaneously, she's decided to put all her energy into a single blossom -- and it's lovely. It may be hard to tell from this photo, but the newest addition to her wardrobe (the one closest to the top of the photo) is a bit larger than the other two, and the petals are spread wider. A bit more showy, perhaps, but in a refined sort of way.

What with the weather being warm and moist, we've been allowing her to "take the air" on the front porch. (The porch roof will, of course keep her out of direct sunlight. She's lovely, of course, but somewhat delicate...)

Deb and I know that there are Blanche fans out there, and we wanted you to know...