Do you believe in miracles?

Do You Believe in Miracles?

During the week of June 12^th, I started feeling that pesky spleen pain again.  My oncologist and internal medicine doctors jointly had me checked into St. David’s North Austin Medical Center to get another CT scan prior to my chemo which was to be on June 19^th.  As they had seen on all previous scans there was a fluid pocket/hematoma sitting just off my spleen.  Almost all thought it was just some leakage from the splenic embolization surgery I had on Valentine’s day earlier this year.  They also thought that the body would absorb the fluid without incident.  Most were reluctant to go in and drain it because of the risk of infection, especially considering the reduced immune system I currently had due to the side effects of chemotherapy.

So we chalked it up to, “it’ll eventually get absorbed, off to Houston/MD Anderson we go.” On June 19^th, Nita and I patiently sat in our little room and had bag after bag of desensitized FulFox pumped into me.  Finally, around 12 hours later, Nita and I headed back to Austin.

On June 20, I started developing an ear infection.  They put me on a cycle of amoxicillin.  There was considerable jaw and ear pain.  On the 21^st, Nita took out the pump and flushed my port as she had been trained to do (dates important just to see how quickly this thing moved).  I was so tired and felt kind of crappy so I didn’t take a shower, even though I was riding the high of my best friend Omar’s PGA pro championship win.  He would now play in this year’s PGA as well as earn 6 tour exemptions over the next calendar year.  He called me and left me a message saying that the win “was for me!”  He had never done that before.

The next day, I was lying in bed with little Josephine watching a movie, waiting for my next pain med time.  All of a sudden, at 9:30 am I felt a huge surge of pain in my abdomen. I still had 30 minutes to go before I could take my hydrocodone, so I figured I’d just gut-up and wait.  Nita got the kids fed and off to the morning activities.  I stumbled to the man cave and waited for my drugs to kick in.  By 10:30, still nothing other than excruciating pain, the hydrocodone failed to put a dent in it. Around 11:30 Nita started getting lunch ready for the kids, prepping them for afternoon camps.  I sat uncomfortably in the man cave and shivered with chills and about four quilts draped over me.

She came to ask how I was doing and I told her that it was time to go to the emergency room.  She piled us all in the car and dropped me off.  I went into the ER and knew something was terribly wrong.  I’d texted some of my doctor friends and they came to check on me (each pushing on my belly). Another CT scan was performed. Finally, a bad ass doctor came around 5 PM or so and said we were going into surgery.  Nita came in to pre-op and gave me a kiss and said she’d see me after surgery.

They told me this was not a quick or minimally invasive laparoscopic job, they’d have to open me up.  When they got in, they discovered that the “fluid pocket” was actually a cyst that was the size of a personal watermelon wrapped around my spleen.  As soon as the doctor cut into the cyst a volcanic explosion of puss and fluid came gushing out, roughly three liters, even though it had already ruptured (at 9:30 that morning with my insides filling up with that puss). It went everywhere and the surgeons had to jump out of the way.  They had to use blankets to mop up the floor.  I found out later it was the wildest thing anyone of them had experienced.  My doctor had never seen such a thing in his entire career of surgery.

Still intubated

They did a quick patch job on me and took me to the ICU to discuss options.  I had already crossed the sepsis threshold and was on the clock.  However, due to the total timeline, for all intents and purposes, I should have died that night.  Nita and a couple of the “sister wives” (SW) from the tribe came into the ICU to see me.  Bear in mind that my surgical incision was still open and they would be going back into surgery within the next several hours.  Nita was understandably in shambles.  Had she just spoken to her husband for the last time? Was this it?  Was it time to call a Priest, or my cousin in the funeral business? In fact, she had these conversations with the surgeon.  My understanding is that she was almost in a fog as she explained what the doctors told her to my Pete and my mother.

About 24 hours later they went back in.  They decided to leave what was left of my spleen because it was so close to the pancreas.  The pancreas is so toxic, they didn’t want to introduce any new potential infections into my body.  Plus, my pulse and blood pressure were so erratic that they didn’t want to keep me open very long.  As it was described to Nita, “my heart was exploding out of my chest.”

When they resumed the surgery (in layman’s terms and literally) they took my internal organs out of my body, cleaned/hosed them off and stuffed them back into my abdomen.  So now if anyone asks if I’ve ever had an out of body experience…okay, you’re right, that was beneath me.

I was very lucky not to have gone into shock, again the surgeons, my wife, and the SWs all thought I was going to/should have died on Thursday night.  So after stuffing my organs back in, they took some cultures to see if there was an infection.  My white blood cell count had been crazy high for the last 8 weeks, but they assumed it was the chemo, the pneumonia, ear infection, or some combination of the three.  More on that later.  Needless to say, I survived and checked off what I consider at least one miracle.

On Friday the 23^rd, I woke up with an intubation tube down my throat, a Foley catheter, a JP (drainage) tube by my spleen, and a picc line (a catheter like a temporary port inserted in my biceps).  I had survived the second surgery. 

My hands were strapped to the bed and they couldn’t sedate me any further.  Apparently, I had exceeded the amount they could give me at that time. So I was wide awake and I needed to communicate.  My sign language was much to be desired.  I finally gave enough of a hint to have one arm un-restrained and was given some paper and a pen.  I could now communicate!

Within a few hours they had taken me off of the breathing tubes.  A few hours after that I was sitting up in a chair.  I am fairly certain that this second surgery and fairly rapid recovery qualifies as another or at least a piggy back of the previous miracle.  Believe or don’t, cool, whatever.  I’m telling you, I should be under ground, and yet here I am.

sitting up in ICU

Back to the story.  On Sunday, I was moved from ICU to 3 North, my favorite pod with the best nurses on the planet.  With my experience in business and now hospitalization, I am of the opinion that, like sales, nursing is a calling.  It is equal parts knowledge, art, and passion.  You can show up and go through the motions, or you can strive to be the best.  I feel the pod in 3 North is filled with those that have all three.

The Serbian woman who saved my bacon by getting me walking after my cancer surgery in 2015 was there and she was ready for another battle, she may be one of the better examples of art, passion, and skill.  She takes no shortcuts.  The doctors and nurses told me (which I already knew from a previous abdominal surgery) that in order to wake up my insides, I needed to walk, chew gum, sit up, and move.  This would first stimulate a fart (which would take me off of my ice chip diet), then poop, (which would move me to an all liquid instead of clear liquid diet, and eventually low residue diet).

Several days later I found out why walking helps.  One of the doctors explained that your intestines hang in your abdomen like theater curtains.  When you walk, they move, shake, and are agitated.  This stimulates movement and helps usher waste down the correct path.  So the more you walk, the better it is for your intestines to wake up.

Going for a walk with Connor, notice the big bag of gravy (TPN)

Meanwhile have I mentioned that my system coming back on line was quite painful?  Because it hurt. A LOT!  But, who am I to complain, I’m alive y’all.  But being still hurt, lying down hurt, sitting up hurt, walking the hall certainly hurt, in fact, everything hurt.  At least I had a constant drip of dilaudid with a quick boost button (that would eventually go away). 

The other issue with opiate pain killers is that even though they provide pain relief, it comes with a cost; constipation.  If you remember way back to the first surgery in 2015 it was done by a colorectal surgeon.  He used the Da Vinci device and then did a colonoscopy going over my colon inch by inch to clean out any impacted poop I may have had.  He also had a lot more time to do his work as I was not showing signs of cardiac distress and there was no leakage which might lead to septic shock.

I’m not going to make y’all relive every moment play by play, but cutting to the chase I needed to shower too.  I hadn’t taken a shower since Monday the 19^th.  My favorite patient care technician, Violeta, put protective film over my JP line, my incision, and my picc line.  She started the water and sat me down on the stool.  Now my incision was a straight cut from my diaphragm to just below the belly button, about a foot long.  Twenty three staples.  That portion included just about all if not all of my abdominal muscles.  Put another way, any direction I would turn, move, wash, etc. involved my core.  So I was putting immense strain on a muscle group with a big ole slice all the way through. 

Once I got out of the shower, was dried off, had my dressings replaced, and a new gown put on, I was wiped out.  Completely.  I was in pain and had zero energy left.  The good news is that I had already farted a few times and was able to sip some Gatorade, broth, and even some hot tea.  Mom and Nita came to visit and shared what the questions of the hood were.  It even hurt to facebook on my phone, so that was done at a minimum.  Imagine having all the time in the world to do something and zero energy or stamina to do and continue it?  My only activity was lying in bed, moving to my recliner chair, and walking the hall…with all my fluids and connections in tow.

23 staples

Finally, on June 29^th, I pooped.  It was not pleasant. In fact, it felt like I was passing baseballs. Once I started though, I refused to let go until the job was done.  I kept feeling like it was halfway in and halfway out, but we were going to do this! I used the stability poles on either side of the toilet like ski poles maneuvering my body back and forth trying to get whatever was stuck in my sphincter unstuck.  Now, I will never be so stupid as to even think that I have any idea what it is like to give birth to a child.  None!  But now, I sort of feel like I have slid a little further down the empathy continuum.

I could not over-push because my abs hurt and I was told not to put too much pressure on my stitches and tender insides, so I had to do what I could to get it out.  I finally finished the job and was as equally exhausted as the shower a few days earlier.  But at least now my diet would change.  However, the little appetite I had, did not translate into the ability to consume food.  I had a big TPN bag (IV nutrition to ensure my body was getting the correct amounts of nutrition during the healing process) which looked like a 2-pound bag of cream gravy that was providing my nutrition.  So my stomach was not incented to start stuffing itself out of necessity.  The body has several protective systems in place to guard itself after trauma.  One of those is moving bowels after major abdominal trauma, they are the last system to “wake up.” It gave the opportunity to move slowly as my system woke up, but didn’t provide relief.

On Saturday July 1, I had not repeated my past lavatorial victory.  But I was on an opioid pain med, which we know causes constipation.  I was told by one of the four to five doctors who visited daily that there was a drug called Relistor which would block the constipation effect while leaving the pain killing function.  Great! What could go wrong?  I asked my nurse to sign me up. 

So here is the thing, it involved a shot directly into the abdomen.  In the grand scheme of things…I am already getting my fingers lanced to check my blood sugar checked four times a day, plus all the other pokes, prods, blood draws, and general pain.  And it is hard to quantify the pain of stomach distension due to trapped gas and waste.  Okay, I’m in.  It wasn’t that bad.  In fact, about 2 minutes after the shot I started farting.  Then the crooked dog head move.  I needed to get to the toilet and immediately.  They had apparently given me the Dumb and Dumber turbo lax shot.  I would know for the next time that after the shot, I should go ahead and mosey on over to the commode.

I gripped the bars on each side of the toilet and I felt like I was hanging on for dear life.  My bowels emptied and I eventually felt better. This time it was the opposite of the first movement.  It came out quickly, loose, and in large volumes.  All the food on the new low residue diet I was eating and keeping down needed some place to go.  I had to give myself at least two separate courtesy flushes this time.

The next day Nita came without the kids and she helped me into the shower.  Bless her heart and soul she washed me all over so I wouldn’t have to expend more energy than holding onto the rails.  I was able to shave when I was done and change into actual clothing instead of a gown.  Now the goals were to repeat the process.  By that I mean eat and poop.  It wasn’t coming that easily even though I was on the low residue diet.  However, I was walking the halls without nurses now, and we had started working to modify my pain medications so I could have a sustainable pain management strategy with as little of a constipative (not a word, but it should be) effect as possible when I got home.  The doctors all thought my progress was amazing and that I was on track to be home by Friday July 7.

The date was significant because it would be the end of my antibiotic cycle.  I still needed to take my antibiotics via IV and my picc line was getting squirrelly at times.  For those of you asking about the port…don’t ask.  Did I mention that during the surgery they did cultures and discovered I had a staph infection on my spleen as well?  My immunologist said it was a one in a million shot and that I should consider a lottery ticket.  I told him I already bought one and cashed it in last Thursday and Friday.  I used it to stay above ground and as far as I know, they don’t sell winners back to back. 

To be honest, I used to play the lottery quite a bit.  Not large amounts, but I had selected some numbers that were relevant to the family and I’d donate five to ten bucks a month.  This week, when I had built up enough stamina to open up the computer and check on a few things, I was looking at my bookmarks and saw the “Texas Lottery” link.  But this time, I had no interest in it whatsoever.  Not even a curiosity to see what the jackpot might be.

July 4, would be my fourth holiday spent in the hospital.  But I am alive.  I have never been so happy to be alive!  Ever.  I thought I got it.  I thought I was living for the simple moments, but I discovered that there is another level.  My buddies and some family would come to visit me and even though it would zap my energy, I loved every moment with them.  It is hard to explain, but I had come to accept that I survived a major traumatic event.  The love and support of my community was almost palpable and I pledged to never take any portion of it for granted again. God truly saved me and I have no doubt, as previously mentioned, that there were angels and miracles involved. 

Certificate of flag flying in the F-16

The morning of July 3rd, I woke up with stomach distention and without a bowel movement.  I didn’t feel comfortable eating breakfast and filling my stomach with no predictable output from my intestines.  It was pretty painful even considering all the other issues that had been going on over the last week and a half.   I opted for another shot of Relistor and let the games begin.  This was a triple flusher, but I had anticipated the results and wasn’t surprised by any of it.  I had so many nurses wiping my butt, I felt like I was 2 at times.  Also, I had to use a barrier cream on my butt.  Being on my back and in the chair so long made me develop a kind of bed sore, but not an open oozing one.  With the cream it was manageable and protective.

After my turbo lax shot, July 3^rd would be a good day with food intake, pain management, walking, and visitors.  My cousin David was a munitions Master Sargent in San Antonio and had retired in mid-June.  As it turns out he asked for a favor as a gift to me.  He had an F-16 Fighting Falcon from the 182^nd fly over both the Texas Capital and Texas A&M University with a flag for me.  He came and presented me with the flag and certificate and I’ll be honest, I was moved to tears.

On July 4^th, I felt actual hunger pangs. I started to eat better and they would slow down the big gravy TPN nutritional bag.  However, there was still no bowel output which at this point were only stimulated by shots.  My night nurse gave me a glass of prune juice and finally, around midnight, I started to fart.  The relief was amazing. Even though I still had plenty of gas and a somewhat distended stomach, it was a start.  And the feeling was almost indescribable.  I wish I could do some sort of comparative video collage of having a splinter removed, hole in one, watching first child born, getting married, hitting the game winning walk off home run and any number of other things that make you smile years after they occur.  For a fart…technically several.  But it was like that. 

Before you judge on this one, consider that I’m bloated and I am in the hospital for a rupture.  Trust me, you don’t want to go through that ever.  So when something happens to alleviate those feelings, you are pretty stoked about the event…even a fart.  Finally on July 6 I would have three movements which were not induced by a shot or a pill.  I could finally eat and feel confident that it would pass naturally. 

As an aside, I had a lot of time to watch cable and check out a few movies.  I don’t want to artificially extend this blog another two pages to fit in correlations of Tombstone, Field of Dreams, The Punisher and Full Metal Jacket to name a few of the movies I watched.  But it would be easy to link my life, family, and experiences to some point in all of these movies, which I guess is what makes them meaningful.  By the way, if you are looking for a good binge watch: Shooter on Netflix/AMC is pretty awesome.  It uses the Marky Mark movie and takes it to another level turning a two-hour movie into a 10-hour series – so far.  But it shows his love for country and family as well as his unmatched talent as a sniper.  You have to have a little suspension of disbelief, but it is worth the watch.

I would also like to thank and say how proud of my wife I am.  Nita has kept the house running as though things are normal while dealing with work, technology issues, a zillion questions, a husband who almost died, and summer camps.  She has shown everyone what a Rockstar she is and I am lucky to be her husband.

I have some amazing news.  In the “what else could possibly happen” category and If you still aren’t convinced that this has been anything short of a miracle, try this on for size. 

Here is the deal, I have mentioned that statistically I thought this was going to be my last trip around the sun with all of you.  There just wasn't a path (outside of a miracle) to staying alive many months longer.  But with all that has gone on these past two weeks I felt that it wouldn't be crazy if something ELSE miraculous happened.  I don’t mean it in an expectation or entitlement sort of way, just that if I was going to be called home, it probably should have happened on the 22^nd.  I told Nita that I have felt the embrace of God and wouldn’t be shocked if one of the doctors came up to me and said, "We can't explain it, but..."

Well, for shits and giggles I asked one of the doctors to run a CEA score.  On the morning of July 5^th, my doctor came in and said that he ran it and it came back as a 10.0! Down from 45.4 on June 5th.  The doctors and nurses with oncology experience at St. David’s were all shocked and staring at me like they were witnessing something beyond medicine.  They were outwardly elated but I noticed the casual exchange of glances that were in the realm of shock.  There were even hugs and tears.

Before we get too crazy, this is just the blood marker score and not a CT scan measuring actual tumor growth or decline. But it is a time for rejoicing nonetheless. I cannot tell y'all how amazed, humbled, blessed, and honored I am to be on this path.  All of the other stuff has been worth it.  I love you, and hope to see y'all soon. I should be discharged on Friday July 7^th and am looking forward to getting back home.  I am still obviously working a few things out with my bowels, foot and ankle swelling, stomach distention, as well as a few other things...but I am alive.

All those thoughts and prayers were answered this week.  I refuse to discount the events I’ve been a part of, nor would I consider it “normal” or “lucky.”  I love and appreciate everything you have done for me and am looking forward to seeing you folks around, whether it be an Aggie football game, community pool, shuttling the kids around, or just walking the dog in the neighborhood.  The book should be out by the end of July (the first year) and I’m looking forward to that one.  There will be some signings for those that are interested.  But this year certainly seems to warrant another one.  Let’s see how it all goes. 

But for now, I have never been so happy to be alive.  God bless you all and may you never lose faith in the face of adversity.  Find courage and strength where you can and never ever give up.  TeamMarco