Short Post, Turkey Roast (and sips of Eggnog with lemon pound cake)

This post is dedicated to all of you and your “undying” support. It is the shortest of the lemonade series to respect your family time during this Thanksgiving week.

Speaking of Thanksgiving, you’d think with a new diagnosis of cancer, one would be bitter. Actually, it’s just the opposite. Sure, I’d rather not have cancer. But this diagnosis and all the biopsychosocial aspects that come with it, the treatments, and the stigma have opened my eyes far beyond what I understood as a treating clinician. I’ve learned to be more compassionate to others, to live in the moment, to enjoy every flash of life and nature, to embrace every second with family and friends, to equally appreciate all those wonderful colleagues that have shown compassion towards me and my family, and the list goes on. I am a better person due to this diagnosis. And believe it or not, for that I am grateful and thankful on this week leading up to Thanksgiving. I am thankful for every morning that I wake up to live another day and for every holiday I get to spend with family.

Today is11/23/2021 and my family is busily preparing for the big Thanksgiving Day. I‘m posting this in advance of my chemo treatment scheduled for next Monday, 11/29.
Before outlining the many other ways I’m thankful around this festive season, let’s start with something impersonal we all need to deal with daily.

Telephone call: Your call is import to us, blah, blah, blah, repeated each two minutes. Exactly 15 minutes later; “We are experiencing a higher call volume than usual. Please leave your name and number and someone will get back to you as soon as possible in the order it was received…”

Try to guess if this automated message was from my car dealership service department or the oncology office. Nah, you’re all wrong; it was from both and almost an identical message!

After being hung up on, this is a typed message I left on the oncology group portal.
“I have a virtual appointment scheduled for 11/17 at 1:30PM as a f/u to CT Scan that is scheduled for today on 11/15. That CT Scan was changed from 11/15 to 11/24 in the morning. I’d like to either reschedule my virtual meeting with Dr. Onc or meet her/him on 11/29, a few days after the CT scan, when I’m scheduled for my next chemotherapy. Please contact me at xxx-xxx-xxxx to reschedule the virtual appointment to be consistent with the newly scheduled CT scan results or reply here to confirm a live visit on 11/29.”

Within an hour, I did [to my surprise] receive a portal communication.  Here is one issue with the practice that was in fact resolved after I made a formal complaint which I shared here with readers previously. Recall that it is not okay for a random office person to reply to my (or any patient’s) written portal inquiries, pretend it came from the doctor, and/or not identify themselves. Kudos for correcting this problem. Message Title today started as “Jane Doe Medical Assistant Sr on behalf of John Doe, PA” Comment: “forwarded to telehealth”, exactly as I suggested. FOR THIS I AM THANKFUL!

So, my scheduling inquiry was sent to telehealth – a good thing. A couple of hours later [again, to my surprise] I received a call from clerical staff asking me if I’d be willing to meet with the NP instead of the MD to discuss my CT Scan on 11/29 prior to my chemo. Generally, my answer would be yes. However, my answer was that I’d prefer to discuss the CT Scan with my doctor, especially since the NP previously told me that she was not able to make or predict subsequent chemo plans based on the results (“it’s up to your doctor”), and there were other issues that my doctor was going to specifically look into such as policy or lack thereof that would allow me to flush my own central IV port from home (or out of town) if I was traveling. Verbal reply: “I’ll speak to your doctor and call you right back within a couple of hours.”

It’s now been 9 days since the promise to call me back within 2 hours. I called again and to no avail, received the usual automated voice message outlined above. Here’s an interesting reply after receiving yet another automated soulless message…

“Hi. This is Jeff Fudin. I called and left a message. Being a Stage 4 cancer patient, l’m not sure how much time I have left to live, and I suspect you don’t know either. It’s not cool for you to suck up my precious remaining time waiting on hold, and then hang up. Anyway, I waited so long that I’m leaving this message from my grave site, one foot in the hole and one on the ground. Please call ASAP before I slip into the abyss or starve. By the way, I’d change your automated message because it doesn’t seem to reflect that my call is in fact important to you – if it was, a real person would be answering the phone. Communication with your office staff has been an ongoing issue. Do you think maybe you need more staff or less patients? If your patients are in fact important to you, I’d give this serious consideration.”

At my 11/9 visit (chemo cycle 10), Dr. Onc and I discussed in more detail my inquiry about not coming in on day-3 of chemo to disconnect the lemon infuser, flush my IV port with saline and heparin, and then pull out the needle.  These are all things I am trained to do, and I suspect that I have sufficient aseptic technique (keeping things sterile) in comparison to the many nurses that heretofore have provided this service. According to Dr. Onc, this question has never come up as far as (s)he knows. The question to me was, why do you want to do this?  The answer is simple. I have no problem driving 12 minutes to the clinic, waiting for a few minutes, and then having someone perform this 5-minute procedure.  But, if it means staying in town for 2 extra days for something I can easily do myself, when I could be on vacation, or it means I must decline consultant work out of town, that doesn’t make sense. The response was, “I’d be happy to look more into this and will send an e-amil out to several people regarding policy and how we can make this work.”  Then the question to me was about chemo scheduling moving forward with consideration to my scheduled travel (work and leisure) and the holidays (reduced office hours). I gladly shared my travel information and those certain days out of town have not yet been firmed up pending answers from this conversation. Dr. Onc intently listened to my schedule and plans. (S)he replied, “…my goodness you’re awfully busy.” My reply? “Yes, I am quite busy. Isn’t that the whole idea of what we are doing here? Afterall, I’m pretty much leading a normal life right now because of the treatment.”  Dr. Onc was wearing a mask, but the facial muscles and eyes told me there was big smile under that mask. His/her reply?  Yes, you are right – that is the goal!

I AM THANKFUL THAT DR. ONC HAS COMPASSION THAT IS SLOWLY OOZING OUT WITH EACH VISIT. The disconnect I felt previously has completely dissipated.

Here’s a new development! After my last chemo treatment I developed very mild palmer plantar erythrodysethesia (numbness) to my hands, and lots of skin breakdown on my palms to the point that I had bleeding on the creases at almost every joint. This is a common side effect with chemo treatments, and there are no approved treatments. Yet, it can delay chemo treatment and/or require downward dosage adjustments and/or longer intervals between chemo. Anyway, it doesn’t affect me much, at least not for now, and certainly will not delay my chemo at this point. Why?

I made a topical cream (like the old days in lab – like more than 3 decades ago) and added in a special ingredient (no, not CBD) and it cleared up about 95% within 3-days. I am actually considering doing some studies and bringing it to market in my spare time.  A close friend and colleague of mine, Andy D, reminded me what we used to call this. And, Andy isn’t even a pharmacist. He’s an MD specializing in PM & R and quite the educator! The term  he “conjured up” is alchemy.

All that aside, I can’t help but wonder how the hell does the average person survive all this.

What things have I done from 11/11 up to this post?

 

 

 

 

 

 

 

 

 

Two of my mentees, my first two Pain and Palliative Care Pharmacy Residents visited from out of town. Tim and Thien, from Long Beach CA and Nashville TN areas respectively planned this visit several months ago when I was feeling pretty weak. We had a blast!!!  We went to David and Busters to play video games (something I haven’t done in years), attended a movie (haven’t done that in two years), and we finished their visit up with a brunch made by local past resident Erica. It was amazing.  All the local resident graduates from our program attended. The next day after dropping Tim at the airport, I headed down to New York City to meet up with my wife Robin, to celebrate granddaughter Silbie’s third birthday, where I had a memorable milestone with the family.

Then, a couple of days later, Charlotte came to town – she was one of our first post-graduate year-1 (PGY1) pharmacy general practice residents in the mid-90s. She came all the way from New Mexico.  It was so great to see her after so many years (like 2.5 decades)! Finally, there was my neighbor’s tree that lost a huge branch to the fierce wind a few days ago.  I waltzed over there and cut it up with a chainsaw for them – truth be told, it was partly for me just to prove I could do it.

This past weekend was fall cleanup to front and back yard and my 39^th wedding anniversary with wifey Robin,  followed by an overnight visit by local daughter and son-in-law plus their little angel Aria in tow.

So, what am I thankful for this year? The list is huge. But I want to thank all of my readers and followers for your outpouring of love; for extending my life and keeping me healthy. It is your encouragement, prayers, personal comments and posts here and on various social media platforms, text messages, calls, gifts, cards, and omnipresence (especially at PainWeek) that has allowed me to celebrate Thanksgiving with my family this year. I plan to be back next year too with your encouragement.

 

This post is dedicated to all of you and your “undying” support, as I noted above.
Life is good, and so are people. Happy Thanksgiving to all of you who have given me life, afforded me the strength to live life, and the anticipated fete accompli for meeting my two expected grandchildren in February 2022!

Comments are enthusiastically welcomed. I love receiving comments of various social media sites (Facebook, Linkedin, Twitter), but please also paste those comments on here if you have time! Many thanks and congratulations (and thank you) if you made it through this entire post!