There are three kinds of men. The one who learns by reading. The few who learn by observation. The rest of them have to pee on the electric fence for themselves. Will Rogers. 

In the quote above, I would like to think that I am in the first group, and only occasionally fall into the second group. However, in terms of my medical life, I often fall into the third group (although Will Rodgers seems to be unnecessarily harsh on this group). The past, almost three weeks, is no exception.

By way of background and explanation. After being diagnosed with bladder cancer and having two painless operations – painless, I think, because they are deep inside my bladder where, I’m guessing, there are no pain receptors – and after waiting for the damage caused by the removal of the cancer to heal, I started a six-week BCG-TICE regimen to kill any remaining cancer cells in my bladder.

The BCG part of the BCG-TICE refers to Bacillus Calmette-Guérin, which is another term for a weakened strain of Mycobacterium bovis. Mycobacterium bovis is the bacterium that causes tuberculosis in cows. TICE is short for Transintestinal Cholesterol Excretion, which, after a lot of searching, the internet tells me, is a physical process in which the body excretes excess cholesterol through the feces.

I have only the vaguest idea of what all this means – although I do know the meaning of the individual words – but the BCG-TICE concoction, itself, is sort of an old-timey remedy, having been first used in 1934. The mixture is inserted into my bladder through my penis (an unhappy penis at this point, believe me). The immune system senses the foreign concoction inside my bladder and kicks into overdrive, immunizing like crazy, killing any stray cancer cells that it presumably hadn’t noticed before.

After mt first treatment on Monday, three weeks ago, it seemed like the treatment would be shockingly easy; I had a runny nose on Tuesday and felt a little achy, but otherwise, by Wednesday, I felt good. By Thursday, I felt great. That weekend, I was still feeling great, flying high, until my right shoulder started to hurt, then my elbow, followed by my hand. For a couple of days, I couldn’t touch my mouth with my right hand. (Try brushing your teeth with your non-dominant hand; it is way harder than you would think.)

In the meantime, I felt not exactly tired, just feverish and weary. Worn out. Oh, and scared, I have enough old-age problems, and I don’t want another system going on the fritz. At about that time, after consulting the internet’s infinite wisdom, Michele said, “You have reactive arthritis, a rare but real thing.” We called my doctor and had a semi-bizarre conversation with a nurse, who was about four corporate levels above my doctor. He called back, and after listening to my whining, he agreed with Michele. Having a name for what was going on and a cause made me feel much better.

The cancer treatment has been put on pause, which is not a good long-term strategy. The long-term plan is now to take a two-week break and then try a half dose of the BCG-TICE mix. Strangely, even though this treatment has been around since the last century, the thinking on dosage size and timing is still pretty loose. It turns out that a half dose is considered as effective as a full dose.

In the meantime, when I don’t feel shitty, I feel great.

* I say semi-bizarre because the nurse on the phone asked all the appropriate questions, with no accent, but had no idea who I was or what the doctor’s specialty was.

We saw Taylor Tomelson at the Paramount in Oakland last Friday night. On Saturday, we saw Lyle Lovett perform with the San Francisco Orchestra. They were very different from each other, except that, in both cases, we were in what we used to call the nose-bleed section, and both were great.

I liked the Taylor Thomilson show the best. Her humor is filtered through her life journey, and her honesty, candor, and growing self-awareness are remarkable. Michele and I think she is the funniest comic in, what seems to me, a growing crowd pushing the boundaries of joke-telling.

Here are a couple of short samples.

Michele and I have probably seen Lyle Lovett more times, together, than any other performer, but we had never seen him in concert with a full symphony orchestra until last Saturday. It was terrific. Lovett is a musician, but, more accurately, he is a Texas storyteller.

Once done, the bladder will be given a chance to heal. Then, it might be time to go with BCG. This is an intravesical treatment option. That means BCG liquid is inserted directly into the bladder. Bldder Cancer Advocacy Network.

Because BCG treatment uses live bacteria, it is important to speak with your healthcare provider about reducing the risk of contamination when you empty the solution from your bladder into the toilet at home. Ibid

On Monday, I came back to reality with the above intravesical treatment. Afterwards, I felt shockingly fine. By Tuesday, I felt like I had a very mild cold, and by Wednesday, even that was gone. The only problem, and it is sort of a problem, is that I have to disinfect the toilet every time I use it for eight hours after the treatment, and I have to disinfect myself with Lysol and my clothes, then life is normal until next Monday, for the next five Mondays, actually.

The disinfectant regime does make everything seem sort of yucky, but I’m sure I’ll get over that.

To be more accurate, though, we are flying into Barcelona and then driving to the reunion in Die, France, with a short layover in Carcassonne, France. After the reunion, we are driving to Paris, with a layover in Lyon. Then we fly to Ireland, where we spend several days at Michele’s family retreat in Baltimore, Ireland.

No one said it would be easy, but somehow, that’s what I heard. A refrigerator magnet that Michele has on our refrigerator, not for my latest surgery, but certainly applicable.

In the meantime, I am recovering from my bladder surgery. Not recovering very gracefully, I should add, now that I found out that I have to do the surgery all over again. The doctor thinks that he got all the cancer, but will have to return to inside my poor bladder to dig through the ruins to be sure he got everything.

Meanwhile, Israel Pearl Harbored Iran, and Russia continues with its efforts to eliminate Ukraine. It makes worrying about an uncomfortable surgical procedure seem pretty.

I’m a nurse. What’s your superpower? – Unknown

Nursing is one of the fine arts: I had almost said ‘the finest of fine arts. – Florence Nightingale

I’m back from my procedure at Sequoia Hospital, uncomfortable but otherwise fine. The doctor said everything went well. The cancer tumor was small, and he thinks he got it all. Hopefully, we will get word by Friday that I am cancer-free.

Whoopsie Daisy!

Last night, my – I’m not sure what to call it, I’ll say drainline* – drainline clogged up with blood clots, and we ended up in the Sequoia emergency room at about two…it was not fun. But we got back home a little after three, slept to about noon today, it is a beautiful, clear day, and I feel much better (despite the Trump Administration running amok in LA). Poor Michele is taking the brunt of this.

The visit to ER was shocking for two reasons. One, it took much less time and hassle than we expected, and two, it is – apparently – much more common than I would have thought. The nurse said that he was just going to replace the drainline because it was much easier and faster than trying to muck around and replacing catheters was the favorite part of his job.

*Michele says that it is a catheter (I knew that). Michele, who is much less sanguine than me, also says: “When we left the hospital the catheter tube had big blood clots in it and the nurse said that it was ok, ‘tap the tube, and they come loose’. Well, that worked for awhile. Before  I started getting ready for bed, while Steve wanted to stay up a bit longer, I suggested I help him empty the catheter bag, and started  thinking it was weird it wasn’t filling up. Got him to drink more water. That eventually caused him to pee more, but, oops, it wasn’t flowing down the tube, it was squirting out of a port on the tube. After I crimped that off then he started peeing around the tube.  I did what I could to tape a bunch of gauze on him to catch the leakage and by the time did all that and cleaned up the mess and covered the seat of our new car with towels and plastic, we headed to the ER  got to there at around 1:30. Steve had me call ahead so they were prepared and it was lightening fast, but still, it was 3 am by the time we got back home. Then I couldn’t really fall asleep until about 6 because, by then, the catheter was filling up quickly and I was worried (unnecessarily it turns out) it would overflow. Now I need to run to the pharmacy to pick up the pain pills they should have prescribed in the first place.”