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Monday, January 26, 2009

Records come, records go

Earlier today, the 17,000th visitor to my blogs, CancerVivor.blogspot.com and kohnzone.blogspot.com, stopped by for a few.

They were greeted by either photos of a really cute newborn named Emily (kohnzone) or some less than cute images of the inner workings of my body (CancerVivor).

At the former, I was announcing the birth of my first grandchild and showing off some photos. That's pretty self-explanatory, so I'll focus on the cancer site.

There, as I have since it launched, I am trying to educate as many people as possible about esophageal cancer and how to avoid it.

So I'll rehash some things I've said in the past:

First, YES! You can get cancer from heartburn. It's not all that difficult, apparently. I did it. Just eat spicy foods -- lots of them -- mixed with greasy, unhealthy items. For a long time. That will set you in the right direction. To follow up, avoid seeing a doc about heartburn or taking meds to treat it. Then, when the heartburn fades away suddenly, think of it as a blessing that your self-medication has helped, not the condition know as Barrett's Esophagus which masks a pre-cancerous condition. If any of these symptoms occur, longtime heartburn or sudden discontinuation of heartburn for no real reason, see a doctor.

Second, esophageal cancer survival is so low because it often is diagnosed in advanced stages. For me, the tumor was large enough to block much of my swallowing, but not all. So if you find it difficult to get food from your mouth to your stomach, see a doctor. The sooner the better.

Third, statistically, esophageal cancer is growing, both nationwide and in Florida. It continues to be very lethal, as noted above. Of the 1,170 Floridians to come down with the disease, 1,010 people died in the American Cancer Society's most recent statistical report. The numbers were grim nationwide as well in 2008: 16,470 new cases and 14,280 deaths.

There's a five-year survivability rate of 34 percent for those with the cancer contained to the esophagus, as mine was, so I'm not nearly out of the woods yet. For all stages of the cancer, the survivability rate plunges to 16 percent.

When diagnosed, I was staged at 2 to 3, meaning it was advanced but had not yet spread to the lymphatic system. That's what saved my life -- so far.

Across the country, esophageal cancer is the seventh-leading form of cancer among men, claiming 11,250 lives -- or 4 percent of all male cancer deaths.

So please, please, if any of this sounds like you, get help. Get it now. Do not wait. I'm not a doctor but I can speak from experience and, sadly, this is an area in which I have experience. Be cautions and take a proactive stance.

It could save your life.

Friday, January 23, 2009

Ah, food

I had a gyro and fries this afternoon, my first solid food in a couple of days. A better 3 p.m. breakfast was not had by me in recent years.

It was at the Daybreak Diner on Curry Ford Road, and it was a tossup between the gyro or their special sloppy joe.

But why have breakfast at 3 in the afternoon? The answer is simple. That was the quickest we could get there from Florida Hospital after my endoscopic procedure.

Dr. Philip Styne conducted the endoscopy and had to inject Botox into my pylorus to get the valve at the base of the stomach to better regulate food flowing into the small intestines.

This is why I have had various forms of chicken soup and Jell-O for the past two days.

And it's why I was dying to have food this afternoon.

In short, the good news is the procedure worked. The bad news is I had to drink my meals for a couple of days.

Below is a look at what the good doctor saw when he went digging into my insides. The numbers correspond to descriptions at the bottom.

Now can you pass the ketchup?
1) Surgical site; 2) Pylorus; 3) Small Intestines; 4) Pylorus; 5) Surgical site; 6) Surgical site

Thursday, January 22, 2009

Souper duper

If we lived in ancient Rome, I'd be very wealthy.

That's because I'm on day two of a "clear liquid diet" that will lead to yet another endoscopic exam on Friday.

But let me explain. The exam will likely involve either dilation of a stricture in my reshaped, remade, bionic esophagus or an injection of Botox into my pyloric valve at the base of my stomach. All this to help me process and digest food just a little better than I'm doing now.

So since Wednesday I've been dining on Jell-o and soup. That way by the time Dr. Philip Styne peers into my insides the path will be clear of gunk and leftovers and other nasty-looking contents. He'll be able to navigate and treat whatever it is that's been keeping me bloated for a month or so.

Dr. Styne, the best of the best of the best in his business, will perform his magic at Florida Hospital's main campus. I'll have some happy juice and snooze a few minutes and then go home. The procedure is scheduled for the afternoon, but I have to arrive at noon. Daughter Karen is my ticket there and home, since I won't be able to drive afterwards.

Oh, and as for the wealth remark above? Ancient Romans viewed salt as a measure of wealth, and, for a time, it was used as currency. With the amount of soup I've consumed yesterday and expect to consume today, trust me: Lots of salt.

Friday, January 9, 2009

Beat goes on

Turns out I don't have heart disease. That's the outcome of today's cardiac catheterization, and I couldn't be happier.

Well maybe I'd be happier if I didn't need to undergo the procedure. But shy of that, I'm about has happy as can be.
A couple weeks ago, we thought I may have had a heart attack. The symptoms matched and it had the Dr. Catherine Seal of Approval. But after today's procedure, there's no blockage to be found. So my climb up Mount Everest earlier this week on the doctor's treadmill kind of threw Dr. James Miner for a loop.

As he said, they'd either find nothing or something. I'm very happy, and so was Dr. Miner, that the test found nothing.

Conducted by Dr. Alejandro Franceschi, the cath went smoothly and did discover one thing -- my heart has one anomaly. An artery in the heart branches out at the wrong place and then doubles back to its proper location. It's weird enough that Dr. Franceschi plans to send the films of my exam to a doctor who compiles all the weirdness that has to do with hearts in a book, sort of the Guinness Book of Records but for hearts.

The procedure begins with a shave and a haircut -- two bits -- and the usual IV and a swap from my bed to the procedure table in a very refrigerated room. Monitors are suctioned to your body and a sterile drape is placed over most of the body. Once the doctor steps in, things move quickly. He injects local anesthetic to the groin and a short time later the catheter is already inching its way up the femoral artery to the heart -- a show that's visible on a computer monitor above the table. Once in position, the doctor injects a dye that shows up on the screen. That's when the docs can examine the various arteries for blockages.

After the procedure, a nurse applies pressure for a while and you're sent back to a recovery room, where another nurse applies pressure for about 20 minutes, followed by two hours of sedentary rest with a sand bag adding pressure to the site to ensure it seals. You don't want the femoral artery to leak.

Honestly, my jitters before hand were quite misplaced. I barely felt the catheter enter my body and had no discomfort at all during the procedure.

Another obstacle overcome.

Thursday, January 8, 2009

8 hours until my procedure

I'm not sure why, but for some reason I'm more nervous about my cardiac cath than I was the night before my esophagogastrectomy -- the cancer surgery more than a year ago.

I know this is misplaced and all yet there's this lingering feeling of dread.

I'm sure in about a dozen hours I'll be back here writing how ridiculous I was tonight, so all will be well.

But until then, I have the pre-op jitters.

Just when you thought it was safe...

Just like the ads for the Jaws sequel, there's always something lurking.

For me, I learned this past summer when I met my family in California, heart disease is a part of my genetic history. My father had the first of his three heart attacks at age 35. My brother Dan suffered a heart attack just a few months ago; thankfully he survived and is thriving.
So while I'm surprised that I've had some discomfort and all in the past few weeks, I'm not shocked. After all, some 24.1 million Americans had some form of heart disease, roughly 11 percent of the population, in 2006. There were 652,091 deaths caused by heart disease in 2006, ranking it as the nation's top killer with a rate of 222 per 100,000 people in the general population.

All that said, I met with Dr. James A. Miner of Florida Heart Group on Tuesday (photo from the Florida Heart Group Web site). He was concerned with the repeated chest discomfort I've experienced in the past few weeks and sent me onto the treadmill. I kept up well, though got out of breath when the tech set the machine at the Mount Everest-level climb. Dr. Miner sat in on the test and then reviewed the printouts.

Afterwards he offered this summary: "Either it's nothing or it's something." I'm happy with the former, less so with the latter. If it's something, it may be a clogged artery, meaning I'd need a stent.

To find out, on Friday I wake up very early and go in for a cardiac catheterization. This is where they slink a very thin tube up to the heart through arteries in the leg. There, with the aid of X-rays and a fluroscope, the doctor can observe the heart and decide whether there's a problem.

I've spoken to a few people who have undergone the procedure and all pretty much assured me there's a very low level of discomfort. Actually, one assistant at Dr. Miner's office said there's some pretty good pain drugs afterward. I guess that's the reward for good behavior.

I'll post updates Friday after the procedure and will tray to grab a couple of images from the doctor to post.

Meantime, it is safet to go into the water. Just watch where your step.

Friday, January 2, 2009

Holidays swoosh by, like meeting with Dr. Styne

I failed to mention the other day that on Monday I had an appointment with Dr. Philip Styne to discuss some digestive issues.

For the past couple of weeks, I've had a bloated feeling and I think either the stricture in my esophagus (what's left of it, that is) -- previously dilated with a balloon-like tool during an endoscopy -- or the pyloric valve -- forced to remain open with the use of Botox -- might need another treatment.

So in the coming weeks I will have another endoscopy at Florida Hospital to fix either or both of those problems. Before that, however, I have an appointment with cardiologist James A. Miner this coming Wednesday to clear me for the procedure and related anesthesia.

It's sort of a downer because after both of those treatments I seemed to feel nearly normal. I mean, I still can't eat as much as, say, two years ago (Do I want to eat that much any longer? No!) but I was feeling quite normal. Now I'm more cautious and also feeling more full -- even when I wake up in the morning.

I'm sure Dr. Styne will get that all under control. He's the best of the best.