Wednesday, September 29, 2010

So long, Cito. And thanks.

Today is Cito Gason's last home game as Blue Jays manager. I don't really have a lot to say here, but I wanted to acknowledge what Mr. Gaston has done for the Blue Jays. He was the hitting instructor in the mid-80's, when the Jays went to the post-season for the first time. He became the manager in 1989, and the Jays returned to the playoffs. They won the AL East three more times, and of course won the World Series in 1992 and 1993. If the 1994 season hadn't been cut short, who knows what might have happened (Jays vs. Expos in the World Series? It wasn't out of the realm of possibilities...) Gaston helped to take a team that was on the way up and bring them all the way to the top.

Cito announced earlier this year that he would be retiring after this season, so I wanted to write this as my way of saying thanks. Thanks for the pennants, the championships, and the All-Star games. Thanks for the slow trips to the mound and the arguments with umpires. Thanks for being a quiet but commanding leader. Thanks for letting Todd Stottlemyre do his own baserunning. But most of all, thanks for the greatest moment in Blue Jays history:

Saturday, September 25, 2010

Hospital: Recovery at home

This article is the third of a three-part series on my hospital experiences. Part one is called A day in the life, and part two is Surgery and post-surgery. At the end of our last instalment, I had just been discharged from the hospital after eight weeks.

Coming Home

I was discharged on Good Friday (which my then-7-year-old son Nicky called "Awesome Friday" because daddy came home). The Easter weekend was the warmest of the year to that point, and may have been the warmest Easter weekend in many years. I sat out on my deck with my dad for a little while – no jacket, no sweater, no long pants, just a t-shirt and shorts. We left the windows open all weekend. It was the most amazing weekend I can remember.

Both my energy level and my appetite were very low when I came home. I spent a lot of time lying down on the couch over the next several weeks. My weight was 151 pounds when I was discharged, 27 pounds less than I was before this all started. I hadn't eaten solid food in eight weeks, so my stomach shrunk quite a bit. My normal sized meals were way too much food, and there were plenty of meals when Nicky would eat more than I would. Trying to get enough calories into me to give me more energy (and stop my weight loss) was quite difficult. I had to eat every hour or two because the meals I was eating were so small. We bought things like Boost drink boxes, some meal replacement bars, and Ensure Plus. Boost was OK but I got tired of the taste pretty quickly. The meal replacement bars were pretty good, but were so filling that it took me an hour just to eat one. The Ensure was pretty good and has about 350 calories per bottle. One of those by itself would fill me up – and I mean fill. After finishing one, I felt like I'd just eaten a 20-oz steak in ten minutes. I kept a little journal of everything I ate along with how many calories it had. For at least a couple of weeks, I was eating between 1100 and 1500 calories a day, but there were days where I ate less than 1000 calories. Just for comparison, a Big Mac and a medium fries (with no drink!) is 920 calories. We went to McDonalds for dinner a week or two after I was home and bought three happy meals (with a boy toy!) instead of the usual two – and I couldn't finish mine. I was told I needed to bump my intake up to about 2300 calories a day just to maintain, and more if I wanted to gain. This seemed like a completely insurmountable task at the time, and I became quite frustrated. I was eating at least six meals and snacks a day and was totally (sometimes uncomfortably) full after every one, and then I was told that I had to more or less double my food intake.

I lost about ten pounds in two weeks at home, down to a low of 141.5 pounds. I was looking pretty gaunt. My arms and legs were like sticks and my face was sunken in as well. I went to see a nutritionist and she gave me a pamphlet on increasing your caloric intake. The crux of this document was "do everything Weight Watchers tells you not to do." Put real whipped cream on your dessert, hot chocolate, or milkshakes. Use cream instead of milk. Drink homogenized milk instead of 1% or skim. Use sour cream or mayonnaise. Add sugar to stuff. Add butter to stuff. Avoid foods labelled "light", "calorie-reduced", or "low calorie". This is many people's idea of "heaven" and I thought it was pretty cool as well. A couple of times I stopped at Tim Horton's on my way somewhere to get an Iced Capp, which I really like but generally try to avoid because they're filled with calories (unlike the donuts that I don't make so much of an effort to avoid). I managed to convince myself that I needed the Iced Capps for medicinal purposes, as part of my recovery. Even given my free reign to eat whatever I wanted (she even told me to avoid fruits and vegetables because they were filling but had minimal calories – I called them "empty nutrition"), it took me ten weeks to gain back the ten pounds – and then I only had another fifteen to go before I was at my goal weight. Before this all started, I could have gained the ten pounds in five days at Fern. I was a little concerned that once I started gaining weight I wouldn't be able to stop. Luckily this has proven not to be the case – I've gained back all the weight I want to and I've maintained roughly the same weight (low 170's) for a month or so now.

Some days I ate fairly normal meals, although much smaller than normal – a typical day might have looked like cereal for breakfast, yogurt as a mid-morning snack, a chicken wrap for lunch, a fruit cup for afternoon snack, chicken or beef casserole for dinner, and an Ensure before bed. That would have been about 1100-1200 calories. But there were other days where I just didn't feel like eating so I basically forced myself to have an Ensure in order to get calories. There was one day where my entire food intake was a bowl of cereal in the morning and four Ensure's the rest of the day. Some of my favourite meals at the time included bruschetta pizza (a tortilla with bruschetta on top and maybe some chicken (no cheese), broiled in the oven for a few minutes), satay noodles (Gail made a big batch and it would last me several days), and toast with peanut butter because it had lots of protein. Gail really pushed the protein hard because it helps to rebuild muscle. Besides the handy pamphlet I mentioned before, the nutritionist gave me some more specific ideas for increasing my caloric intake too. I started eating lots of Quaker Harvest Crunch (which I've always loved) and I bought a big Costco-sized jar of mixed nuts – a quarter-cup of nuts has 200 calories so that was a good snack option.

I knew I needed to keep moving to try to build up my stamina, energy levels, and muscles but it wasn't always easy. For a while my exercise regimen was to get up off the couch, walk one lap around the main floor of the house, and then go lie back down again. After a few days I felt a little stronger, so I would walk up and down the stairs five times (sometimes four if I was extra tired) and then go lie back down. My goal was to get up and do this every hour, but that didn't happen – I was lucky if I did it three times in a day. After another week or so, I wanted to get outside so I started walking down the sidewalk a couple of houses and back (and then go lie back down). Each day I tried to walk a house or two further until after a couple of weeks I was able to walk all the way around the block (most of 1 km), and then go lie back down. (Are you seeing a common theme here? I spent a lot of time on the couch.) Most of the walking I did was hunched over because of the pressure on my incision. It was mostly healed on the outside, but took at least another month or two before the pressure and pain stopped inside. I had to make a conscious effort to stand up straight, and sometimes I just couldn't do it.

I was exceptionally weak as well. I drank a lot of Gatorade and a couple of times, I had to get Ryan to open the bottle for me. I remember Gail deciding to mow the lawn for the first time in the spring (a job she absolutely hated). We have a battery-powered mower, and the (very heavy) battery was downstairs in the workshop all winter. I went to get it for her and couldn't lift it – she had to come down and get it. She mowed the lawn for about a month before I was strong enough to do it. Even trying to do things like put clean dishes away was a far bigger chore than it used to be – I would usually pile all the plates up on the counter and then lift the whole pile into the cupboard at once, but I found to my surprise that you need stomach muscles to do that. I had to put the plates and bowls away one or maybe two at a time for a while.

Despite the fact that my weight was the lowest it had been in probably twenty years, my stomach was quite distended and even now, months later, it still is somewhat. When I went to see my family doctor, I mentioned that I was starting to gain weight, but it looked like it was all collecting in one place. With the rest of my body being so thin, the protruding stomach made me look several months pregnant. She said that it was distension and that I didn't have enough body fat to have a beer gut. She assured me that it would likely go away in time. A friend of mine who's had a C-section told me from experience that "the shelf" may never go away. It does seem smaller now, but I'm not sure if that's because it's shrinking or if the rest of my body has grown and made it seem smaller.

False Alarms

In the middle of May, I started feeling some pain in my right pelvis area. Sitting or lying down was fine, but I started walking with a limp because putting weight on my right leg was painful. I called the doctor and he had me come in for a CT scan, which found some fluid build-up in my pelvis. The pseudo-cyst that they drained back in March was so big (had to be, to hold four litres of stuff) that it extended from my upper abdominal area all the way down into my pelvis, and I guess the rest of the fluid that they couldn't drain during surgery, along with some all-new fluid, had collected in the lower part of the pseudo-cyst. The doctor was hoping it would just drain away naturally or be re-absorbed, but that wasn't happening so he said I needed another drain put in. It was a simple procedure though – I'd go in Friday morning (May 28th) and then be home Friday afternoon. Of course, I assumed that he meant the same Friday but that's not the way it worked out. They did a routine blood test before the procedure and found that my blood clotting numbers were too high for them to put the drain in. They wanted the number to be 1.2 or below, but they could probably be convinced to do the procedure at 1.3. My number was 1.5 so they re-admitted me and started giving me fresh frozen plasma to try to bring that number down. After 3 units, the number was down to 1.4. They gave me some vitamin K and two more units, but the number went back up to 1.5. After two more units, I was up to 1.6. They were as puzzled as I was, but they gave me more vitamin K, four more units of plasma, and at least three units of blood as well (type A+ if you're curious). All of these units were on Friday, Saturday, and Sunday and by Monday, Dr. Pace had had enough. He told the radiologist to just go ahead and do the procedure, which he did with no problems or complications. They kept me in until the next Friday (June 4) just to be sure everything was OK, and then I went home again. I had a nurse come in every other day to check the drain and change the dressings, and she taught me how to do most of it myself. I had to disconnect the drain bag, attach a syringe pre-filled with saline to the drain and inject it, then pull up on the syringe plunger to pull out as much fluid as I could. This helped to keep the drain from getting clogged. Once I did that two or three times (depending on how much I pulled out), I would reattach the bag.

A week or so after getting this drain, I hit yet another complication – the valve that connected to the bag cracked and was leaking. I called the nurse but she didn't have any parts that fit and suggested I go to the ER at St. Joseph's in Hamilton, to avoid driving to Kitchener. I did that but St. Joe's uses a different supplier for these types of things, so the ones they had didn't fit. I ended up getting Gail to drive me to Kitchener where we explained the situation to a radiology nurse. She went and got me a replacement bag and connecting hose and we were good to go once again.

Dr. Pace took the drain out on Wednesday June 16th and everything seemed fine – for about three days. On the Saturday I started feeling some pain in my pelvis again and on Sunday morning it was worse, so we spent the bulk of Father's Day in the ER at Grand River. After five and a half hours, I was sent home with an appointment to come back the next day for an ultrasound. The ultrasound showed nothing unusual so they just chalked it up to residual pain and fluid build-up from the drain removal, and I should come back if it didn't get better. After another couple of days it did start to feel better, so that was a false alarm. But a month later, I had another. In mid-to-late July I started feeling pain in my abdomen, just above the scar, on the right side. Back to the ER I went, this time to St. Joe's. I was there all day and had another ultrasound, which again showed nothing. They didn't know what to tell me, but I was scheduled for a CT scan in Kitchener the next day so I figured they'd find the problem. The CT also showed nothing unusual, but Dr. Pace said that many of my internal organs had hardened as a result of the pancreatitis and the surgery. As they soften up again some of them can stick together temporarily so I can have phantom aches and pains all over the place, and that's probably what this was. Sure enough, the pain went away a day or two later and never came back.

Back To The Grind

Sybase was great throughout this whole thing. I got emails from HR and my boss asking about my status and when I would be returning, but there was never any pressure to come back quickly. I asked about setting up a return-to-work schedule and they said that whatever schedule my doctor is OK with is fine with them, including working part-time to begin with and working from home whenever I needed to. They were very flexible. My boss Mark and the VP of Engineering Dave were both very supportive as well, and both said that they wanted me back as soon as I was ready, but again, with no pressure. My co-workers were fantastic. I had hospital visits from a number of people, phone calls, and countless emails offering support. When I returned home, they sent me a gift box containing a bunch of stuff donated by the team including a Wii game and two Wii Motion Plus adaptors (to help me stay active and get my energy back), gift cards from both Tim Horton's and Subway, and a get well soon card signed by a whole bunch of people. When I returned to work part time (June 21), I found my office packed with balloons and a big welcome back "card" taped to my door with at least 30 signatures on it. Not only do we have a bunch of really talented engineers, writers, and managers, but they're just great people as well.

I worked part time (M-F mornings) for two weeks before returning full-time on July 5. I went into the office only once that first week, and worked from home the other 4 days. The next few weeks were split 3-2 or 2-3, and by mid-August I was back to my regular 4 days in the office and one at home.

Nurses are Good People

I can't count the number of nurses that I dealt with over this whole thing but if this experience taught me anything it's that nurses have one hell of a tough job. Twelve hour shifts (sometimes overnight), giving patients needles, drawing blood, inserting IVs, dealing with zillions of different types of medications, bathing and cleaning up after patients, inserting things into places many people don't generally like having things inserted, changing unbelievably smelly colostomy bags (one of my roommates had one – I tried to time going for a walk when the nurse came to visit him just in case she had to change it), and that's just the medical stuff. I'm sure most patients are fine but some take nurses for granted, think of them as personal servants, are rude and surly, and some even get verbally and physically abusive. I know there were a number of nurses that were yelled at by patients (at least a couple of my roommates) for doing nothing more than their job. Sometimes it's not the patient that's the problem, it's the patient's family, particularly if the patient is elderly. I'm sure there are many nurses who have been yelled at by someone's wife or son because they think the nurse isn't doing their job properly – and it ain't the wife or son that's there changing a soiled bed at 3:30am. And of course the nurses aren't allowed to tell their patients off when they get this way, though I'm sure they'd like to now and again. Maybe nurses should get one STFU per month with no repercussions. More than that and they'll get in trouble, but they should get one freebie. Of course, nurses are dealing with people during a very difficult time in their lives, so it's not unlikely that they're going to get treated badly by some of them and I'm sure they realize that. That doesn't make it right, nor does it make it easier to deal with for the nurses.

I imagine the worst part of being a nurse is treating a patient with a terminal illness or injury. When you've dedicated your life to helping sick people, and spent years in school and on the job learning how, it must be especially frustrating when you have a patient that you know will not survive and all you can do is try to minimize their pain until the end.

I had a bunch of great nurses, but I think nurses can sometimes be like system administrators - if you have a great one, you don't always notice them. They do what they need to do and don't get in your way. But when you have a bad one, you will definitely notice. I remember a few names of nurses I liked: Terri, Monika, Brenda, Andrea, and Sarah. I had one nurse (Nebo) from Zimbabwe who spoke Zulu, and I asked her how to say "thank you" in Zulu. Luckily she wrote it in my book: Ngiyabonga. Another nurse (Andrea) was a friend of a co-worker of mine which we discovered when she came to visit me. Another (Grace) knew I was a "computer guy" so when she saw me playing around on the internet, she told me that she was planning a vacation to Poland and asked if I could find cheap flights for her from Toronto to either Warsaw or Szczecin. I had nothing better to do, so I went on and found her one through Frankfurt to Warsaw, and then a commuter flight from Warsaw to Szczecin. I didn't ask why she figured I would get better search results than she could.

Of all the nurses I had, I only had one that I was really unhappy with. She was only assigned to me a couple of times, but she wasn't overly friendly and did a few things that weren't very sensitive to her patients, and she was downright rude to one of my roommates. The "not very sensitive" thing was kind of silly but annoying – she came into my room at 7:00am, right at shift change, to introduce herself and give me shots. The first thing she did was turn my overhead light on, so I was awakened rather suddenly to a very bright room. She wrote her name and the date on the whiteboard on my wall and then remembered that she hadn't done that in the previous couple of rooms so she immediately left to do that – leaving my overhead light on and not coming back for at least five minutes. Like I said, not a terrible crime but not very sensitive. But the thing with my roommate was way worse and inexcusable. He was elderly and obviously had some form of dementia. He had made a mess in his bed but wouldn't let her clean it up. He was clearly not in his right mind, but she was yelling at him the way you might yell at a belligerent child. Everyone in the hallway could hear "You're lying in your own feces! Why would you want to do that? That's disgusting! I need to clean you up! You're lying in feces!" over and over. Trying to use logic with someone who couldn't understand it is bad enough, but there was no need to humiliate the guy. I only had to deal with her once or twice after that, but I was happy when they moved me to a room on a different part of the floor away from her.

An article talking about the great people from Grand River wouldn't be complete without a mention of Ruth. I never caught her last name, but she was a porter who took me to and from various procedures throughout the hospital. I had many procedures done that required a porter to take me there and back, and it was kind of strange how often it ended up being Ruth. She was very friendly and went out of her way to make sure I was comfortable. And not just me – she and Gail hit it off too. The CT scan waiting room was always cold, and so whenever she took me there she got me a warm blanket (kept in this little oven-like thing, so when I say warm, it was warm), and she'd always get one for Gail as well. A couple of times, she'd bring me down for a procedure and then go off to do something else. Then she'd come back a little while later, usually bringing someone else down, and notice me still waiting. Without a word from me, she'd go and find out how much longer I'd have to wait and sometimes even manage to bump me up in the queue somehow. She was always asking how I was doing and seemed genuinely concerned. After I was discharged, I returned to the hospital for a follow-up CT scan and saw Ruth again. She came over and hugged both me and Gail and said she had been wondering how I was doing. She is a wonderful person and I feel really bad that the letter I've been meaning to write to the Grand River Hospital executive praising her has not yet been written.

I went to see Dr. Pace again a few times after discharge, and during one such meeting he said something that has stuck with me. We were talking about my return to work and he was telling me not to rush back, to make sure I was really ready before I went back. He told me "You've just been through a life-threatening illness and major surgery, and..." but I don't remember the rest of the sentence. I was stuck on "life-threatening". He confirmed that yes, this was indeed life-threatening, and Gail admitted that doctors had told her right from the beginning that there was the possibility of things like multiple organ failure. I didn't know any of this. I'm not sure if I was optimistic or just na├»ve, but I somehow managed to survive eight weeks in the hospital without seriously considering that this illness might kill me. I'm pretty sure the thought did occur to me a few times, but I always managed to push it away without really thinking about it. Perhaps the really dangerous part was at the beginning when I was doped up on painkillers 24/7, and by the time I was coherent enough to really think about such things, I was already on the mend. I'm actually glad that I didn't know how serious it was at the time – that kind of anxiety would not have helped my recovery in any way. Every time I saw Dr. Pace after that, he mentioned in some way that this had been life-threatening – Gail and I figured he was exaggerating just a little bit and it almost became a running joke. Once I told her that I couldn't wash the dishes or do some other minor task because I'd just been through a life-threatening illness. But part of me was always a little nervous making a joke of such a thing, because what if Dr. Pace wasn't exaggerating about that? What if I had been close to death? Then again, it doesn't really matter now since I'm pretty much recovered, and because I no longer have a gall bladder, I don't have to worry about it happening again. It occurred to me the other day though – am I more likely because of this to suffer some from related kind of gastrointestinal problem when I get older? Is my pancreas working OK for now but damaged enough that it could just fail sometime in the future? Did this shave ten years off of my life expectancy? I'm sure there's no way to know and honestly, it doesn't much matter. I've always been a "live life to the fullest" kind of guy, and worrying about it won't change anything. I'm going to enjoy the time I have as long as I have it, whether that's five years or fifty. But I'm kinda hoping for fifty.


Parts of these three articles were a little weird to write, since my life is pretty much back to normal at this point. I've been working full-time since the beginning of July, taken the boys to soccer games and practices, gone on family vacations, played golf, tennis, and volleyball and walked many kilometres, even driven from Sundridge to Sudbury, back to Sundridge and then to Baysville in one day (total about 475 km). My abs are still quite weak compared to before, and there are parts of my belly that are completely numb (the nerves were cut during surgery). The numbness is really disconcerting (bumping into things or leaning against things without knowing it) and feels a little creepy, and the doctor says it may last a long time. My leg muscles also get really sore after sitting for long periods of time. But I haven't been in a hospital since the end of July (it's currently late September), I rarely feel significant pain or discomfort related to my surgery, and other than a few minor issues related to the aforementioned ab and leg muscles, there's nothing I could do before that I can't do now. 


I left the hospital less than six months ago, but thinking about all this stuff already seems surreal. Everything I've written about here is so different from normal that it almost seems like a dream. A long, painful, frustrating, terrible dream. Was it just a dream, or did all that crazy stuff really happen? <looks at fourteen-inch scar across tummy> Holy crap, it did.

Hospital: Surgery and post-surgery

This article is part two of a three-part series on my hospital experiences. Part one is called A day in the life, and part three is Recovery at home. When we last left our hero, he (that is to say "I") had been in the hospital for over 5 weeks and was getting pretty tired of being there.

24 Hours Notice

For the entire month of February, Gail and I kept asking the doctors what would be happening next, mainly to try to figure out when I could go home. They told me I'd eventually be getting my gallbladder out, but they couldn't tell me whether that would be days, weeks, or months away. The most common answer to any of these types of questions was "We'll just have to wait and see". At one point near the end of my stay, a nurse told me that I had been very patient through this whole thing (I guess I was a patient patient HA HA HA) but the truth is that I had no real choice. All I had heard for five weeks was "wait and see", so my options were (1) be patient or (2) go insane. At the beginning of March my stomach seemed to be growing larger and more uncomfortable. The doctor said that a pancreatic pseudocyst was forming, and all of the dead tissue from my pancreas was collecting there, as well as blood and other fluids and stuff. On March 15th I was told that they wanted to do surgery tomorrow to remove my gallbladder and drain the pseudocyst. By this point, I was getting quite uncomfortable so I welcomed this news. Not to mention that this was the first step in actually solving the problem – all the ultrasounds, CT scans, and X-rays were just for diagnosing it.

The surgery began around 4:20pm on March 16th and went for a couple of hours, followed by about three hours in recovery. They wheeled me down to the operating room in a stretcher and Gail stayed with me as long as they would let her. But eventually they told her she had to go to the waiting room and they wheeled me into the OR. They hooked my IV up to the anaesthetic, and then the anaesthesiologist put a mask over my face and said "You'll be under in ten seconds". I didn't make it to five. The next thing I knew, I was waking up in the recovery room several hours later. Gail, my parents, and my sister were all in the waiting room the whole time and they all remember the exact moment that Dr. Pace walked in after the surgery. He wasn't smiling. They all stood up and walked over to him. He took Gail's hands in his and the first thing he said was "It was a mess in there. <pause> But he's going to be OK." The pause only lasted a second or two, but they all remember what they were thinking during that time. Gail thought "Oh God, either he's dead or the surgery didn't go well". My sister figured that both Gail and my mom would collapse and she was trying to decide which one to catch. Perhaps if Dr. Pace had reversed the order of those two statements, some momentary anxiety might have been avoided.

I had figured I'd be mentally out of commission (i.e. either sleeping or awake but incoherent) the rest of that day and part of the next day, but once I woke up in recovery I was pretty much alert. I remember being wheeled back to my room and when I saw everyone, I attempted to be as upbeat and chipper as possible to convince everyone that I was OK. I didn't think about the fact that I'd already been out of surgery for a few hours, and everyone else knew far more than I did about how it went. My gallbladder was removed, and most of the pseudocyst was drained. I almost fell over when Gail told me that four litres of "stuff" was taken out. Four freaking litres. They couldn't simply remove the pseudocyst because it was physically attached to my pancreas and as far as I know, it's still there.

Tubes, Staples, and a Pain in the Ass

I lifted my gown the next morning to see that my abdomen was covered with bandages, and I had two drains in – a "J2" tube and a T-tube. I don't remember what the J2 tube was for, but it was basically a little plastic bulb. The T-tube went from my common bile duct out through my abdomen into a bag to drain off the excess bile that would normally have been stored in my now-absent gallbladder. The J2 was only there for ten days, while the T-tube was there for several weeks, even after I was discharged. I also had yet another tube up my nose which went to my stomach but this time rather than pushing nutrients into my stomach, it was pulling stuff out. This was, again, to make sure my stomach stayed empty to let the pancreas rest. When I had the bandages changed the next day, I saw the actual incision for the first time – a long nasty-looking cut with staples holding it closed. The staples (all 43 of them) were removed on March 29. My sister Trudy had had abdominal surgery a couple of years before, and she told me that the staples were similar to your standard paper staples, but longer and had little hooks on the ends to make sure they didn't come out. When the nurse came to take the staples out, she couldn't figure out why I was so nervous about it. I kept asking how this was going to work and she showed me the tool she was going to use to do it, but I was still nervous. Eventually I asked about the hooks on the ends of the staples, and she had no idea what I was talking about. Turns out that the staples I got did not have hooks, so they just looked like three sides of a square. The tool would bend the middle one, forcing the other two up (making the whole thing look like a capital M) and straight out. No pain, no discomfort, and the whole thing was done in maybe 15 minutes. I was ready to call Trudy and yell at her for scaring me but she assured me that her staples did have hooks, and by the end of our conversation, she was ready to call her doctor and yell at him.

About a week after surgery, I had a CT scan that showed that there was a collection of fluid in my pelvis. The doctor said that they were going to put another drain in, but it might be uncomfortable. The best way to do this would be to go through my buttocks. So they inserted the drain by putting a needle straight through the middle of my right butt cheek. This was done in the CT scan room – I lay on my left side in the CT scan machine. They took a scan then started to insert the drain. Every now and again they'd stop, take another scan to see where they were, and then continue. After my surgery, I was given a pain pump, which was a machine on an IV pole that dispensed a measured amount of painkiller whenever I pressed a button, so I could control how much I was getting. Of course, there were some rules – pressing the button more than once every five minutes would do nothing and if I pressed it more than some number of times in an hour, it would lock out and have to be reset by a nurse. During the insertion of this drain, I forgot about the second rule, so I stared at the clock and pressed the button precisely every five minutes. About halfway through the procedure I hit the second limit (though I didn't realize it) and so all button pushes after that did nothing. This meant that I was getting no additional painkiller for half of this procedure. As a result, this was the most painful thing that happened to me during my entire hospital stay. The fact that the radiologist hit my sciatic nerve twice didn't help. Once they were done, they padded the hell out of my butt so I could still sit down comfortably, and I had another bag to pin to my gown. But this one didn't drain much at all – a few mL a day - and Dr. Pace (who was on vacation when it was put in; another doctor made the decision to do it) told me later that it was either put in the wrong place or entirely unnecessary. Great.

On March 29, Dr. Pace told me after yet another CT scan (I had a ton of those) that there was still a gallstone in my common bile duct, and it was likely the one that caused all the problems in the first place. There were three ways to get rid of that stone: (1) put a scope down my throat, (2) put a scope in through the T-tube, or (3) as a last resort, more surgery. Two days later, I had an ERCP (endoscopic retrograde cholangiopancreatography) – this was option 1 above. He couldn't remove the stone, so he put a little cut in the bile duct so that the stone would fall through into my intestine where I would eventually pass it. The next day I had an X-ray, and the technician said that the stone was still there, but Dr. Pace said this wasn't too surprising and that I shouldn't worry about it.

Get Out Of Here

By this point, I was really ready to go home. Dr. Pace had acknowledged this, saying that I had "hospitalitis" and he would try to get me home as soon as he could. He had also mentioned the possibility of going home temporarily – he could give me a "day pass" so I could go home in the morning as long as I was back in the evening. They had been preparing me for discharge as well – the J2 tube was gone, the T-tube was still there but clamped, I no longer had anything up my nose, and even my IV had been removed. I assumed that the one remaining gallstone would have to be gone before I could be discharged, so when the tech told me it was still there, I was quite disappointed. This was April 1st, the day before Good Friday. I figured the X-ray techs would all be gone for the Easter long weekend, so I wouldn't be able to have another one until Tuesday, which meant I wasn't going home until at least then. First thing the next morning, Dr. Pace came into my room with some surprising news. "It seems you have been given some incorrect information", he said. "The stone is gone". In my mind, I jumped up and did some cartwheels around the room. In reality, it was likely nothing much more than a little fist pump and a muttered "Yes!" before Dr. Pace asked the Dumb Question of the Day: "Do you want to go home today?" I decided that "Duh!", although correct, wouldn't be an appropriate answer, so I just said "Sure!" and he went off to begin the discharge paperwork. I called Gail and asked her the second Dumb Question of the Day: "If it's not too much trouble, would you mind coming to the hospital to pick me up?" She was happy enough because she thought I'd gotten a day pass, but when I told her I was being discharged, she almost dropped the phone. She and the boys were in the van within minutes. It was exactly eight weeks after I was admitted.

After getting some prescriptions and arranging for a home care nurse, I got dressed in something other than a hospital gown for the first time in two months. Bending over to put on and tie my shoes was a challenge and I almost asked Gail to do it for me, but I persevered and did it myself. I remember the feeling of walking out the front door of the hospital – it was as if I'd been released from prison. Gail asked if I wanted her to bring the van around so I wouldn't have to climb the four stairs into the parking garage (it had also been two months since I did stairs) but I decided if I could tie my shoes, I could climb four stairs. The van ride home seemed quite bumpy – for the next few weeks, any bump we hit while I was in the van caused discomfort or pain in my belly. But by 2:00pm I was home, and we had my parents, my sister, and Gail's parents over for dinner that night. They probably had barbecued burgers and potato salad and stuff like that for dinner, while I had a small bowl of soup that I couldn't finish. But that night I slept in my own bed, with my family less than 45 minutes away, and it was fabulous.

Coming up next, the series finale: Recovery at home.

Email scam

Gail received an email the other day from a friend of hers. The email said that she had gone to London, England for an impromptu vacation and gotten mugged, and now they needed money to get home, and asked if we could help them out. The email was fairly convincing:

Hey There,

    How you doing? This has had to come in a hurry as it left me in a devastating state...  Myself,<husband's name> and the Kids made a trip to London (United Kingdom) unannounced some days back on vacay, Unfortunately we got mugged at gun point last night! All cash, Credit card and phone got stolen, we are stranded in London, fortunately passport and travel docs was back in my hotel room.  It was a bitter experience and I was hurt on my right hand, but would be fine. I'm sending you this message cos I don't want anyone to panic; I want you to keep it that way for now!

Our return flight leaves tomorrow, but we're having troubles sorting out the hotel bills.. This is embarrassing enough, wondering if you could loan us some dollars to sort out the hotel bills and also take a cab to the airport about ($2000). We have been in contact with the police  and the Embassy here, but they aren't helping issues, We got limited means of getting out of here, Already canceled our cards and made a police report.. We don’t get new card numbers till we get back home! So we really need your help.

You could wire whatever you can spare to my name and hotel address via Western union:

56 Kentish Town Road
London, NW5 2AA
United Kingdom

Please get back to me with the details once you have made the transfer; would def refund it to you once I arrive! Hopefully in 2 days,  Sorry for any inconvenience this might cause you.

I await your prompt response.

Thank you,

Gail forwarded it on to me asking if we could help them. I was immediately suspicious (turns out Gail was too, but she didn't say that in her email) and I responded to Gail warning her that this had a bad smell to it. I told her that if she was going to respond, tell her friend to call us collect and send no money until we'd talked to her in person. I asked if her friend ever used the word "vacay" (I don't know anyone who does) or if she'd be likely to say "I await your prompt response". More importantly, is she the kind of person who would take off for England on short notice? Even if she was, would she bring the kids during the first month of school? Gail decided that this was not likely and called her at home. Sure enough, she was there, her email account had been hacked, and she had already had over 40 phone calls from other people. Hopefully nobody got suckered in.

I've seen lots of different email scams and most of them are obviously fake. This one looked relatively legitimate – so much so that while I was immediately suspicious, I didn't dismiss it out of hand like I usually do. Be careful out there.

Hospital: A day in the life

I know I said before that I was done writing about my hospital experience, but I realized since then that I've written about the pancreatitis attack that led to my hospitalization, and the roommates I had while in the hospital, and some numeric totals regarding my stay, but nothing about the hospital experience itself. I recently looked over my blog posts about my visit to the UK last summer, and thought that I should do the same for my hospital stay. Before you run away screaming, don't worry, I won't be going through day by day and there are some details I will be leaving out. Some things, well, you just don't need (or likely want) to know about. There's lots of stuff about my stay that I will likely forget in the near future, so I've written about it here for millions of internet users around the world to enjoy for years to come posterity. It wasn't until after I started writing this article that I realized how much information there was to convey (read: it got really frickin' long), so I've broken it into three parts: pre-surgery (this article), surgery and post-surgery, and recovery at home.

The Button and the Balls

I went into the hospital on February 5, 2010. I've already written about that day, so I won't go into those details again. The next week or so is a blur. Gail suggested I keep a little diary to record changes or problems or questions or whatever since I was in a fog much of the time, and she kept a separate one as well. The first entry in my journal is Feb 11, and most of the first few entries are about painkillers. I remember having to call for the nurse whenever I needed painkiller, and a few times I had to press the nurse call button a few times before she would come. I was in a fair bit of pain at that point, so every minute it took her was an eternity. At one point I got frustrated waiting, so I started writing down the time whenever I pressed the button and the time at which I finally got the shot. When you press the nurse call button, a light goes on above your door in the hallway as well as in the nurses' station, but what I didn't realize at the time was that pressing it again does nothing. Once you've pressed the button, there is no point in pressing it again until it's been cancelled. Sometimes it took 15-20 minutes before the nurse actually arrived, but whether I pressed the button once or fifteen times was irrelevant. Looking over my diary, there were times when I didn't receive the shot of painkiller until 30-45 minutes after first pressing the button. On February 12, I started on long-lasting dilaudid – I'd get one 6 mg pill at 8am and another at 8pm, and that would be it. If I had excessive ("breakthrough") pain I could ask for a shot, but that only happened a few times – other than that, the long-lasting stuff worked really well.

I had an IV for medication the entire time I was hospitalized. (In fact, for a day or two after my surgery, I had so much stuff going into me that I needed two IV poles because all the stuff didn't fit on one.) For the first couple of weeks, I was also on oxygen since there was a large collection of fluid below my lungs (a "pleural effusion") that made it painful to take a deep breath, and so my blood didn't have as much oxygen in it as it should have. They gave me a thing called an incentive spirometer, which consisted of three parallel plastic cylinders, each containing a ball. There was a plastic tube coming out of one of them. I was supposed to put the tube in my mouth and suck in like a straw – if I sucked in hard enough, each of the three balls would rise to the top of its cylinder. When I first got this device I could raise the first ball all the way, and the second one would move a little but the third one didn't budge. The fluid under my lungs gradually went away and as it did, I was able to move the second and third balls, and my oxygen saturation level started to grow again. By February 17th I could raise all three balls to the top and hold them there for half a second, and by about the 20th, I was able to remove the oxygen tubes completely.

The nurses kept asking me when I peed and how much, so I started recording it in my diary. So I have a record of exactly when I went and how much there was for every day for most of February and half of March. No, I'm not going to include that information here, but email me if you're interested. Actually, don't.


I had a feeding tube that went up my nose, then down my throat and directly to my small intestine, thus bypassing my stomach. Since my stomach was not being used, my pancreas was also idle. The idea here was to allow my pancreas to heal by not using it. It's amazing what you get used to – what you consider "normal". For the next four weeks, I had a tube up my nose 24/7 and that was "normal". When it was time for me to have a shower, I'd ask the nurse to see if the shower was available, and to disconnect me from the feed pump and IV. The tube was still in my nose, but it could be disconnected from the feed pump and had a little valve that could be closed. Then I'd put on my shower slippers (plastic ones, as opposed to my fuzzy slippers which were more comfortable) and make my way to the shower room. The first time I did this, an orderly named Lou, who was the one of the friendliest and most helpful people I met at Grand River, helped me with everything but the actual shower which I could do myself. After that first one, Gail would usually be there to help me, though I think I managed a shower or two on my own by mid-March. The shower room had a single stall and a cabinet with towels, gowns, and pants, plus various soaps and shampoos. After my shower, I'd go back to my room where I'd remove the tape holding the feeding tube to my cheek, shave (all the while holding the feeding tube in one hand so there was no chance it got pulled out), and then call for the nurse to come back and tape the tube to my cheek again and reconnect the feed pump and IV. This whole process took about an hour, and none of it seemed weird to me. At the time, this was what "normal" was.

I went through a bunch of doctors at this point. My first couple were from the ER, and then I was passed off to the gastrointestinal group. This group rotated once a week, so I'd have one doctor for a week, and then on Friday they'd switch and I'd have a new doctor. The doctors were Dr. Ismaili, Dr. Golubov, Dr. Meghji, Dr. Sharma, and Dr. Bissonnette. One of them introduced me to Dr. Pace, who specializes in surgery involving the liver, pancreas, and gallbladder. Dr. Pace eventually became my surgeon. I was also introduced to Dr. Needham-Nethercott, who I believe was head of the ICU. She put me on an "ICU watch" for a while, which meant that they were paying close attention to me (they checked on me every four hours), and if my condition deteriorated in any way they'd have me moved to the ICU immediately. She also said that whenever she hears "pancreatitis" she basically assumes that the patient will be in the ICU for months. I never had to go to the ICU, so I was pretty lucky. I was told that the fact that I was relatively young (40 last summer) and in pretty good physical shape really helped. I have been exercising a couple of times a week for years, and I started running last summer too – who knew that getting lots of exercise could help save your life?

For a while I wasn't allowed anything to eat or drink – not even water. If I was dry I could suck on ice chips, but I had to spit the water out rather than swallowing it. Eventually I was allowed water to drink and then was put on a "clear fluids" diet. This consisted of water, juice (apple, orange, or cranberry), Jell-O (yellow, orange, or red), and coffee or tea (no milk or cream). At lunch and dinner I also got chicken or beef broth and a can of Schweppes ginger ale. I eventually requested no broth (didn't like it) and no ginger ale (the carbonation didn't agree with me). On Valentine's Day, I was given a banana popsicle instead of Jell-O and thought it was the best thing I'd ever tasted. I assumed at the time that this was a Valentine's Day treat, but I got popsicles now and again after that and they were always welcome. There was a fridge that patients could use, so Gail bought some popsicles for me and put them in the freezer, so I could have them whenever I wanted, as long as I had the energy to walk down there to get one. The room with the fridge was maybe 100 feet from my room, but some days it may as well have been five miles away. I stayed on the clear fluids diet until March 9, when I began the "full fluids" diet – still nothing solid, but closer. The first day I had yogurt and Cream of Wheat with milk for breakfast, and cream of chicken soup, yogurt, and chocolate pudding for lunch. For dinner, I had cream of broccoli soup with apple sauce, but I was actually still too full from lunch to eat any dinner. This was a little foreshadowing of how it would be when I came home in early April – my stomach had shrunk so much that when Gail made me 2 scrambled eggs for breakfast one morning, I couldn't finish them. While I was on full fluids, Gail occasionally went down to the Tim Horton's in the lobby and got me some chicken soup, though I had to strain the chunks of vegetables and chicken out first. I was on the full fluids diet for exactly one week. After that was my surgery, and then I was back on ice-chips-but-spit-the-water-out. I went back onto clear fluids a week later, but I didn't have anything solid (i.e. that I could actually chew) until I came home on April 2.

The Routine

A typical day would begin around 6:00am when I would be awakened for my morning shots. A nurse would also draw blood for tests at this time – not every day, but a couple of days a week. I usually tried to go back to sleep until about 7:00-7:30. The nurses worked 12 hour shifts, 7:00 to 7:00, and usually the new nurse would come in by 8:00 to give me my painkiller and if I hadn't met her before, introduce herself. (I'm going to use feminine pronouns for nurses although I did have one male nurse for one shift.) I'd usually have the same nurse for two day shifts followed by two night shifts, so I'd have one nurse, say, Monday and Tuesday during the day, and then Wednesday and Thursday nights. Sometimes they'd switch shifts or whatever but that was usually the schedule. Breakfast would come around 8:00, and Gail would normally arrive between 9:00 and 10:00 after dropping the boys off at school. If my parents or Gail's were staying at our house, she'd sometimes ask them to drop the boys off so she could leave earlier. If Gail had to pick the boys up from school, she'd leave around 3:00. Sometimes she'd come back with the boys for a few hours in the evening, and then leave around 8:00 to get them home to bed.

I need to say a few things about Gail here. The entire two months I was in the hospital, there were only two days that I didn't see her. There were a number of days that she drove in and back twice – and we're talking about a 45-minute drive each way. I only had one procedure done that I can think of that she wasn't there for, and that one was scheduled at 7:30am on a day where nobody else was available to take the kids to school. I think she cried in front of me maybe twice the whole time – hell, I cried in front of her way more often than that. Not that she didn't cry at all, but (I found out later) she made a serious effort not to do it where I could see her. She was essentially a single parent for two months, and came to the hospital just about every day, all the while (mostly) keeping up with her full-time job at EDS. Oh, and she was also chair of the school council and a Beaver leader. She was an absolute rock, and I don't know how I would have gotten through this whole nightmare without her. Sweetheart, I tell you this every day, but it bears repeating ad infinitum: I love you more than you will ever know.

Anyway, back to the routine. Lunch came around 12:30-1:00, and dinner around 6:00. If I was going to have a shower, I usually tried for mid-afternoon, since the shower was usually available then. I usually had a 45-minute nap in the morning and a longer one (60-90 minutes) in the early afternoon. The lengths of the naps was not scheduled or anything, that's just how long they usually lasted. If I had no procedures (ultrasounds, CT scans, stuff like that) scheduled, the rest of the day was spent goofing around on the internet, watching TV, watching movies on my laptop, checking work email (which I read once or twice a week but rarely responded to), or reading. I didn't read much during the first few weeks or so because I couldn't concentrate long enough, but eventually I was able to read more. I read By The Time You Read This by Giles Blunt, Pirate Latitudes by Michael Crichton, Open: An Autobiography by Andre Agassi, Extreme Vinyl Cafe by Stuart McLean, and some of the stories in Just After Sunset by Stephen King. I had a number of visitors over my stay, and a few of them brought me magazines to read. One brought me a puzzle book to keep my mind working as well as an external hard drive filled with TV shows and movies public domain videos copied with the creator's express written permission (thanks John!), another lent me her PSP with some games (thanks Dove!), and another lent me seasons 1 and 2 of Star Trek: Voyager on DVD (thanks Ian!) so I had those to keep me occupied as well. Gail didn't take any vacation time - she brought her laptop to the hospital almost every day and worked. HP was very flexible – I'm sure they knew that Gail wasn't likely putting in her full 40 hours every week, but they also knew why not, and cut her a lot of slack. We paid $20/week each for wireless internet access, but it was worth it so that Gail could be there with me. After dinner was more of the same – internet, movies, TV, books – until bedtime, usually 10:30-11:00. I had the occasional needle through the day (don't remember them all – there was heparin four times a day to prevent blood clots, and another one specifically for the pancreas, though I don't remember the name), and sometimes I had shots at midnight or 3:00am as well.

A535, TV, and PICC

I didn't sleep well for the first week or so, since the painkillers I was getting at that point would only last a few hours. Once I was on the longer-lasting stuff, I could sleep a little longer, but I was getting lots of fluids via IV, so I had to go to the bathroom a couple of times a night. Sleeping for four hours straight was unusually long. By the beginning of March, my back was getting sore from being in bed all the time, so Gail bought me a memory foam pad. This helped immensely. We asked if I could use Rub A535 on my back at bedtime, and we were told that since it wasn't ordered by the doctor, the nurse couldn't give me any, but there was no reason we couldn't put it on ourselves. So Gail brought me some and I put it on, and that helped too.

At one point, my sister suggested that if I was having trouble sleeping, I could ask the doctor for some Ativan, which was a safe drug that would help me sleep. It's not a sleep aid per se, it's used to reduce anxiety, but the net result ends up being better sleep. That evening I asked my nurse about it, but I forgot the name of the drug. I knew it began with 'a' so I started guessing names and eventually came up with Ambien, which I had probably only heard of thanks to online pharmacy spam. The nurse immediately said "I am not giving you Ambien." Since Trudy told me that the drug was pretty much benign (though Wikipedia says it can be addictive), the nurse's strong reaction told me that I had gotten the name wrong. The nurse said that Ambien is an anti-insomnia drug that you can't get in Canada, but a few years before when she was working in the US, she saw patients who had bad reactions to Ambien, causing psychotic episodes. After hearing this, I wholeheartedly agreed with her decision not to give me any. She eventually figured out what drug I actually meant and gave me some. It worked pretty well, and I took it a couple more times over the remainder of my stay.

From what I've read, if we lived in the USA and didn't have insurance, two months in the hospital plus the surgery and medications and medical imaging and all that stuff would have cost many tens of thousands of dollars. Because we live in Canada, all I had to pay for was the TV and phone in my room. Well, that and $40 for the ambulance ride, but my work insurance reimbursed me for that. The phone was about $15/week, but the TV was crazy expensive. It cost about $90/week, which I didn't really realize until late February or early March, at which point I cancelled it. Luckily this happened after the Olympics ended, so I was able to watch a lot of the Games (including all of the men's hockey games involving Team Canada) from my room. There was also a TV in the lounge down the hall, so a couple of times Gail and the boys and I would go down there and watch skiing or snowboarding or something. We watched the first two periods of the gold medal hockey game from there, then Gail and the boys had to go home. I watched the third period and overtime (Sidney Crosby baby!) from my room. The majority of my TV viewing was sports – SportsCentre during breakfast, Olympics, and Leafs games after the Olympics ended (boy, going from watching Team Canada to watching the Leafs was a bit of a letdown). I also watched Star Trek: TNG, Deep Space Nine, or Voyager whenever they were on.

On March 4th, I vomited and my feeding tube got dislodged, so they removed it. A new tube was inserted the next afternoon but after another day I barfed that one up as well. I had had the feeding tube in for almost a month at this point, and my throat was sufficiently sore and irritated that they decided not to put another one in. On the 10th, I had a PICC (peripherally inserted central catheter) line put in. This is a very thin tube that went into a vein in my right arm, up my arm to my shoulder, then around below my neck and down almost to my heart. The PICC line was used primarily for TPN (total parenteral nutrition), which means that I was being fed intravenously. The feeding tube had basically been putting stuff equivalent to pre-digested food directly into my small intestine, which would then absorb the nutrients. With the PICC line, they pushed the nutrients directly into my bloodstream. The TPN was a whitish liquid, so it looked like I had a big bag of milk hanging from my IV pole. The PICC line was also useful for drawing blood, so when that needed to be done, they would just disconnect the food tube, flush the line with some saline, then draw the blood out. This was slower than the standard needle method, but didn't require me to get poked like before. It also caused one pretty scary moment. Part of the pancreas's job is to create insulin, so if the part of my pancreas that creates insulin was damaged, I might have ended up diabetic. And not the relatively easy Type 2 treat-it-with-medication diabetes either – this would be full blown Type 1 you-need-multiple-insulin-shots-every-day diabetes. One day, a standard blood test came back with an extremely high glucose value. I don't know the units of measure, but the "normal" sugar values are below 7. Gail (a Type 2 diabetic) has seen her numbers up around 10 or so (before she was on medication), and that's not bad. A high value would be around 16. This value was 33. The nurse told me that this definitely indicated that I was diabetic but before this news could really sink in, they had drawn more blood and done more tests and found that the 33 was an anomaly – probably some of the TPN stuff had gotten mixed with the blood that was extracted from the PICC line. The next few tests showed a blood sugar level of around 8.5. Kinda high but no diabetes.

Shave and a haircut – to bits

In early March, Gail bought a hair trimming kit because my hair was getting a little long and hard to keep clean. We put some towels on the floor of the bathroom and I knelt down over the sink and she gave me a buzz cut. We had a bit of an accident though – she took the trimmer off to do my sideburns, and then realized that she hadn't finished the back yet so she went to do that. After one stroke she said "oops" and then put the trimmer back on. For the next few weeks I had fairly short hair with one rectangle of very short hair at the back. Gail felt pretty bad about it but I thought it was kind of funny. Most of the time I was in bed or sitting facing the door so most people didn't see it, though the occasional nurse asked about it. The rest of the time I just figured one of two things: (1) I wasn't looking my best anyway, and (2) I was walking around a hospital wearing a gown and pushing an IV pole, so people who saw the swipe at the back of my head would think that I had just had brain surgery.

From the day I got to the hospital, we kept asking when I could go home. When it became clear that I would need to stay in the hospital for a while longer, we started asking if it were possible for me to be transferred to a hospital closer to home, preferably MacMaster or St. Joe's in Hamilton. My doctors could see no reason why not. I have absolutely no complaints about the care I was given at Grand River; we were looking into the transfer purely for convenience. My sister, who is a behavioural therapist, talked to some of her many friends and colleagues in the healthcare industry to find out who I should be seeing in Hamilton. She came up with a doctor at Mac named Dr. Marcaccio, so we gave that name to my doctor. He called Mac and even spoke directly to Dr. Marcaccio, but Mac's policy is that they won't accept patient transfers unless there is a solid medical reason for it. If there was something that they could do for me at Mac that they couldn't do at Grand River, they'd be happy to approve the transfer, but they wouldn't do it just for our convenience. I remember thinking later that I was lucky that this didn't happen when we were in France or the UK or somewhere much further from home than Kitchener. We asked a couple more times but the answer was always the same and we eventually gave up.

In our next exciting episode of the "Hospital" series: surgery and post-surgery.

Wednesday, September 08, 2010


Despite the fact that half a billion people are on facebook and millions are on twitter, there are still people who don't like social networking sites and think they're a waste of time. Haters gonna hate. But whenever I hear negative talk about these types of sites, I think about this:

Facebook status

To everyone who came to the hospital to visit me, or called on the phone, sent me an email or facebook message, wrote on my wall, left me a comment, or even just clicked "Like" on my statuses, thank you. My family and I have been through a lot in the past several months, and it sounds corny but knowing I had so many friends out there thinking about me, worrying about me, and praying for me really warmed my heart.

I met with my surgeon this morning, and he told me that we had to "break up". There is no longer any reason for me to visit him, so I have no further appointments scheduled with either him or my family doctor.

This article is quite late – I should have posted it months ago, and for that I sincerely apologize. But thanking everyone like this felt like something that shouldn't be done while I was still recovering. Today is the first day since the attack that I really feel like it's over. I am not 100% back to the way I was before, and the doctor says it's possible I may never get there. But I feel mostly normal, I can play sports, I can beat my eight-year-old son at arm-wrestling (that was not a given a couple of months ago), I have no doctor's appointments scheduled, I have no medication to take, I can eat anything I want, and I've gained back all the weight I lost. In fact, I've gained a little more than I wanted to. Now I'm back to trying to lose a few pounds, which means that things really are back to normal.

I said before that I wasn't going to write about this whole ordeal again, but I've changed my mind. I'm in the process of writing an article describing my experiences in the hospital and during my recovery at home, if only so that everything I remember now gets saved away somewhere before I forget it all.

Thanks again.