Wednesday, March 23, 2005

Feeling Fine...But For Spring Fever

Spring has sprung,
a crocus has ris,
I wonder where that sunshine is...

It can't snow forever, right?!
Today's rain/snow forecast played havoc with Alex's first spring training baseball practice (like Pedro Martinez, he's with the Mets this year), but it can't wash away the sweet taste of Tuesday.

Spring weather made a least a cameo appearance and we sprung into action (in between regular trips to the blood lab.) In my post T-tube days, I've been closeted in the smallest room of the house chasing away a stomach bug. Tasha's been chasing all the bugs she can find outside and trying to convert them to inside ''pets,'' but none have yet survived the pincer-like grip of her dainty digits.

There's been no shortage of sad, sad news coming our way in recent days, carpeting our struggling blue sky with dark clouds. Just after a joyous St. Patrick's Day (as ever, underscored by the notion that the Irish spirit isn't what you drink and we're blessed to be Irish every day of the year), we learned that a dear friend, Stan, lost his 22-year-old son, Chip, in the crash of a small plane in Kentucky. Chip's girlfriend, and her father, who was the pilot, also were killed.

On Monday, we learned that another dear friend, Mike, lost his mother over the weekend. Mike, a hero of mine for his incredible devotion to his own children, was a tremendous support throughout the twisting drama of my liver transplant saga.

But, wouldn't you know it? Just when you think you can never shake off the funk, along comes spring. I really admire the Iranians, who celebrate Norooz (literally ''new day'' in Persian). There is something inherently sensible in starting the New Year on the Spring Equinox, with all the hope and joy that it brings, rather than on a frigid mid-winter day.

There's no better way to defunkify than to hang out with a bunch of three year olds. Yes, this is really me saying this.

I had the immense pleasure of joining Tasha and school bus full of her classmates on a field trip to a nearby farm Tuesday. The half0day outing fit my rehab program of walking and exercising while taxing the interpretation of the ''relaxation'' side of the equation. Tasha's delightful teacher, a long-time cat herder in the classroom, says she's been doing this trip for nearly two decades and it's always the same organizational frenzy each year. Why is that, she mused. Helpfully, I offered, I saw a distinct theme here - each year, the kids are all three years old.

Nancy was aboard, too, along with several teachers and a handful of other parents. There were two Dads - and wouldn't you know it - offsetting me in my 2004 World Series Champions Boston Red Sox cap was Other Guy - wearing a Yankees cap. No sweat -at three the kids are old enough to make up their own minds.

Mercifully, the bus ride wasn't an endless round of the ''Wheels on the Bus,'' sung by dozens of little voices. Someone, it seemed, did put a quarter in the shriek machine early on, but as the bus got in gear, things shifted into a steady, low roar. I had the immense pleasure of riding with Ryan and Jack, Tasha's pre-school classmates. Both looked remarkably baby-faced, despite their replies that no, they hadn't shaved that morning. We dispatched the small talk quickly. Neither of them are married. What could we possibly have in common to talk about?

We counted down to blast off as the bus lurched from the parking lot and Jack asked why we were stopping as we encountered each red light. It was then that I was struck by the oddity of what appeared to be a nearly empty bus with disembodied munchkin voices chattering away, as only the adult heads were tall enough to see or be seen over the seat backs. Ryan looked out the window for crocodiles; Jack pointed out the barber shop where his Dad gets his hair cut. I proved to be a wizard of predicting when we would next make a turn and how soon we would get to the farm (remember, I was the only one of our trio that could actually see, let alone read, the road signs.) I stunned them with a magic trick (it's a visual that the written word can't do justice to. Trust me. Suffice to say ''stunned'' is an accurate description.) We searched for the right sunlit angles to make shadow figures on the high seatbacks. Jack said we were in a jungle and searched for lions, a hippopotamus may await us at the farm, he hypothecized.

In no time, animals of a more modest cut were before us. Slimmish white cows with black spots, and chestnut brown horses lurched toward the fence, hoping that the flurry of tiny hands held tasty treats. Horned Billy was a welcome sight - I wasn't the only old goat on this scene with a snowy white beard. Where's Jack's Dad's barber when we need him? The scene took me back to a farmyard trip with Alex, when he was just at that sweet age of linguistic exploration. He fearlessly approached the fence and received a bracing bovine hello. ''A yittle cow yicked my yittle yeg,'' he

After scrambling to top of a hay bale pyramid, it was time to slog down the muddy path to the tractor for the ride to the barn where the person in the Easter Bunny suit hung out. We passed a group of picnic tables abutting the animal pen and the sign welcoming groups to reserve the area for meals. As the air hung with the unmistakeable smell of animals being animals, the invitation went ignored. Not for all the money in the world, declared a savvy mom, all senses firing on all cylinders as she scoped out the immediate environs. So firm was her protest that she emitted a strong air of having made the dreadfully wrong decision on one past dark day.

Agro-economics these days dictate that farms pack in as many kids as they can for such seasonal trips, with Easter egg hunts becoming the pre-growing season counterweight to Halloween corn mazes, which often rake in more cash than actually growing and selling corn. I'm old school in this sense, but it's no surprise that for many of these pre-schoolers the highlight of the day was the person in the Easter Bunny costume - not the real animals. Tasha's day was made when a tortoise-shell kitty sauntered through the barn, proving she had the run of the place.

One of those inflated bouncy castles stood at the center of the barn, luring kids to shed shoes and climb in. Nearby a huge sow seemed intent on scaling the fence to have a try and get some air under those cloven hooves. Kids giggled as they fed kids (of the goat variety) from open-palmed hands and got a tongue tickle for thanks. Hatchling ducks and chicks huddled in huge piles under the type of infra-red lamps that keep fast-food French fries warm while the grease soaks in.

Fluffy bunnies of every stripe hopped around in wire-front cages, twitching more than usual as tiny fingers probed their fur, and reminding me that I must keep in my Easter prayers Mr. A. Fluffy Bunny, my funny phlebotomist friend who probed my veins with needles during my three-week residency in NYU's transplant ward.

Ryan, who by now had fully adopted me and kept a steady grip of right hand, freed himself briefly to romp with others in a feed table full of dried corn kernels. Think of it as a mutant cross of one of those playground ball rooms, a sandbox and a (clean) feed through. Surely a few corny souvenirs made their way home by sneaking into shoes, exhibit A in proving the visit to an actual working farm. We made good use of the hand sanitizing lotions on offer.

But the main attraction, lorded over by the becostumed, waving bunny person was a maze of hay bales with baskets of multi-colored plastic eggs at the end. Plastic bags were handed out and the expedition headed off, using the heads of adult chaperones waiting at egg-station ground zero in the distance as their navigational devices.

Rules were strictly enforced by the egg police - only five per person. I was deputized as an official counter and authorized bag-tie-er-up-er when the limit was reached.

Opening the eggs was verboten until kids were back home - a farmhouse rule which probably has its roots in trying to avoid mini meltdowns over potentially disappointing contents.

After a quick return to the hay stack pyramid and good-bye to the horses (Tasha's proclaimed favorites, which she dubbed Flower and Leaf), Ryan declined my suggestion that he should pick an animal that he could take back with us on the bus. He wasn't buying my keep-the-goat-in-the-bathtub idea, as the folks back home are surely grateful. He fell asleep against my shoulder on the ride back to school, despite Jack's attempts to tickle him awake.

The secret the eggs yielded was that not all of them contained the expected candy treat. When Tasha opened her eggs at our kitchen table, shell after shell yielded fluff-ball critters with tiny, beaded eyes and attached banners proclaiming Jesus Loves You. So what? A few fewer Sweet Tarts never hurt anyone.

Let's hope there's really not someone out there claiming that they've been ripped off and blathering: ''For Christ's sake, who the hell do these people think they are, imposing Jesus on our Easter celebration!''

As the little fluff-ball says: Jesus Loves You.
Happy Easter.

Now, where did we hide those blue marshmallow chicks...


Monday, March 14, 2005

Totally (Un)Tubular Today...

Folks -

Things were totally tubular today at NYU, as I was de-tubed from my T-tube.

It was pretty much all over before I knew it - and as ever - the worst parts were the pulling of Band-Aids off my hairy skin and the pinch of the IV connection for precautionary antibiotics.

The actual procedure (technically a cholangiogram) took about 30 minutes - they injected contrasting dye into my abdomen and, using x-ray technology, searched for any stray bile. Everything went smoothly and the T-tube (running from an exit hole in my abdomen down into the bile duct of my new liver) was removed, with a short, sharp tug. A temporary wire was put in its place to facilitate the implantation of a new T-Tube, if I developed complications.

After the de-tubing, I rested on a gurney in an alcove, chatting with Nancy while Dr. Sohail Contractor and nurses popped in frequently to see if I was experiencing any pain. But I didn't suffer any problems with tube withdrawal, so after about an hour I was made wireless, cut loose and free to go.

After suggesting I take it easy for the rest of the day, the doctor told me I am ''free to do whatever it is I do.''

First thing on the to-do list: EAT.
Because of the procedure, I was barred from eating after midnight Sunday. Since it had been 17 hours since I had something other than water, even hospital cafeteria food hit the spot.

Actually, what I have been doing a lot of these days is thinking about and praying for friends that are facing their own medical issues.

We spent Saturday celebrating friend Hannah's 4th birthday at Chuck E. Cheese's - amid a cacophony of video beeps, shrieking kids on pizza and cake overload and performing animatronic rodents - while praying for Hannah's hospitalized grandmother. Sara, who will soon be 7 and is facing medical maladies far beyond her years, and Michael, a fellow NYU liver transplant ward grad who's dealing with some setbacks, are at the forefront of our thoughts.

My thought for the day calendar carries two entries today:
"Life must be measured by thought and action, not by time."
- Sir John Lubbock

and the anonymous prayer:
"How hard this is to do, Lord. Help me move outside of time, and daily carry Your hope to those You put into my path. Amen."

Spring is less than a week away...and hope springs eternal.

Tuesday, March 08, 2005

Of Tubing, T-Tubes And Fewer Pills...

Well folks, it's just a matter of days now before my T-tube is removed and the last hole in my body from my liver transplant surgery is sewn up.

Next Monday morning, I head into NYU's radiology department where the procedure will be done. The T-tube is the thin rubber strand - like a string of spaghetti - that's been protruding from the right side of my body just below the ribs and above the abdomenal scar from my Mercedes-Benz incision. The other end of the tube extends into the bile duct in my liver. It's sort of a safety valve to make it easy to ensure that there isn't any leakage of bile. In the procedure, a dye will be released into the region to detect any stray bile.

If all goes well, I should be heading home after a few hours. Doctors say the actual removal of the tube can cause bile leakage, so for two hours or so after the procedure I'll be under close monitoring for potential infection. In about 10% of such procedures infections occur which can require a couple of days of hospital care and a regime of antibiotics.

So, I'll be taking along a good book, a notebook, a toothbrush and a change of clothes, just in case.

In the meantime, doctors continue to slash my meds. At Monday's check up, two meds were cut out completely and the dosage of Prednisone - my daily steroid - was cut in half. I'm now down to ''just'' 8 meds for a total of ''just'' 15 pills daily, but that's a far cry from the 14 meds and 40 total pills I was on when I came home from the hospital on Dec. 30. I'll never be free completely from taking some steroids and anti-rejection pills for the rest of my life - but there will likely be further cuts in dosages. Once a transplant patient, always a transplant patient.

As baseball season approaches and steroids are Topic A (especially among those who don't want to focus on the Red Sox's astounding World Series championship), it's worth mentioning that the type of steroids I'm on aren't the kind that athletes are interested in. In fact, my steroids slow down, rather than speed up the healing process and weaken - rather than strengthen - muscle tone. For me, the interest is in slow healing so that scar tissue doesn't grow and create problems with the new liver. Long time use of high dosages of steroids can cause the face to grow much rounder and puffier - what's called ''Charlie Brown head.'' Comparative photos over the years of ballplayers implemented in the steroid scandal graphically unscore this. Good Grief! In the most ridiculous obfuscation of the steroid story I've seen to date, Barry Bonds actually said that proof that he's worn the same sized fitted baseball cap throughout his entire career proves he doesn't use steroids. But, of course, they don't make your cranium grow - they cause your face to bloat.

Doctors also told me I'm now allowed to resume driving and could fly in an airplane, if I chose, as my three-month initial risk period is drawing to a close -
but I couldn't convince them to issue an Rx for an islands vacation.

These days, the vehicle of choice for Nancy and the kids has been inner tubes as we left the snow of New Jersey for the snow of New York's Catskill Mountains last weekend. My main jobs now are to undertake a great deal of rest and and a great deal of exercise. On Saturday, I rested while they tubed and Sunday, I hiked five miles on country roads to the maple syrup barn and back, getting caught up in a swirling snowstorm. Tasha and I did our own version of the Ididarod sled-dog race on Monday. She was the sled (in the jog stroller); I was the dog ask we mushed through about four miles of local slush.

Doctors say I probably could have gone joined the family spinning and bumping down on the snowy hills Saturday without doing any damage. But I would have felt more than a little silly explaining to them that I accidentally yanked out my T-tube while tubing.

Call me old-fashioned, but I'll settle for having it removed the traditional way. And I'll wait until the T-tube is taken out before I take to the tubes.