Mexicowoods—An Expatriate Life

Surgery Tomorrow

St. Lukes Hospital, Houston.

I spent the last two days slogging through medico-bureaucratic hell. I’ve been x-rayed, prodded, injected with radioactive goop, scolded (high blood pressure), weighed, and scanned. Each doctor wanted new blood and urine samples. Apparently none of them trust the other guy’s lab work. I’ve got tracks on my arms—I look like a drug addict.

The administrators, too, have taken shots at me. My insurance card is worn out. Processing co-pays has rubbed the gilt paint off my credit card. I’ve recited my address and phone numbers a dozen times. All records from prior visits to my doctors were full of errors. Nurses complained that Doctor A hadn’t received a report from Doctor B and threatened to snatch away my precious surgery slot unless I straightened out the mess.

In the USA Medical System, this exercise is called “Pre-Op.”

—§—

I chose surgery as treatment for my prostate cancer. The procedure is called radical prostatectomy—removal of the entire prostate gland. Major surgery, today it’s usually done laparoscopically using robots. Unfortunately, I have too many abdominal surgery priors for this approach. My doctor will do conventional open surgery, picking his way through scar tissue and adhesions to reach the prostate. Remember that frog you dissected in Biology 101A? I’m going to look like that.

Six months ago, I didn’t even know what the prostate gland was for except to cause problems for aging men. Now I’ve learned it’s pretty darn useful, and I’m gonna miss it.

Shortly after prostate surgery, urinary continence can be a problem, so preparation includes learning how to do Kegel exercises. Laura took this photo in the lab where a lovely Nurse named Kara helped me learn proper technique using biofeedback.

Kegel exercises strengthen the muscles of the pelvic floor. Biofeedback involves using sensors and computers to monitor one’s ability to properly flex those muscles. I’ll leave it to your imagination as to how flexing is sensed.

Throughout the training, Kara entertained us with the story of her semi-arranged marriage (she’s from India).

“... my cousin knew this medical student over in the States that she thought was just right for me... Oh! I think that sensor has slipped. Let me just fix that... There. Now it should stay in... so she wrote my mother and suggested she talk to his mother...”

I found the whole encounter kind of homey and almost pleasant, if a little surreal.

—§—

Pre-Op was hugely stressful. Surgery will be much less so since I won’t be present when it happens. It’ll be harder on the surgeon, the anesthesiologist, the nurses, and especially on Laura, than it will be on me.

I’m feeling sadness from the realization that I’ll be changed. Hereafter, my body will function differently. I won’t know if I’ll be cancer-free until a month afterward, when the biopsies are complete. I won’t know how functional I’ll be for up to a year or eighteen months afterward, as the affected structures and nerves slowly heal.

This isn’t my first major medical milestone and with luck, it won’t be my last. The surgery should be completed tomorrow afternoon. Then recovery, a process that’s becoming all too familiar to me, will begin.

Many, many people have shown concern for me and have told me they are keeping me in their prayers. I cannot begin to express how grateful I am for all the support I have received.

Blessings to you all.

Comments:

Blessings to you too John. Hang tight! Bob Mrotek | Homepage | 07.15.09 - 8:32 pm | #

You are in my prayers now and through this night. Steve Cotton | Homepage | 07.15.09 - 8:53 pm | #

Although I've never commented, I'm a regular reader of your blog. Please know that you will be in my prayers. Terri | 07.15.09 - 10:02 pm | #

I don't pray often but appreciate it when others pray for me. Tonight is one of those nights when I will be saying a prayer for your speedy and successful recovery. I consider you a friend and will worry about you as friends do for each other. Stay strong mi amigo. wayne | Homepage | 07.15.09 - 10:29 pm | #

I wish you well, John. Felipe Zapata | Homepage | 07.16.09 - 8:40 am | #

You are in my thoughts and prayers. Don't forget, we are here too. Call when you can or have Laura call if you need something. Billie | Homepage | 07.16.09 - 11:01 am | #

good luck and keep thinking postive purkey | 07.16.09 - 12:23 pm | #

best wishes and a speedy recovery. what a scary thing to do. Sam told me about your post. so i checked it out! no jokes form me this time.....just get better. Kip Kip | 07.16.09 - 12:44 pm | #

John is in recovery and doing very well. His surgeon felt the procedure was a success and is optimistic that the pathology report will show that the cancer has not spread beyond the prostate. Thank you for your support! I have saved your comments here to read to John in his room as I know they will mean a great deal to him. Laura Laura | 07.16.09 - 5:11 pm | #

Laura, Pls tell John I am thinking of him, as is Sharon, and we will say a pray or two for his full recovery. He may not have told you this but I think he saved my life once (for sure) and maybe twice. This must be a Godthing as I only check on him sporadically and tonight was the time. Pls take good care of him....and Sharon sends her hugs and loves and her web site for when he is up to it - www.sharonseale.com... Randy Randy Seale | 07.17.09 - 1:13 am | #

"hang tight"???? what a comment. My son up here in Santa Fe forwarded your pics of the new Rosewood site with the cranes hovering in front of the Parroquia. So now I have your blog address and don't need to be wondering when the surgery will be happening. I do wish you all great good luck. You've got a certain style with the black socks and johnny look. No need to take it to Milan on the runways tho. I'm heading south tomorrow with a stop in Truth or C...New Mexico. Too hot here in Santa Fe and it is the opera season; all those Texas cars we get in thesummer are up here too. LOL Georgia georgia wright | 07.17.09 - 9:43 am | #

Great Good News for us all. Georgia georgia wright | 07.17.09 - 9:45 am | #

Thanks for the update Laura. We have been worried. wayne | Homepage | 07.17.09 - 2:31 pm | #

John & Laura - Of course we are greatly relieved that all went well and trust that the rest of this will as well. We are regular readers - but want to say that John's candor through all this has been thoughtful and considerate as these kinds of issues are often so personal the rest of us learn little. As John wrote a few months ago he knew little to nothing about this matter and now he is greatly aware and involved. So thanks for the information. You two remain in our prayers. John Calypso | Homepage | 07.18.09 - 8:48 am | #

John, I'm a stand for your recovery and continued good health. Really nice piece of journalling. All my best, Tim. Tim | 07.18.09 - 1:05 pm | #

Wishing you a good healing after your surgery. TandJ | 07.23.09 - 9:14 am | #

Changing Planes in Houston

If you play your frequent flyer upgrades and credit card premiums right, you get to use Continental's President's Club while you're waiting for your next flight. The main advantages of this are: free diet cokes, and a wi-fi hot spot so you can check email, surf, and update your blog. Which I'm doing right now.

To get to San Francisco from San Miguel, your main option is through Houston. There used to be a direct flight to Oakland, on the other side of San Francisco Bay. Maybe there still is. But it's a redeye, sometimes it makes a stop in Zacatecas, and it terminates in... um... Oakland. I'd rather leave home at 9 AM, spend more time in transit, and wind up someplace I wanna be. Going to California is an all-day affair any way you approach it. Might as well do it in comfort.

—§—

Continental sent me an email, offering me the option to check in online. I bit, and clicked the link. Eight pages later, after making entries in several fields and clicking various buttons, I got a page that said I couldn't get my boarding passes online because the Guanajuato Airport doesn't allow online check-in. Boy, did I feel like a dummy! Trying to check in online from BJX! Duh!

Now, wait a minute. Didn't I just say that Continental sent me an email asking me to check in online? They want me to cooperate with them in this because it saves them money. But... somewhere in their system, they know that Guanajuato will not permit online check-in, because their computer served me a web page saying so. So why the hell don't they just implement a little program branch that says, "If the passenger is leaving from Guanajuato, don't bother sending him a check-in email, because it's just gonna piss him off."

—§—

Things have gone from bad to worse with luggage allowances. Some time ago, most airlines made a new rule restricting checked luggage to two pieces per passenger, neither weighing more than 50 lbs. (A far cry from the days when we carried 24 MacIntosh computers to Moscow as checked baggage, no questions asked.) You could get around the rule by paying $20 for an overweight bag. Sometimes, it was worth it.

But in the fine print, Continental warns you that at certain times of year, they won't accept overweight bags at any price, and we learned today that this restriction was now in effect. But in effect only in Guanajuato!

The check-in agents were strictly enforcing the new rule, causing in a huge back-up at the desk. Seems like everyone had overweight bags. Sometimes by ten or twelve pounds, sometimes by less than a pound. No matter. Overweight? You had to do something about it. 

It was amazing. Ahead of me, a woman had her open bag on the scale. She'd managed to get six pounds of stuff transferred from her checked luggage to her carry-on. The gate agent said, "You've got another pound to go." She jammed some more stuff into her hand baggage. The agent said, "Whoah. Whoah! That's enough!"

I may have been witnessing the first regulation in Mexico ever precisely and honestly enforced. No mordida. No letting anyone slide for a few ounces.

Of course, the question is, Why? Why 50 lbs? Why only Guanajuato?

It's not like baggage handlers can't move heavy bags. They've been doing it for years. Does it have to do with some limitation of the aircraft? Maybe the runway is a little short in Guanajuato, and a full plane can't take off with too much baggage? But then why does everyone get to shuffle their stuff from bag to bag. The plane winds up taking off with the same weight on board.

I'll never understand airlines.

—§—

I visited the men's room next to Gate #3. The screen in the bottom of the urinal was advertising a deli. The slogan said, "Aaaaah. ¡Que Rico!"—"How Delicious!" What genius came up with that? Many years ago, I saw a urinal screen in a bowling alley in San Mateo, CA, that said, "Artistry in Plastics." Until today, that one was the record holder for stupidity.

—§—

Between most neighboring countries in the world, things look pretty much the same on either side of the border. This is definitely not so at the Mexican border, and you can readily see it from the air. In Tamaulipas just south of the Rio Grande, the land is sere, taupe-colored desert, a few scattered dusty towns, and narrow highways with no traffic. Just across the river in Texas, orderly green irrigated fields, prosperous communities and busy freeways define the landscape. It's startling the first time you see it. How is it possible that the same biosphere can look so different on either side of such a thin line?

Of course, what we're seeing is not so much an environmental difference as one of wealth. In 2004, the Mexican per capita income was $6,770. In the U. S., it was $41,400, six times as much. When you're poor, you can't afford to develop, to pave roads, to irrigate. You can see it at the border from the air: The color of money is green.