Friday, March 7, 2014

The year that started with me being cut open

A year ago today, March 7, 2013, around 1 p.m.,  I underwent what is listed here on the surgical order as a "L Diagnostic VATS Open Thoracotomy Decortication."

In English, that means a guy I'd never met until two days before cut me open, spread my ribs apart and then spent four hours scraping a load of gunk off my left lung.

While he did so another total stranger, an anesthesiologist, carefully monitored a tube he had shoved down my throat which closed off my left lung, leaving my hopefully-happy right lung to keep me alive.

So, essentially, I was laying there like something in a butcher shop, sliced open, a couple of guys keeping me alive and, I sincerely hoped, making it possible for me to live longer and happier.

That's mind blowing when you think about it.

Who are those guys? Why do I trust them? Why are they doing this for me? If the fact that they are standing there working pretty darn hard to make my future life better doesn't strike you as miraculous, or at least darn amazing, then you really do need to get out more.

There's a lot of debate about medical care these days. I have to admit I'm astonishingly fortunate. Utah has some of the best in the nation. I'm also fortunate that my lovely wife has a job with an entity that provides darn good coverage for health care. She works for the state of Utah, and the Public Employees Health Plan (PEHP) does a darn good job.

It's state supported and funded. Your tax dollars at work! So thank you, all of you. We should broaden PEHP so everyone in Utah is on it.

I was undergoing all this because, if the doctors and anesthesiologists and nurses and whoever else didn't do these things I might not die right away, but life was on course to be incredibly uncomfortable.

More so than it had been the previous three months, and those three months had really sucked. I look back on them and shudder, not only for me but for my loving wife, who had to suffer through it all as well.

I'd had a wet cough for a couple of weeks before Christmas. Had to wear a surgical mask to visit my new grandson, Oliver. Christmas day I started coughing on the way home from a family dinner, started having trouble breathing and ended up in the emergency room with more than 130 other folks. After a fun 8 hours they said I had pneumonia, loaded me up with antibiotics and said I'd be OK in 10 days or so.

Only I wasn't. The damn cough never went away and after a third course of antibiotics things were getting worse yet again, I went to the doctor on March 4 where they tested and measured and guessed and prodded and finally did a second CT scan and said I had empyema.

"Sounds like something you get with rice and beans and Javier's," I said.

No, he said, it's a ball of infection on the outside of my lung. The infection from my pneumonia inside my lung had somehow leaked outside it, my body had sensed the infection, encapsulated it, and there it sat, getting bigger, pushing my lung out of shape so the pneumonia was never going to go away.

"We'll send you to the emergency room, they can drain it and you'll be fine," the doctor said, but the ER said "no, send him to a surgeon," so they did. I visited with him the next morning and he explained how my body, to protect itself, had not only encapsulated the infection, but probably coated my lung. Unfortunately the body isn't real smart about these things, and the infection was still growing inside that ball.

Fun.

It was on the 5th I saw the surgeon, Dr. Rafe Connor, whose skill I still very much appreciate because two days later I was on the table and he was slicing in to me.

Having surgery is like being dead. You're out, no memory, no dreams, no nothing. The medications induce amnesia, so I don't even remember going unconscious, that whole "count backwards" bit that movies love. I also don't remember them installing the catheter, so that's a plus.

They wheeled me into the room, scooted me onto a table and the next thing I knew  the world was full of nurses and tubes and hands and voices asking me where it hurt.

I was told later there was a 4 1/2 hour gap there. My wife said the surgeon, when he came to talk to her, looked dog-tired. He didn't tell my wife, but told me much later that "when we got in there it looked like a bomb went off," and said a student who had been observing the surgery still stopped him in the halls weeks later to remark on what a mess that had been.

Actually, he told me, he'd found two empyema when he opened me up. One was on its way to attaching itself to my chest wall, where it would have worked its way out, and isn't that a lovely image?

So much for x-rays and CT scans. Nothing like taking a look for real.

Cleaning out the infection, clearing off the gunk and coating, re-enflating my lung, was what had taken so long. He'd had to shave off a section of rib so it wouldn't break when he bent it back but still I can't imagine the work that took in close quarters inside a living human body.

They had me on antibiotics for a month. They had three drains in my chest. The scars from the holes they left -- each about an inch wide -- look like bullet holes.

I spent five days in the hospital and, again, there I was surrounded by folks I'd never met, all doing their best so far as I could tell, to take care of me and make sure I didn't die.

Yeah, they got paid well for it (or at least the hospital charged me well. I sure hope the nurses and doctors got a good chunk of that) but all this still allowed me the luxury of not having to spend any time worrying about myself.

I've done this both times I had surgery. Ed Abby said, "when the situation is hopeless, you have nothing to worry about," and while my situation wasn't hopeless, I sure as heck had no control over it. Either the medical care worked or it didn't. I was extremely fortunate that the surgeon had said "it's all fixable," and I held onto those words daily.

It's interesting that all this took place three weeks before I was scheduled to retire. It was life reminding me that everything can change overnight, so don't dawdle, I am convinced.

I'm just taking a peek at some of the posts on Facebook that my wife put up back then. The relief in her writing is palpable.

I remember the only time I really broke down out of fear was driving home from registering for the surgery on the 6th. It had, very suddenly, gotten very real. But it was very real for three months for that lovely lady -- three months of listening to me cough and cough, so much so I slept on the sofa much of the time just so she could sleep, and I was more comfortable there anyway, able to get up or read or fidget or whatever, knowing at least she could sleep so one of us, at least, could get her job done.

And I didn't care about work anyway. I was close to retirement, I had oodles of sick time saved up. I was told betting was strong I'd just stay home and run out the clock...I didn't, but with all the sick time I put in I might as well have. I didn't miss any columns though. Not only am I good at BS, but I had a nice stock of "evergreen" columns to run through.

A word about my amazing wife.

I've often said that it is the caregivers who have it hard, not the sick. The sick know their lot, after all, while caregivers have to watch, powerless, and just care.

I didn't know why I was so sick for so long -- I went home from the doctor's office on the 4th of March happy, overjoyed, that finally we know what was wrong. But my wife had had three months of watching me shrivel (I lost 15 pounds) and hack and cough and wander around, and had no idea if I'd ever get better or if the surgery would really fix it.

I at least had the hope of a fix. She had to watch and worry. Which job is harder?

Anyway, I went home on the 12, retired on the 30th or thereabouts (I forget) and that was that.

People ask me how retirement is. Pretty nice, I say.

I think, often, that having all that medical stuff happen so close to retirement might have been a message to live a new life, or a different life. Some might say it was a message to go hike the Amazon or something.

But the life I had wasn't so bad before, except that then it was at a newspaper. I was burned out on newspapers, but newspapers are changing so much that I suspect the feeling was mutual.

I have a lot more fun these days working at Union Station. A lot of the work -- digging through old history stuff -- is not much different from what I did at the newspaper. Mostly, now, I don't have to go to fires or wrecks, or deal with politicians.

Funny part: I'm the young turk pushing the internet and web to that place. "Let's shoot video of stuff," I've even found myself saying. "Is everyone here on Facebook?" I actually told the board of directors last month. (No, they're not.)

Those are the same things that so changed my job at the paper that I didn't recognize it any more. Those are why newspapers are hiring folks who do them a heck of a lot better than I do.

But at Union Station I'm the guy who's bringing it on.

That's what we call irony, but life's full of that.















Sunday, March 2, 2014

Hostler's Annual Show A Model of Success

Loved the annual Hostler's show at Union Station so much I had to go twice.
Story Trentelman

Of course, on Saturday I was shepherding grandchildren around. When you are busy watching grandkids you don't see much of the show. I had to help carry, feed and help get them to the train ride out front. Model Trains? They're in there somewhere.

So Sunday was mine. I wandered, I looked and wished. I bought a pocket watch.

And, wow, great show. Huge thanks to the Hostlers. This was their 25th year at Union Station and attendance on Friday and Saturday was just a 100 or so below last year, which set a record. More than 8,000 saw the amazing displays in our amazing Union Station.
But, hey, I'm not prejudiced.

I have several favorite displays. The Hostler's massive setup in the grand lobby is a must-see, of course.  There's tables full of train cars, engines and other gear I just love to wander by. Every time I see the Lionel stuff and wish mom hadn't sold mine at that yard sale.
Max and Alice 2nd car back

Steve Moore
But not all displays are showy. In the grand lobby I met Steve Moore from West Jordan, sitting by himself at a table with a bunch of clear yellow sheets of plastic with holes cut in them.

I don't do model train layouts myself, but anyone who does needs to know how to plan their system so trains can make the curves without running off the edge of the table. Those plastic circles are a system of templates that Steve designed. They work sort of like those protractors you used to have in grade school to draw curvy lines, allowing you to set precise curves on HO, N and O model railroad scales. You can do easements, tangent alignments and much else that Steve confused me with, but I'm stupid.

If you missed him at the show, his web site is here (click!)

This is Coldwater Gulch's 14th year at the show, and theirs is always a huge winner in my book.

Ron Wilson at Coldwater Gulch
 As Ron Wilson explained, Coldwater Gulch was the dream child of the late Dick Watson. The idea was to have not just a model railroad, but a whole community, complete with history and institutions.

The members of the group went one further. Most model railroad groups let members build module segments of the display as they want, the only rule being that rail connections and electronics had to link up.

Coldwater Gulch went one step more, requiring the whole display to have the same scenic theme, a mountain and cliff look not unlike the rocky mining districts of Utah and Colorado. This meant, said Ron, that module builders had incentive to finish their module first, since that meant the guy next to him was stuck matching his cliff, or river, or whatever.
Dr. Bill Hughes waiting for
a freight to go by

They're always happy to teach. How do you make those tiny shingles on those tiny buildings? Ron said Dick Watson would collect business cards from folks, cut strips off the cards and then little cross-slits every 8th of an inch or so and voila! Instant strips of shingles, any color you want to make them.

It was more work, but makes for a really great display overall. Theme is the important part of any story, and the Coldwater Gulch story is told very well by these guys.