Spring Fever

 

The Cycle of Life

Autumn Rests in Easy Chairs

Spring Gets into Bed

 

 

Spring Fever

 

It’s a relief to realize this condition is not found in the ICD manual (International Classification of Disease). The phrase is a misnomer. There is no fever and sexual activity actually decreases in the Spring and increases in the Autumn.

People do often feel happier in the Spring due to the resurgence of light and nature’s beauty. It’s especially rejuvenating for sufferers of Seasonal Affective Disorder (SAD). They often benefit from an intense light source in the Winter such as a light box or light visor (the visor allows walking around while “lighting up”).

In a poetic sense, Spring Fever is an apt term as a season of one’s life. Yet older people still get out of their easy chairs from time to time and head to the bedroom. But they will never likely call them easy beds.

 

Depression

Melancholia

Ancients blamed body fluids

Serotonin Pleas

 

 

This is a retreat of the mind from day to day living. Severe cases can lead to hopelessness and helplessness. It can be difficult to recognize depression in oneself or others. In ancient times, before understanding human physiology (study of the way the body works), many theories were promoted, including the humoral theory by the Greeks.

They believed health and temperament were determined by the proper balance of four body fluids (humors): blood, phlegm (thought to come from the lungs and brain), yellow bile, and black bile. Depression was thought to be caused by excessive black bile. They wrongly believed the fluid came from the spleen (on the left side of the abdominal cavity) rather than the right sided liver. The word melancholia derives from melan (black) and cholia (bile).

It is now known that depression is indeed a problem with imbalances; of chemicals such as serotonin at the synapses of the brain’s nerve cell junctions. We still “humor” the ancient theory. A treat on a hot summer’s day is aptly delivered the The Good Humor Man.

 

 

 

Nightmare

     Wordpress has a tool for writing practice called The Daily Post. WordPress gives you a word to write about as a post on your blog. The word today is the title of this post. I am reading a book called ‘A Tale For The Time Being’ by Ruth Ozeki. It is a well written, thought provoking book. I am only 1/4 of the way through it. On page 25, Nao, a young woman, contemplates writing stories about her 104 year old great grandmother, Jiko. She notes, “I mean, if I thought the world would want to know about old Jiko, I’d post her stories on a blog, but actually I stopped doing that a while ago. It made me sad when I caught myself pretending that everybody out there in cyberspace cared about what I thought, when really nobody gives a shit. And when I multiplied that sad feeling by all the millions of people in their lonely little rooms, furiously writing and posting to their lonely little pages that nobody has time to read because they’re all so busy writing and posting, it kind of broke my heart.”

     A postscript to that final sentence is on the bottom of page 26. It is from ‘Book of Laughter and Forgetting, 1980 by Milan Kundera. “Once the writer in every individual comes to life (and that time is not far off), we are in for an age of universal deafness and lack of understanding.”

     Nightmare is figurative since I was wide awake when I read these passages. But nightmare is a figurative term for something worrisome or scary. Is this blog, or for that matter, most blogs, any more than a diary that only few people might be interested in, and then only if prompted by me?

     The photo for this posting explains my philosophy about the value of blogging. If we share ideas; if I visit your blog; if you write a comment on my blog; if I write a comment on yours; if our ideas help us understand the world and each other better…..It doesn’t have to become a nightmare. Perhaps it will become too time consuming. A truly interactive blog is likely very time consuming; not easy for a full time parent or worker. I’ll be working nearly full time again from September to January. No doubt, the blog will suffer. But I would like to carry it on. After January I hope to spend a lot of time on it.

 

Intoxicating or Toxic

Intoxicating

Or is it really toxic

Don’t trust willpower

 

     What are the main causes of illness? Genetics? Random disease? Poverty? Infections? Autoimmune disorders? Trauma? Aging? What is the role of Addictive Behaviors? With our now worldwide obesity epidemic, high rates of cigarette and alcohol related illnesses and death, sedentary lives of excessive screen time and other sensory stimuli, perhaps much illness is something we have control over.

      If obesity went away, many of the most “successful” drugs would sit in bottles on shelves gathering dust. If emphysema went away, then most people would just need oxygen that’s already in the air; not in metal bottles from medical supply stores. If drug addiction went away, then drug cartels might have to repurpose to community service agencies. If most people got daily exercise and could choose healthy foods, then the children and grandchildren would better learn what’s important for health from their role model parents and grandparents.

     What stimulates addictive behaviors? Anything that is pleasurable! Living is a Catch-22. We are programmed to seek pleasure. Pleasure seeking means survival.  Our ancestors had to constantly move and seek food to survive. The more rest they could find, the more fat and sugar food had, and the more possessions they had,  the more likely they could pursue and slay the next mastodon. We have not evolved beyond that quest for rest, food, and stuff. But the mastodon steaks are already shrink wrapped at the grocery store. We pursue them in our cars. Our stuff encourages sitting a lot.

The advertising industry is expert at encouraging us to seek pleasure. We are expert at seeking pleasure because it is pleasurable and we know all the secret passageways to getting there. We can get through the minefields of medical people, magazines, government agencies, relatives, and friends all reminding us to choose more wisely for our health. Nothing can stop us from taking a hit of dopamine whenever we want, such as anticipating and eating a piece of chocolate cake a la mode.

Dopamine is a chemical Pied Piper of brain neurotransmitters showing you the way to Emerald City,  Shangri-La, or your pleasure-of-choice at the moment. Dopamine is living in the past. It still thinks a saber-toothed tiger is lurking around every corner and wants you to be well fed, rested, and carrying the most modern shield and spear before encountering it. Dopamine means well. It has just become a little misguided.

     We don’t want pain either. Most people like to avoid a healthy amount of exercise because it is often rather unpleasant and causes soreness, especially if we smoke and are overweight. It also takes away time from the pursuit of the vast array of pleasures our culture offers us.

Most of us like the pleasure of false hope. However, there is no snake oil, or magic pill, or diet, or app, or 5 minute abs exercise that will give you a healthy body. But don’t listen to me. This article is just another land mine to avoid on your way to the pleasure center. You’ll find me there enjoying another bowl of ice cream.

 

 

 

 

HYPERTHYROIDISM

GRAVE’S DISEASE

 

Thermostat set high

Overheated and sweaty

Surprised eyes bulging

 

 

This is one cause of Hyperthyroidism. Hyper means excessive. The thyroid is a gland in the neck below the Adam’s Apple. Grave’s Disease is an autoimmune disorder named after an Irish physician, Robert Graves, who studied this over 150 years ago.

Antibodies attack the thyroid cells and instead of destroying them at first, they cause the cells to increase the production of thyroid hormone, the main supervisor of metabolism.

The resulting state of being “hyper” leads to elevated temperature, fast heart beat, sweating, jitteriness, and weight loss. Antibodies can also affect tissue behind the eyeballs and cause them to protrude somewhat.

Treatment is often Radioactive Iodine to destroy the dysfunctional thyroid gland followed by lifetime treatment with replacement thyroid hormone (a daily pill). Nowadays, it’s usually not such a “grave” disease.

 

 

 

Mind Your Body

myocardial

Does The Heart Attack?

Does The Victim Strike The Heart?

Who Fired The First Shot?

 

 

Myocardial Infarction (MI) (Heart Attack)

Myo refers to muscle and cardial to heart and infarction to death of tissue. The word infarction comes from a Latin verb meaning ‘to stuff’. The heart is a powerful, tireless muscle that gets its own blood supply via the coronary arteries. There are many types of heart conditions but this article only is addressing typical coronary disease. 

Poor blood flow due to partial coronary obstruction can cause heart pain, known as angina pectoris (from Latin for strangling and chest), especially during emotional stress or exercise. If the blood flow is completely blocked, a portion of the heart muscle dies (infarcts) and is labeled a heart a heart attack.

Over decades, artery walls throughout the body develop cholesterol plaques. The vessels’ inner linings can rupture and expose the plaque contents to the blood stream. This causes a blood clot to form at that spot and block the blood flow through that vessel.

The amount of plaque is called plaque burden. HIgher amounts have many causes including factors we don’t have control over such as genetics, and, as most people are aware, factors we do have control over such as choosing certain foods, amount of exercise, and smoking. 

 

INTERVIEW WITH FRED SINGER

Why do people get coronary heart disease? Is it genetic? Is it the food we eat? Lack of exercise? Yes, it is these factors. However another very important cause comes from our minds. This post addresses issues related to the mind’s influence on the body. The posting for hyperthyroidism is postponed until the next blog entry. This summarizes an interview with Fred Singer. He is an author, teacher, and historian. He was born and raised in the Bronx in New York City. He attended Long Island University His graduate work was at CCNY-City College of New York. He has written books and has been a high school and university teacher in Germany and Japan and in Denver, Colorado.

He became interested in the influence of the mind on the body when one of his psychology students brought him an article 30 years ago describing research that proved a connection between certain personality types and the tendency to get cancer. He “couldn’t fathom it” at first. He began a journey studying research about this subject. He found there is a link with personality and disease states of heart disease, cancer, and rheumatoid arthritis. He also found there is a disease resistant personality.

He has taught many subjects and is particularly interested in “the beginnings of things” in his teaching of history. These include but are not confined to ancient history and colonial America. He taught “everything” through his long and successful career. He was blessed with a healthy childhood. He cites a researcher who stated that virtually every case of Rheumatoid Arthritis has a psychological component. Dr. George Solomon wrote, “The arthritic process is not merely frequently, but always the expression of a personality conflict.” “Personal problems affect the immune system”. He has been exercising almost daily for 40 years. He goes to the gym and lifts weights. He has ridden bikes and jogged in the past. He likes the gym because he can get a good workout rain or shine. “Another benefit of exercise in the fitness center is socialization, a key, proven factor in health and longevity.”

In 1990 there was “just no evidence” that spirituality and religion influenced health. When he wrote a book at that time, called  “CHANGE YOUR MIND, SAVE YOUR LIFE: How your mind affects your health and what you can do about it”, he did not have a chapter on these subjects. He has since become aware of new information showing there is a beneficial connection. He notes also that a sense of purpose, a sense of meaning, is important to one’s health. He notes that in his own life he is “maybe a poster boy” for having a sense of purpose. He’s now working on his 10th book. He feels he has both a need to prove himself and he has a genuine interest in the subjects he researches and writes about.

With all the information about what constitutes a healthy lifestyle, he wonders if people really absorb this information. He notes that less educated people tend to have unhealthier lifestyles. He believes it’s due to being less knowledgeable about what’s the right way to live. Also, many lifestyle choices are “just habits”, like smoking in his father’s generation. If friends make these choices, it’s much more difficult for you not to. Exercising causes people to live longer and healthier. “The gym costs too much…..it takes too much time….I’ll get to it someday… ”  It’s also hard to convince young people, he notes.

“If you want to find groups that are long lived, many religious groups have that”. Such as the 7th Day Adventists. Both men and women of that faith live into their late 80s. It’s not a genetic issue. It’s due to their healthy lifestyles. Nuns, Mormons, and others live much longer and healthier than other groups. Many religious people are good role models of health for fellow believers and give a lot of social support. “You have the notion that God loves you. You have social support”.

The Lester Breslow study, completed in the mid-1970s, followed 7000 people for 35 years. It discovered 7 healthy behaviors that make a significant difference.

1. Don’t smoke

2. Drink small amount or no alcohol

3. Sleep 7-8 hours a night

4. Exercise 30 minutes a day, several days a week.

5. Forget the scales. Eat moderately

6. Eat regularly whether that’s two, three, or five meals a day. Whatever you do normally, keep it up because it’s the regularity of life and moderation in eating, sleeping and exercising that makes all the difference.

7. Eat breakfast every day. (Confirmation of the health benefits of eating breakfast comes from a 2013 study that found that men who skip breakfast have a 27% higher incidence of heart attacks.)

One finding of the Breslow study was that a 60 year old who follows all 7 recommended behaviors will be as healthy as a 30 year old who follows fewer than 3 of them.

 

Studying evidence is important. Anecdotal information is not necessarily applicable to a given person. “Look at the source…..evidence….evidence”. Look at who is making the statements; don’t just take it at face value”. “If you Google something, you get a hundred hits. Most people don’t think of the psychological angle. People aren’t going to embrace new ideas easily. Isaac Newton said if you come up with a new idea, you will spend the rest of your life trying to defend it. The idea of the mind-body connection is like that”. Karl Menninger said “One of these days the cancer research people…will wake up to the fact that psychology has an influence on tissue cells, a proposition which they have consistently regarded…as a preposterous heresy”. 

Psycho-neuro-immunology is a field that developed in the ’70s and studies the mind-body connection; particularly the influence of psychology and the nervous system on the immune system. Everything that we know that is negative is going to impair the immune system. Such as depression, despair, hatred, anger, repressed emotions, cynicism, bereavement, regrets, social isolation and many others. “Depression is the big Daddy of all of these. It’s going to affect your immune system. Happy people are going to be less sick than pessimistic people.”

A sense of purpose is important for retirees. Mr. Singer feels fortunate that he’s never had a boring moment in his life. Older people who are active and engaged in life are going to live longer and happier. In one study, being laid back, feeling happy, and social relationships were less important than staying productive in terms of longevity and health. He identifies Grandma Moses as a role model for healthy lifestyle. “She had every trait you’d expect for a centenarian.” 

He enjoys being a conduit between researchers and the lay public who have read his books and articles. Even though he himself is not a researcher of basic problems, he is an organizer of information from research and enjoys presenting it to the public. We will connect with Mr. Singer again to pursue more information about the mind-body connection. If you are interested in having Fred speak to your group on any of a wide variety of subjects related to the mind/body connection–for an hour or a one day seminar–he can be reached at Fred9243@q.com. 

 

Hashimoto’s Thyroiditis

 

Thermostat set low

Needs laxatives and more clothes

Heart trudging along

 

This condition is the main cause of hypothyroidism in our country. Hypo means under or beneath and refers to the thyroid gland producing an inadequate amount of thyroid hormone. There are different types of thyroiditis (-itis at the end of a medical term means inflammation or disease).

This type was first described microscopically by Hakaru Hashimoto,  a Japanese pathologist, in 1912. It is an autoimmune process and causes slow destruction of thyroid tissue. Before the availability of thyroid hormone medication, people often died of myxedema coma, the end result of halted metabolism.

The symptoms include lowering of body temperature, slowing heart rate, dry skin, constipation, lower leg swelling, weight gain, and general sluggishness. 5% of adults over age 60 develop hypothyroidism, most due to Hashimoto’s. Don’t assume you’re just slowing down due to age. You might need a pill a day to keep the clinician away.

Stay tuned next time for hypothyroidism’s antsy cousin, hyperthyroidism.

 

 

 

 

 

 

Acid Reflux (GERD)

Chewing tobacco

Ignited by firewater

Flames rise to your throat

 

Gastro(stomach) Esophageal(gullet) Reflux(back washing up the gullet) Disease is usually a chronic condition. GERD refers to the periodic escape of stomach contents back up into the esophagus.

It’s caused by a leak in a sort of valve at the stomach inlet. The esophagus does not like the stomach acid. The main symptom is heartburn. This is a hot discomfort going from the stomach up to the throat. Sometimes the acid can be tasted.

Over time, changes in the lining cells of the esophagus called Barrett’s epithelium can occur. This can lead to cancer. Other problems include choking on acid at night.

Treatment includes medication, eating smaller meals and not close to bedtime, optimizing weight, limiting alcohol, avoiding tobacco, and choosing healthy foods. In other words, if it tastes good, spit it out except if you like the taste of kale or Brussels sprouts.

Allergic rhinitis

Seasonal nosefuls

 Explosions send it flying

Nothing to sneeze at

 

This hallmark of Spring is somewhat of a misnomer though it is a legitimate medical diagnosis. There is no fever and it has numerous triggers besides hay. The word rhinitis derives from rhino which means nose. It’s also a year round problem for many and can occur at any age from innumerable gremlins (antigens).

This is an immune system problem of hypersensitivity; but not like autoimmune conditions such as lupus, since it involves different immune cells and chemical pathways. It’s an overreaction to foreign proteins such as pollens, dust mites, and pet danders. Surprisingly, excessive sterilizing of a child’s environment with soaps and sanitizer increases their risk of getting allergies and eczema.

Allergic rhinitis can lead to asthma and anaphylaxis. So it’s worth trying to blunt the reaction. Medications help and allergic testing and allergy shots are sometimes advised. It’s also important to limit exposure to known antigens. For example, wearing a mask at times of high exposures (if you can’t convince someone else to mow the lawn).

“Not Much Choice”

 Chronic Pain and Ills

Prepare for Mortality

Live Like You Can’t Die

 

Introduction to the Interview:

This post is an introduction to an interview, then an interview with a man named Mike whom I’ve known well for over 20 years. He suffers from chronic illness and chronic pain. A very useful book on some of the subjects covered in this interview is called “BEING MORTAL”, by Dr. Atul Gawande published in 2014. It outlines our society’s attitudes towards the aged and the disabled and our systems of caring for them. Another excellent, recent book is “THE PAIN CHRONICLES” by Melanie Thernstrom. It reviews the attitudes of society toward pain and the treatment of pain. This blog post deals with these issues of aging and medical infirmity including chronic pain and cancer. I am doing an interview together with a journalist, Cathy Zimmerman. We drove an hour to meet with Mike.

He greeted us at the door to his pleasant home in a neighborhood of east Vancouver, Washington. Mike is a 6 foot 5 inch tall tree trunk of a man. Aged 63, he is broad shouldered and appears robust at first glance. Upon closer inspection, I notice his face is somewhat pale and sweaty when we first arrive. He describes these spells as hot flashes due to a hormone secreted by his cancer cells. During our interview he periodically stands and stretches for awhile to relieve his back pain a little.

In the interview, he relates his transition from healthy young man to chronic illness and pain. We review his various conditions and the way they affect him and those around him, including his current wife and his first wife. He reviews interactions with the workman’s compensation system and his health insurance. He describes his coping mechanisms including the importance of the support of family, friends,  doctors and other medical care providers. He reviews some of the factors in what to look for in a doctor. The book Being Mortal analyzes doctor-patient communication and concludes on page 201 that the best style is one that Dr. Gawande refers to as “interpretive”. This style goes beyond the traditional “paternalistic” and “informative” styles and I believe describes what Mike looks for in doctors and medical care providers. Mike describes some of his previous and ongoing treatments including many operations. He relates the many obstacles and frustrations he’s had to surmount in his quest for a life worth living.

He is remarkably optimistic and resourceful. He is good-humored and articulate. He spent over 2 hours doing the interview, despite being in some constant pain. He provides insights that will be helpful to other people who also suffer chronic illness and chronic pain.  When Cathy asked him how he has managed to survive his numerous medical crises, he said, “Not much choice.”

 

 

INTERVIEW

40 years ago Mike was a healthy young man who loved to participate in many team sports and hunting. He enjoyed non-team sports with his friends. “I did a lot of dumb things when I was young”, he notes. He and his friends hugged the train tunnel wall by the cemetery as trains went through. They dropped under the tracks of the trestle of the bridge over the Missouri River onto cement supports when trains raced overhead.

He couldn’t imagine a life of illness and pain. At age 23 he developed blood clots in one leg with pieces of the clot traveling to his lungs. He has hospitalized for 3 weeks. “My wife was induced for delivering our first daughter when I was in the hospital. I was wheeled down the hall on a stretcher to be with her”. Even after that he couldn’t conceive that he would become chronically ill. “You’re pretty invincible when you are that age. I didn’t understand how serious it was until years later”.

Before our interview, he reviewed his health history with his 91 year old mother-in-law who lives with Mike and his wife. After doing this awhile, she said “Enough!”. The list of surgeries alone is formidable: 7 spine, 2 achilles tendon, 4 knee including 1 total knee replacement, gallbladder removal, shoulder surgery, kidney stone removal, exploratory abdominal surgery, and infusion of radioactive beads into the liver to fight the cancer.

His medical conditions include: blood clots mentioned earlier, serious injury to his back on 12/12/78, about age 27, spinal meningitis after a back surgery 20 years ago, an unusual type of cancer known as pancreatic neuroendocrine that he’s had probably for 10 years, pneumonia, arthritis, gallstones, kidney stones on 3 different occasions, shingles (1 year AFTER his shingles vaccine), chronic and severe lower back and cancer pain.

He hurt his back at work slipping on spilled chemicals. He fell 1 story onto his side and lower back area on a hardwood surface. 2 years, at least 12 myelograms (spinal canal X-rays using dye injected into the canal) and other tests later, it finally became apparent he had seriously herniated 2 discs in the low back area due to the injury.

PH: Tell us about your experiences during that time.

Mike: “I was not the same person. I was hard to get along with. I had little kids. I had some back surgeries after that. I had a lot of problems and pain with my surgeries. They dealt with it with pain medications; Percodan and Percocet. The surgeon was a real ass. If you weren’t well or better, he’d yell at you. One day he told my wife he didn’t want me as a patient anymore. He finally lost his license to practice. After that I ended up with a really nice orthopedic doctor. His wife was the county coroner at the time. He helped me and gave me wonderful advice on how to choose doctors.”

“Off and on I worked during that time. For years, the workman’s compensation program for the state was intimately involved with my case. They did everything they could to keep me going back to work. One day they put me on 100% disability and said “He’s on his own now”. They wouldn’t let you earn a dollar (doing other work) when you are on this. They give you a fund that is used to live on. (The state puts aside a fund that pays me a pension for as long as I or my wife live.)  I had a family to take care of. They went from one day saying there’s nothing wrong with me to saying I’m 100% disabled. I applied for social security (disability) twice and was denied. So I hired an attorney and finally a judge ruled in my favor to obtain social security.”

PH: Tell us about your feelings and activities during those years.’

Mike: “I was a totally different person. It’s very degrading to have someone help you get dressed every morning. I had to have someone drive me. I was still in my late 20s. You feel like you lost some of your manhood. I could no longer play basketball or softball. I could only hunt from a chair. The drugs change you. You get short tempered. The littlest things would upset me. I hollered at my kids, at my wife, at the dog. I took a whole bunch of steroids (prescribed by doctors). I was trim when I got hurt. I put on bulk. I was hard to get along with. Even with other people. I had such a quick trigger. Before that I was a happy person with a good job who could support his family. And I’d play golf every Saturday with a group of guys. All of sudden, that just came to an end.”

“People said, “What about taking up knitting or crocheting? I can see why my first marriage didn’t go as good as it could have. I was married to her for 24 years. We are still good friends. I’ve been with my second wife 20 years. I moved to her home town because I wanted to be somewhere where people don’t know me. You just get tired of talking about your health problems. Once people know, that’s all they want to talk about. We just started over. I found myself a new doctor. Luckily! It was a huge relief. When you have a lot of medical problems, a lot of doctors don’t want you for a patient. They like patients they can help cure. I was on pain meds. When I had first been on them, I had problems taking too much. I think I was trying to kill the other pain in my life. I was depressed. I felt terrible about myself. I didn’t feel I was taking care of my family. So when I took some more (pain meds), you just felt better, you know. Now, even though I take narcotics, I don’t get a high from any of them. They just help manage the pain. One of my fears is that the pain will get super bad. We tried other meds such as Neurontin, but they didn’t help.”

PH: The pain is not just from Mike’s back problems. The cancer causes a lot as well. The tumors in the liver bulge the liver capsule (outer membrane) and this is painful. The cancer is slow growing and more treatable than many, but not usually curable. Steve Jobs died from this same cancer.

Mike: “The pain goes all the way up to my right shoulder (referred pain from the liver metastases). Sometimes the tumor pain is very intense. Last week, the back pain was severe. The pain meds help both types of pain. I also take a lot of nausea medicine”

PH: What other things in your life keep you going?

Mike: “My wife. She’s the most up person. I was a very closed person. She makes you feel like it’s OK. I was too sick to go to a birthday party yesterday. I felt guilty about not going. She assured me it was OK to not have gone. We do a lot together. We camp. She does all the driving. Even if I was healthy, she’d do all the driving. We get to the outdoors. We’ve got grand kids.”

“Taking care of grandma (his mother-in-law)….easiest person in the world. I feel good about helping her. She asks for nothing. She is extremely happy. She has her own room. She likes the dogs….Emma, the yellow lab; and Sam, the Australian shepherd, and Gus, the golden retriever. My life is pretty simple.”

PH: Tell us about some of the difficulties you face.

Mike: “The biggest thing I had to learn is to let other people do things. That is the hardest thing. Even having someone change the oil.  I hire somebody to do the grass. I tried to work on a fence the other day. I got really sick and it screwed up the back pain worse. I had to find someone to do the work. It kinda drives me crazy. You can’t keep asking family to do things.”

“I hate to spend the money. I still fall down. I have learned to fall with an art. I tell everybody I can fall with the best of them. It’s like somebody stabbed me in the back. It takes me over 2 hours in the morning before I’m not so sick. I wake up a lot during the night; often from sweating. I take shots of Sandostatin (Octreotide) for the cancer. I’ve lowered the dose; now it’s every 3 weeks.”

PH: Octreotide is a hormone drug that suppresses the cancer cells’ growth and production of a chemical that causes the sweating and nausea.

Mike: “When I was diagnosed with the cancer, they told me I had about one year to live. Another doctor said maybe 5 years. I’ve been on the shots for 7 years. There’s so much scar tissue from the shots that 30% of the time the needle plugs and I have to get another one. They can only give them in the hips.

“My doctor now (Dr. Zafer Yildirim, Oncologist in PeaceHealth Medical Group); a neat guy; says “Prepare like you’re going to die tomorrow. Live like you’re going to live forever”. It took about 3-4 years to get to the point where I can do that. Christmas is an important marker for us each year. I’ve had way more than my wife and I ever planned on. So we just keep goin’. I think the experimental surgery they did on me has given me all this extra time. We’re going through a little fight right now (in regards to the Sandostatin shots). They changed the formula but didn’t tell anybody. People are complaining. I used to have 3-4 days of feeling more normal after them. Just like when you got here today, I was sweating a lot. I finally got a letter from the company this week. I don’t know what’s going to come out of that.”

PH: Do you have any opinion about what caused your cancer?

Mike: “Here’s my thoughts on it. You can take it for what it’s worth. I grew up in Great Falls, Montana. Hanford (nuclear plant in Washington state)  back in the 50s did a lot of releases (of radioactivity). A lot of that stuff came down in Montana. There is money for people with cancer that live in certain counties of Montana. Great Falls is not covered to this point. My Mom brought it up to me. I read some articles about it.”

PH: What have you learned about what matters to you in a health care provider?

Mike: “Best thing that can happen to you when you need health care is somebody to listen. I tell this to my friends. You’ve got to make a doctor understand how it’s affecting your life. We don’t let “grandma” go into the doctor by herself because she’s one of those persons that whatever they say, she doesn’t question. I think you need to ask questions. You need to be more proactive in your health care. I don’t think you should just take what they say. If you go to a doctor and they don’t seem like they really care of if they seem like they’re in a hurry, then I say, go find another doctor. Because you need somebody who really cares about what’s going on with you. Luckily, with my Medicare insurance, I can go to any doctor I want. It’s really important that you can talk to your doctor.

“The worst doctor I ever had was the surgeon who first operated on my back. Then I met the orthopedic doctor who taught me what to look for in a doctor. Every since him, I cannot think of a doctor I’ve had that I didn’t like; that I couldn’t talk to. I was careful about picking my doctors. I just won’t go to any doctor that someone sends me to. I will tell them I want an appointment to just talk to a new doctor first.

PH: How important is the ancillary staff?

Mike: “I think it’s very important. When they call you by your first name, it’s amazing how much better you feel. Twice, my wife brought paper work to a staff person who never seemed very happy; who didn’t seem to care. My wife had a very bad opinion of the girls who work in the office. But it wasn’t the girls; it was that one girl”.

PH: Mike has some final thoughts about his cancer doctor, Dr. Zafer Yildirim in PeaceHealth Medical Group; a nurse, his marriages; and his parents. He says he would NOT do his life differently if he could live it over again.

Mike: “I have a great cancer doc (Dr. Yildirim). He says I’m part of the family. He says you can just go to a major medical center if I want. I said I don’t want to go there. I want to stay here (small to medium sized town). He says there’s no complete explanation why I’ve lasted as long as I have. But he says there’s a higher authority than us. He said, don’t question it. One day he said, “Don’t let ’em cut on you anymore”. He’ll say, “This test doesn’t mean a whole lot”. He’ll tell me what matters and what doesn’t. He’s completely honest. He’s just a nice guy. He asked me to see a pain specialist, so I did because I know it helps him to care for me better. The pain doctor went through what I’m doing and taking and said, “You’re doing fine”.

“One of the nurses has the same birthday as I do. She was giving me a shot one day with a big needle. My wife was there and we were joking. She was getting ready to poke me with the needle. She said, “Oh, I live on a ranch. I’m used to giving these to cows. So this is no big deal.” The staff just makes you feel comfortable.”

“My first marriage was affected by my medical conditions, but we were 2 different people. I was ready to go into the police department when I was 21 (he married at 19).”

PH: She asked him not to because she had heard that all policemen cheat on their wives. She gave him an ultimatum that she would leave if he  became a policeman. That experience didn’t help his marriage although they stayed together another 22 years.

Mike: “We are still good friends. It worked out for the best. I met my wife. I wish I’d met her 20 years earlier. Everything turns out for the best. I don’t want to make it sound like I’ve gone through all this horrible medical stuff. It’s been over a long life. And it’s been stuff we’ve gotten through. In the last year I’ve lost about 55 pounds. I’m just not eating as much. I think it’s better for my back. Plus I don’t want to be an old fat fart. I do pay attention to my body.”

“Dad went to the war. They came through that era where people had work ethic and right and wrong. That’s where we got our philosophy. Mom, to this day, has a little green book to keep track of expenses. When I was young, she wouldn’t let me get out of paying off debts.”

“I just feel lucky to be here. When my mother-in-law and I say goodnight, we’ll say “See you in the morning” and the other will say, “Let’s hope so….it’ll be a good morning if we do”.

PH: Thank you, Mike.  And thank you, Cathy, for helping with the interview and reviewing this blog post before publishing.