Lymph Journal # 59 - A little walk, a little surgery

4/27/2012

I woke this morning after a great night’s sleep.  One truly positive thing to say about how things are done here is that once your nurse has “tucked you in” after last vitals of the day they bid you “gut Nacht” or “gut Schlaf” (Good sleep!) and refrain from interrupting said sleep until it’s time for morning (after the sun has risen) vitals.

I’ve tolerated yesterday’s chemo very well apart from a brief period when I was in no shape to operate heavy equipment.  If that is as bad as this “high dose” stuff gets we’re going to get through this well. 

I had a bit of a floorshow with my breakfast.  My roommate was getting his central line installed while I had my brötchen and coffee.  It seemed to take a little bit of time.  He may have his turn to watch me during lunch as I’m scheduled to get an extra entryway installed soon.

After breakfast the physiotherapist showed up.  He’s an Italian technician who spoke passable English (well beyond either my Deutsch or Italian).  He ran me through a set of exercises for legs, buttocks, hips, back and arms.  I now have my own stretchy ribbon of health that I can use on the hanging bar over my bed (“hanging bar” – maybe I should say, “the bar that hangs over my bed”). 

I also got out for a walk in the dangerous fresh air after I was temporarily disconnected from the IV pole. The grounds are shaping up nicely – daffodils are past it but the tulips are going strong as are the lilacs and pansies.  I found where the seemingly incongruous ducks of my first visit hang out and I made it past the train tracks to the huge cemetery nearby (OK, no smart remarks about good planning)….

(Oops, taking a break here it’s central line time and I just popped some sort of tranquilizer.)

Well, that was something I wouldn’t want to do on a daily basis.  (SPOILER ALERT – the balance of this paragraph is descriptive of a medical procedure that you may or may not wish to read).  Once the bed was reconfigured with my head at the foot (an old-school mechanical bed unlike the pushbutton one my roomie has) I got surgically draped and my head was positioned looking far left.  My Argentinian doc was doing the procedure for about the tenth time (yes, I usually ask) under the supervision of a more senior doc.  I insisted that they talk me through every step.  On the positive side, I’ve got “huge” veins in the neck – hope this bodes well for future stroke avoidance.  They snapped an ultrasound picture to prove it.  On the down side, my soft neck skin apparently has the real consistency of leather.  In a case of, “It’s cruel to be kind”, this made for a tough insertion – even after two Lidocaine shoot-ups.  My Argentinian was too gentle and the other doc stepped in with more brazen aggression to finish off the leatherworking phase.  So, it goes like this: Ultrasound location and inspection of the target, marking the skin for the entry point, needle inserted through leather and into vein (also on the tough side), wire inserted through needle, needle removed from wire, catheter “slipped” in over the wire (here was the aggressive but welcome intervention), wire removal while catheter goes further in (ultimately about 20cm/7.8 inches), sutures to hold things in place, cleanup of the area from blood etc., bandages to cover until needed and finally a trip to X-ray to check if all is OK. The target, by the way, was the interior jugular and the end result is three more hookups available for the upcoming chemo and the return of the stem cells.  All in all (minus the Xray) about an hour.

Back to the morning stroll.  It was a pleasure to smell fresh cut grass and hopefully not a health hazard.  The cemetery is enormous and, as most German cemeteries are, quite beautiful to those who enjoy riots of flowering plants and trees.  There’s always something interesting in a cemetery.  One grave with all German names had a Samurai warrior statue – hmm?  The graves of Italians are easy to spot.  They always seem to have, behind a sturdy, impervious glass cover, a photograph of the deceased on the headstone.   This kind of cemetery is not, what we call in the States, perpetual care (meaning official grounds-people see to mowing, trimming and such while frowning on and/or outright prohibiting any creativity from loved ones that make the job more difficult).  These cemeteries are more like perpetual responsibility.  Loved ones tend each plot.  They make the decisions, sometimes quite aesthetic, sometime quite eclectic, regarding what will be planted or placed on each plot.  The cemetery makes available water spigots (free water in Germany, this is a big deal), watering cans, bins in which to place trimmings, etc.  It was interesting to observe one lady biking into the cemetery with her own personal watering can in the front basket (that was sort of sweet) and a shortened twig broom strapped to the rear rack of the bike.

Last night I figured out some inside exercise.  My wing (yes, it’s mine!) runs off of a three-story atrium.  Counting 33cm tiles, I figured out that forty laps equal one kilometer.  Nordic walking is BIG in Germany.  Nordic walking is basically walking with ski poles so as to exercise the upper body at the same congruently with the bottom half.  Well, I’m perfecting the chemo version with my pole as the “Nordic Walker” (I am three-fourth Swedish). 

I did a half k and, by the time I finished it became apparent that, two floors down, a little concert was about to begin.  One guy on the cello and one gal on the accordion and vocals made up the band.  After cooling down and informing roomie of the upcoming festivities I went back and enjoyed the mix of German and French tunes until my IV started ringing and I had to report back to the Krankenschwester (sick sister aka nurse).

Waking up this morning in the light of my own situation, prefiguring a cemetery walk, and remembering the recent passing of our friend Mari Ellen I got to thinking about one truth of life for the believer.  It’s really a sort of dichotomy of what can be spoken into our life each day. 

On the one hand Jesus may say, “Lo” (because that’s how He spoke in 1611), “I am with you always, even unto the ends of the earth”.  In that case we have His presence – what that means is wrapped up in the mystery of the Trinity.  Jesus is with me, Jesus is in me?  I’m convinced that the Incarnation was God’s throwing His lot in with us forever in bodily form so, Jesus was raised in bodily form, ascended in bodily form, is standing and interceding for us in bodily form, and is coming back in bodily form.  I know God is the author of the laws of physics but how can Jesus be with me, in me while in bodily form elsewhere?  Like I said, it’s a mystery wrapped up in the Spirit’s role in the Trinity.

On the other hand He might say, “Today you will be with me in Paradise” as one crucified thief once heard.  Or as Mari Ellen must have heard, “Welcome to Paradise and on, of all days, Easter.” 

So, in Christ, on any given day one of two statements apply (well maybe not the Easter Day part).  They’re both great!

Well, just got hooked up for chemo.  Let’s get this party started.