NYC Journal

One currency based upon a now largely arbitrary notion of trust is just as good as a made up one. I'll take zero. 😎
Good to see you back, Cal.
Lots of bike related news over this way. I need to update my host with a bunch of new photos, it's been a while.
Phil
 
Around 9:30 PM last night I took note that my left ankle was swollen, along with some mild swelling of my calf and thigh.

Pretty much could be a blood clot that happens about 1-2% of the time after a surgery. These blood clots if they migrate to the lungs can cause a pulmonary embolism and can take you out.

So I went to the ER and got home around 3:30 AM.

Ends up that I did have a blood clot, but they could tell by it’s size and how porous it was that it likely formed about a year ago.

I’m reminded of Phil’s experience where cold restricted blood flow enough for a clot to form.

So last night was rough. Only 4 hours sleep.

They moved the patch that attaches the collection tube from the cathera to my right leg. Evidently my old clot along with the loose elastic bands of a leg bag were enough to cause endema.

Had ultrasonic imaging of my legs and then a Cat-Scan of my torso. A new abnormality is likely scaring of lymph-nodes, that they don’t think is lymphoma.

“Maggie” is looking mighty tired. She does not handle these kinda emergencies well. When I saw the swelling I knew I needed to go to the ER. Only took notice because I was removing the scrubs I was wearing. My discharge papers mentioned that any pain or swelling should attended to immediately.

I followed the clear instructions.

Cal
 
The scarring of lymph-nodes is suggesting that my Cancer has metasticised.

Things are suggested also that it is not lymphoma.

Cellulitis which I also had three bouts of over the past 3 years could be the reason and explain the scarring that is not Cancer related.

My torso is less delicate and weak. A not so small baby-step today. Much easier getting out of bed, less itching, and sneezes and coughs are less painful.

Already pooped once…

I guess I’ll find out more soon with the second biopsy. Those results can be due at any time.

Friday I’ll have the cathera removed.

Cal
 
Pooped again.

Seems like the irregularity in my lymph nodes can be explained by my Cold Agglutinin Disease (CAD).

My urologists say that the nearby lymph nodes were suspect, they were excised with the prostate, but are not definitely or definitively Cancer that metasticised.

If I am lucky the Prostate Cancer didn’t spread. Yesterday’s Cat-Scan provided some useful data and led to an understanding and insight. The second biopsy will kinda be a tell all about the limit and spread.

So it seems like my CAD opens up the risk of DVT (Deep Vein Thrombosis) and the risk of embolisms to the brain or lung. There also is a higher risk of clotting and bloating in my legs.

I learned that my immune system is somewhat compromised, and I am more prone to infections getting out of hand. This too is CAD related.

“Maggie” has OCD tendencies, so after doing her thorough research she has discovered a lot more research was done, and now there are all these correlations that involve my CAD.

My glucose levels are just above the upper threshold of normal. This is likely due to the lack of daily exercise. Pretty much a few miles of walking or something gentle is needed to normalize me. I currently hover at the very low end of the pre-diabetic scale. If I ate sugar, soda, or cake, or even highly processed foods my glucose levels would certainly be higher. Right now they are elevated due to inactivity.

So biking, the gym, and working out are key for me to avoid chronic disease. My life is in my own hands, and I have a great reason to bike or exercise every day.

I don’t really feel fatigued like I would expect from only 4 hours sleep.

I have an appointment tomorrow with my old geezer hematologist. Pretty much my blood issues need to be addressed and integrated into any treatment programs. Don’t know if I need a blood thinner for the existing old clot, or if because of my CAD if I need to be on a blood thinner to counter the clotting risk.

A lot of chord and scale building going on. Kinda powerful tool to learn harmony and develop my own style. In a ways I’m doing what Charlie Christian did to express himself, but of course in my own way. A kinda endless beginning that connects to everything.

Lots of pattern recognition, and of course a math aptitude is useful and helps develop and understand concepts.

My electric guitars more closely resemble acoustic guitars. Playing 12’s at full pitch is a challenge not everyone can do.

I also have so many guitars that play well. Very inspiring…

Cal
 
There is a kinda cure for my CAD. Move to a warm tropical climate. No cold: no hemolizing or anemias.

So Hemotoligist tomorrow, them at least the cathera comes out Friday.

The second biopsy results could happen any day now, and the envelope is 4-7 days by one account, but 1-2 weeks by another.

I would like to know about my lymph nodes that were removed. If no Cancer is present the abnormality present in my lymph nodes that were excised would be explained by my CAD and 3 episodes of Cellulitus.

This might translate into a lighter load of secondary therapies like hormone treatment, and radiation therapy. It would mean that my hyper aggressive Prostate Cancer was just limited to only the prostate.

There is also a new risk of blood clots making me higher risk for stroke as well as pulmonary embolism. This clumping of my red blood cells increased my risk of developing of clotting, strokes or embolisms.

Pretty much I am a walking time bomb, or a grenade with the pin pulled. Kaa-boom.

Good thing I’m in good health. I don’t want to walk the sudden death path.

A kinda crazy spin. Is this divine intervention? You have to wonder…

Cal
 
Now I need another Cat-Scan, this one of my pelvis before Friday’s cathera removal.

This can be done either Wednesday or Thursday.

Seems like some fluid buildup can happen in the groin area.

My ball sack is fist sized and each ball is the size of a jumbo egg. I was told this is normal.

Cal
 
All of the sudden I go from no maintenance to very high maintenance.

I go from being a fresh Audi A4 that has legs, to be one my 1966 C-10 that is a project truck that needs lots of work.

Not what I entended. I do see this though as a wake-up call of sorts. A decade ago not so much was known about CAD. There is more to know today because there are new understandings.

I now have a life ahead that has both limits and consequences, but overall my style won’t be too cramped, and pretty much I am forced to embrace change and adaptation. There seems to be more focus in my life, and certainly I don’t have the time or will to waste my life on BS.

Still got a lot to be happy about.

Last night the grand daughter had to be reassured by “Maggie” that I was alright and that I’m O.K.

The son-in-law is there to chauffeur us around. Feels weird not being independent. I’m great-full for the support.

Cal
 
Went to bed early yesterday to catch up on sleep. Got up at 4:00 AM.

Something like 2 degrees outside.

Seems like the healing is accelerating. Less bloated, the swelling in my left leg is less, and there is less mid-section tightness restriction.

Somehow I crossed up appointment times: 10:15; and 2:30. My bad. I was tired yesterday from only having 4 hours sleep, and a lot was going on. My scheduling online resulted in phone calls. Then my surgeon called wanting to get a CT performed of my pelvic area before Friday’s cathera removal.

Of course guitar practice requires being well rested and the ability of being able to concentrate. So yesterday was a bit of a challenge. Glad that I’m retired.

It will be interesting to get the spin from my old geezer hematologist. The blood tests show all kinds of out of ranges. I expect it will take a few weeks to get more normalized and resolve.

My new routine with my hematologist is a twice a year monitoring in a kinda watch and wait manner. Generally CAD is a disease of old age that effects people in their 70’s and 80’s. It is a rare disease and I think goes undiagnosed in many. I was first diagnosed when I was the age of 49. This is very young.

So basically I’m suggesting that CAD goes undiagnosed until it manifests itself as a condition that involves aging. Weakness and anemia are the most common symptoms, and I think these symptoms become prevalent as fitness and cardio circulation fade as we age.

I certainly, if not as active as I am, would suffer consequences that get compounded by the deterioration and systemic decline that is part of aging. So my best interests are to stay hyper-active and maintian a pretty high standard of fitness to forestall any impact.

My quality of life should be high, but a mindful discipline will be required. “Maggie” needs to be lower maintenance.

Cal
 
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Four light meals spread out in a timely manner, seems to do me well.

I likely am eating less as far as calories.

My pre-diabetic condition is indicated in the bloodwork.

My glucose levels should be low because I don’t eat sugar, soda, or cake. Almost no processed foods.

But they are just over the high threshold of normal. Pretty much any physical activity would normalize things, as little as a 1 mile short walk, that’s how close to the edge I am. Walking around the house is not enough.

So I really know my body, and pretty much I need physical activity on a daily basis to prevent a chronic disease like Diabetes that certainly could shorten my life.

Of course a low BMI is preferred and any weight gain has serious consequences in an amplified manner.

My hematologist is the medical professional that would get my blood tested on a DNA level. Pretty much my genetic potential for chronic diseases I want to pursue.

I need to get a handle on my expected life expectancy. I have a Cancer, I have an incurable disease (CAD).

CAD is treatable, but it is kinda like a hip or knee replacement, best to hold off until you really need it because once that doorway gets opened there is no going back. Threatment becomes a lifelong event with it’s own set of problems.

CAD treatments involve messing with your immune system. My immune system already is compromise. Any small infection can go into a full blown episode of life threatening Cellulitus. I don’t want to weaken or compromise my immune system further, in fact I need to do the opposite and fortify my immune system through diet, exercise and rest.

Actually to do what I need to do requires a real retirement.

Cal
 
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The Donald needs to have mucho growth to fulfill his plan, otherwise the deficit will become too big a burden to manage.

They are saying the next 100 days are kinda crucial. Pretty much a lot of momentum has to be sustained.

So there is a possibility this could work, but of course there are unintended consequences, there is the risk of inflation, and room for some pretty big mistakes.

So on one hand he kills the economy with tariffs and trade wars, but stimulates business enough to not create a collapse.

Then again the debt problems of the consumers, the car loans, the commercial real estate loans that need to get rolled over, high mortgage rates, and the government deficits are a lot to unravel that are certainly a drag on the economy. They pretty much are still problems that remain.

So maybe we have a need for a complete collapse in our economy to reset it. What coulda or shoulda happened in 2007-2008 might happen still.

Right now Wall Street is looking at some crazy growth that really isn’t real yet, and the debt and deficit burden has been somehow discounted. The growth that happened last year I think involved a lot of stockpiling, and hoarding to create a buffer for supply disruptions, higher prices, inflation, tariffs…

This buffer won’t last too long, perhaps a full quarter or 100 days from now. Sometime after March a reality check will happen. I don’t see things as being so great. As they say, “The markets don’t like uncertainty” and pretty much that is what lays ahead.

Expect insanity…

Cal
 
Cal, please do take care.
My blood clot pathology was never determined, but my good health, low resting pulse and low blood pressure as a cyclist could have been a factor. The low flow allows pooling and clotting. At that time I was in grad school, sitting in class or sitting at a desk all day writing and reading. Just that bit of inactivity over that winter probably caused the clot. Ironic that good health and exercise actually can be detrimental. So ask your doc if you can get your legs moving gently while reclined. No stress load, just movement to get your calves moving. They are described as the heart of the lower body, since calf contractions from walking, do a lot of work to get blood from the ankles back to the trunk.
Phil
 
So I’m delusional again. I thought I messed up today’s hematologist appointment, but when I called Andrew he confirmed that he had the right time for the afternoon appointment.

So with so many last minute things going on, only 4 hours sleep, and my poor aptitude for multitasking, I was kinda confuse.

So everything is good now.

2 degrees in Peekskill.

As far as my CAD goes, it increases my clotting risks for sure. When my red blood cells clump it certainly restricts blood flow.

A year ago I was hospitalized with the nose Cellulitus. The clot in my leg might be due to that week in the hospital.

The clot they saw at the ER recently they estimated happened a year ago. It still resides in my thigh.

I expect perhaps blood thinners for 3 months might happen.

Oh-well…

Time for a nap…

Cal
 
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Seems like I got some test results because I got a message from my medical portal, but when I signed in I saw no new results.

I suspect the second biopsy results are in, but I’m being excluded from seeing them.

If my speculation is true, it took a week to get the results, and this Friday I’ll get the the good, the bad, and the ugly.

Could of been an AI glitch also.

Glad I’m seeing my hematologist today. Pretty much the follow through advised by the ER crew.

All this healthcare is like a full time gig. When I get back into my routine, pretty much diet, fitness, and relaxing will be my full time job.

I thought “Maggie” was somewhat high maintenance, but in fact I am.

Cal
 
I think of how I use to go Cod Fishing on the Viking Starship out of Montauk in January weather in 25 foot swells. The 85 foot boat cork-screwing through heavy seas.

About half the boat endured sea sickness. It did not happen to me on this trip, but I have experienced sea sickness and it is an awful experience.

Anyways, this was what I did for fun and adventure. “The Old Man And The Sea.”

So now that part of my life is over. I’m just glad I did that experience.

Cal
 
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Today, I feel like I’m living in a twilight. I see a pattern where it takes a while to wake up fully, several hours, and then I quickly fade.

“Maggie” similarly experiences a different kinda twilight. She says it is more akin to being like the pandemic, where uncertainty and bad things loomed and emerged.

So as we push forward more and more complications are emerging. If I get radiation treatment it has a big fatigue side effect.

My CAD presents an already weakened state that at best borders on anemia. I expect hemalizing to occur as collateral damage from any radiation treatment, so in my case the fatigue will likely get compounded.

This looks to be the long-haul. Perhaps 2-3 months in the least.

Cal
 
Today my hematologist through a blood test confirmed that in fact I have an active blood clot and am in danger of either a stroke or embolism.

Confirmed is that patients that have CAD have elevated risks of blood clots.

I will be on a blood thinner for 3 months, and that may or may not get extended for a second 3 months.

I had 7 vials of blood drawn, and pretty much the processing was fast tracked and reviewed immediately. STAT service…

One test definitively monitors some compound that accurately denotes if the clot is active.

The ER last Monday was mucho lame.

My old geezer hematologist said my bone marrow is doing a great job replacing damaged cells. Remarkable.

I had an appointment two months from now, and that got pushed out to now 3 months for a follow through.

Seems like any radiation used today is very highly targeted, so that any collateral damage to my bone marrow would be limited. Radiation therapy is no issue for me.

Two months ago I had a highly specific PET-scan for my Prostate Cancer. That scan showed and indicated no irregularities around my lungs. My hematologist suggests this is highly unlikely in so little time that elapsed that this could be prostate Cancer that metasticised, but it could be a low grade B-cell lymphoma, which pretty much is what CAD is or can be defined as.

Basically CAD can be looked upon as a slow growing B-Cell lymphoma, and I have been living with this since at least since I was 49 when I was diagnosed. No news here.

BTW my hematologist is also an oncologist.

Right now the oral blood thinner needs to be ordered at my local CVS and “Maggie” is trying to find one that has it in stock so I can start the medication pronto.

Of course she does not handle this well. She is currently at CVS trying to get help in tracking where it may be in stock. The CVS in Mohegan Lake has a 24 hour pharmacy.

Cal
 
I went rouge and drove my car to the CVS on the other side of the city. Peekskill is big enough to have two CVS’s.

Not really suppose to drive with a cathera. Don’t tell my surgeon or “Maggie’s” daughter, the creature.

Pretty important not to suffer a stroke or an embolism. Maggie pretty much got all wound up. My worry was that she would stroke out not me.

My out of pocket cost was $617.00. This dose is only for a month, so at least two more bills of $617.00. I have something like a $2K drug deductible. “Moo,” said the Pig.

So now I’m on a blood thinner.

Maggie kinda went full-blown Maggie-mode. Pretty much I said let’s just find a CVS with the med in stock, then let’s just drive there. EZ-PZ. No reason to get hysterical.

So for one week the daily dose is double to build up a level.

Cal
 
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