Maturity

On January 7, 2002 I had surgery for prostate cancer.  Unfortunately, health issues seem to set the main theme for this period in my life.

As I look back on it now, I had been having symptoms with my prostate for several years.  My first PSA test had been in 1991 and it was 2.7.  At that time, the PSA test was fairly new, and it was thought that a result less than 4 was "normal."  The latest information says that may not be so.  The current thinking (2008) is that the rate of rise of the PSA is the most important factor.  If it increases over a short period of time, the likelihood of cancer greater.  In retrospect, I probably had prostate cancer ten years before it was diagnosed.  After much deliberation and research, I decided to have a radical prostatectomy as my primary treatment.  My urologist had recommended brachytherapy, radiation seed implants.  He said it was "easier on the body."  It was important to me, with a surgical background, to know the stage of my cancer, and the only way was to remove the gland and have it pathologically examined.

My surgery went OK but with some complications because of my chronic back problem.  For as long as I can remember, if I stay in bed more than about seven hours, my back begins to hurt.  The second day after surgery, the usual back pain started.  My surgeon was afraid I had a pulmonary embolus and sent me to X-ray.  I was in so much pain, every time I moved it was like I had been hit by a cattle prod.  He finally called in an internist, who prescribed an ice pack to my back that relieved me within a few minutes.  I am forever grateful to Dr. Tom Hampton.

I asked for a chair that I could sit and sleep in to get out of the bed.  The hospital claimed they did not have a sleeper chair.  With the help of my best friend Johnny, my wife brought my recliner from home and I spent the remainder of my hospital stay in it.  This and frequent ice packs kept the back pain under control.

The next issue was my leg began to itch and be painful.  The doctor had used a great deal of adhesive tape across the Foley catheter to my right thigh.  He had written on the tape "do not removed under order of death" and it was signed Osama ben Laden.  After loud complaints from me, the tape was removed to expose large blisters and redness of the skin.  I had not had any previous problem with allergies to adhesives.  It took several weeks for the skin to heal.  

I went home to begin my recovery.  I had to wear the catheter for three weeks.  As I remember, this was the worse part of the surgical ordeal.  I had pain when I sat down.  It was helped somewhat by sitting on a gel filled pad we took from Jane's dad old wheelchair.  Getting the catheter out was a relief.

I got bad news from the surgeon.  The cancer in my prostate was much more extensive than he thought.  The pathologist reported it had extended beyond the capsule of the gland on one side.  This meant I would be very likely to have recurrence, as all of the cancer had not been removed.  He recommended external radiation therapy to begin as soon as I healed.  I sought a second opinion from a professor at the local medical school.  He said he would not recommend starting radiation until it was proven that my cancer recurred by following the PSA level.  He said I would foul up what appeared to be a good surgical result.

While I was waiting to heal, I developed another problem.  It became very difficult for me to empty my bladder without straining.  I had developed a bladder neck obstruction, according to my urologist, that required surgical correction.  He had been unable to get a catheter in my bladder in his office and said his experience relieving this situation by dilatation had been poor.  I had surgery, and had to go through a period of total urinary incontinence for several weeks.  This delayed my start of radiation.  I decided that it would be foolish to wait to begin radiation therapy, as a second pathological opinion from the medical school pathologist said the cancer was beyond the capsule of the gland on both sides.   I finished the radiation about the middle of July.  I was not able to go with my friends on the annual guy's Colorado trout fishing trip.

Rather than to bore you with my health issues, I will refer you to this section that sums up a lot of things.

I had been working part time for the Texas Rehabilitation Commission.  I took a short delay during my recovery, but went back to work as soon as I was able.  I have learned that work is good for me.  It gets me out of the house and with other people and gives me some purpose in life.  My good friend George Williams lent me a book to read several years earlier entitled "Get a Life: You Don't Need a Million to Retire Well" by Ralph E. Warner.  The bottom line is that the people who were happiest were doing things for other people in their retirement.  Wealth was not important.  The practice of medicine is doing things for other people, and I have always enjoyed it.

In the fall of 2002 I attended the Texas Medical Association convention and ran into an old friend, Dr. James Fancher, who works full time for the Veterans Administration.  He asked me if I had any interested in going back to work.  I told him that if anything ever became available, to let me know.  Our common good friend Dr. Bernie Yollick currently held their only part time job.  At Christmas time, Fanch called me and said Dr. Yollick would retire at the end of the year.  I applied for the job and was accepted.  The only problem was they could not put me to work until March, as Dr. Yollick was still on the payroll using up his sick leave time.

I started working in at the V.A. clinics in Fort Worth and Bonham.  When I visited Fort Worth on my orientation, I met Dr. Gordon Frank, an ophthalmologist I had known casually when I off iced in the Doctors Building.  He moved his office to the Presbyterian area about the time I relocated to Medical City, and we had not seen each other in years.  We worked out a deal to carpool on Thursdays.  That lasted for the entire five years I worked for the V. A.

I enjoyed the work, and especially enjoyed the comradare that existed among the group of doctors who worked in the surgery department.  I met and got to know Dr. John Houston Smith, a general surgeon.  John had worked in the V. A. clinic since it opened twelve years earlier, as had Dr. Frank.  We all became good friends.  We enjoyed many lunches together where we solved multiple problems, both personal and professional.  The younger guys called us the "brain trust."

I worked in the V. A. clinic at the Bonham facility on Tuesdays.  I enjoyed working there very much, more than in Fort Worth because of the staff.  They wanted me and helped me in every way possible.  Very different from the staff in Fort Worth, who did not seem to care whether or not I was there.

The V.A. has some problems with staff.  Many belong to the union.  Many do as little as possible, as it is very hard for a V.A. employee to get fired.  Some are great people, but a few rotten apples spoil the barrel.  If I had been able, I would have fired the ward clerk in Fort Worth the first month I was there.  He was very unfriendly to the patients and did not appear to be happy in his work.  A major problem for the V. A. is there are few opportunities for advancement.  People get stuck in the same job for years, as there is no where to go without moving to another city and facility.  Being a receptionist in a medical facility is a very hard job.  Sick people are often unhappy people, and some are hard to deal with.  I always said when I was in practice, the most important persons in your office were those who answered the phone and who greeted the patients when they arrived.  When you have an unhappy person in one of those jobs, everyone suffers, especially the patients.

After about a year, the work load in the Fort Worth clinic increased to the point that there was a three month waiting time for a new appointment.  They decided to let me work an additional two days a month, on alternate Wednesdays.  The work load in Bonham remained fairly constant, as that clinic had been in operation for several years.

 After several years, and a couple of near accidents, I began to dread the commute, especially to Bonham.  As I was car pooling with Dr. Frank on Thursdays, those days went by quickly.  I passed the time in the car by listening to audio books.  You can see what I read on this page.  I began to make plans for retirement.  I talked with the man who helped with retirement issues and he assisted me in "buying back" the time I spend in government service with the Air Force.  Those two years would help add a little to my pension.  In the Air Force, you did not pay social security tax.  To be able to use those years toward a V.A. retirement, you had to pay the social security tax for those years.  I learned that after five years of work with the V.A. you would be eligible for retirement.  That date would be March 31, 2008 for me.  I began to make plans to retire.

In 2007, I reached my 70 1/2 birthday.  I was required to take a minimal required distribution (RMD) from my IRA.  It gave us a new problem, more money than we really needed to live comfortably.  We increased our savings and investing, but at the same time our federal tax burden became greater.  I was already paying federal tax on most of my social security income.  I had begun drawing it when I was 62, the recommendation at that time.  Now advisors are saying to delay taking social security as long as possible, as it is a better investment return that you can make in the market place.  My dad used to tell me never to complain about paying income tax, as you should be happy you had income.  I think the tax burdens today are more than my dad ever encountered in his lifetime.  This added to the incentive for me to retire from my V.A. job.

Enough about work.  We did have some fun during this period in our lives.   My illness prevented much travel, but in March after my surgery in January, we made our first trip to visit the Big Bend National Park.  We have always loved the desert and especially mountain desert as we enjoyed for many years in Cloudcroft.  We stayed in Alpine overnight on our way to the park it is the home of Sul Ross, one of the many state colleges.  It is on the railway between San Antonio and El Paso that had been built in the late 1800's.

 We stayed for three days at the Chisos Mountain Lodge, located in the center of the park.  It was comfortable and made it convenient to take day trips to the rest of the park.  We visited several areas of the park adjacent to the Rio Grande River.  We were told that the river no longer empties into the Gulf of Mexico as most of the water is used up by irrigation and much is dammed in lakes in Mexico.  We saw painting on the rock walls made by American Indians in the past.  It is a very remote but beautiful area.

The road between Terlingua and Presidio runs along the river, and is very scenic.  It has some very steep grades and signs warn people who are towing travel trailers to be wary.  We visited Marfa, Fort Davis and the McDonald Observatory near there.  It is run by the University of Chicago.  We spend one night at the Gage Hotel in Marathon where there is a very fine restaurant.  We decided that if we came back there, we would make it our headquarters.

We tried once again to spend time at Cloudcroft.  This time we took along an oxygen generator, and Jane was forced to use it a good bit of the time we were there.  We decided it was time to sell our place.  We remembered that one of our neighbors had mentioned that if we ever decided to sell our place, to let them know.  We did, and they bought it a day later.  We removed a few very personal items, but left it completely furnished.  It was with sadness we left it for the last time.  Yet another example that there is a time and place for everything in our lives.

As I had not completed my radiation treatments, I was unable to go on the annual guys fishing trip to Colorado that year.

Our only trip the next year was our annual visit to Santa Fe.  Jane always has fun.  I had a miserable time, as I was unable to get very far from the hotel or any bathroom.  We had stayed at the St. Frances, located within walking distance from the square.

Our friends the Keiffers told us of a trip they were planning to take, sponsored by one of the local radio stations.  It was to begin in Vancouver and end in Calgary with a train trip across Canada to visit the Banff area.  I had been there as a child and remembered the trip and the very beautiful place.

We flew to Vancouver with the group of about 30 people.  We spent a night in the city and the next day visited nearby Victoria.  It is a lovely place and we felt like we could live there very easily.  The visit included a trip on the bay to watch for whales.  There are several resident pods of killer whales and we were fortunate to see them.

We returned to Vancouver on the ferry and left the next day on the train, headed east.  The route follows the Frazier river valley.  We were fed frequently.  Our group was able to fit easily in one car.  We were to spend the night in Kamloops and were entertained by a play, performed by a local theatre group.

We arrived the next day at the end of our train ride in Jasper to find big elk near the center of town.  We spent the night in a lovely lodge.  The next day our bus took us to Lake Louise to spend the night at the Fairmount Hotel.  This was our 30th wedding anniversary, and we had looked forward to the evening.

Our night there was disappointing.  We had been asked to request our dinner entrée, either fish or beef.  It appears that many people changed their minds, and they ran out of beef.  It took two hours to get served, and some people left in disgust without having any dinner.  When we got to our hotel rooms about 11:00 PM, we were further frustrated by a fire alarm, which proved to be false.  As we left the hotel the next morning, a representative from the Fairmount boarded our bus and offered an apology and a free dinner at our next visit there.

We visited the Atabasca glacier on our way to spend our next night in Banff at a very nice new hotel on the side of the mountain.  We toured this beautiful area and ate a very nice evening meal at a local restaurant.  The next day we traveled the short distance to Calgary to fly back to Dallas.

As we look back on this trip, we enjoyed our visit to the Vancouver, Victoria and Banff areas, but would not recommend the train trip.  Once you have seen some of the Frazier River valley, you have seen it all.

Last edited 11/28/08

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