Chin Up

It has been forty days since my prostate and bladder surgery.

I approached the operation with more than a little dread, but there really wasn’t much choice. In the end, several significant problems were resolved, for which I am deeply grateful.

Still, the procedure itself was no small matter. There was gouging of tissue, suctioning and flushing, slicing and stitching. I remained awake throughout, thanks to an epidural that numbed the lower half of my body.

At seventy-four, recovery has been slower than I imagined.

The greatest frustration is that the incision made to remove the bladder stones has not healed as expected. By now I had hoped it would have closed in the first ten days, yet it continues to weep—a mixture of plasma and a small amount of blood. Suture reactions—where the body mounts an exaggerated response and tries to push the suture out or forms a small inflammatory nodule—occur in perhaps 1–5% of patients, depending on the type of suture material, the location of the surgery, and the person’s immune response.

Three times a day I change the bandage, and each time it is soaked. It remains tender and painful—24 hours a day.

My dear neighbor Marta, a retired nurse who has watched over me with remarkable kindness, does not believe I have an infection. I have no fever, no spreading redness, no foul odor at the wound, and no pus—only the persistent drainage and localized tenderness. Her calm confidence has been reassuring.

On Tuesday I return to the surgeon. I hope for encouraging news.

The emotional side of recovery has surprised me almost as much as the physical.

Throughout my life I have usually possessed an inner resilience—a kind of flame that continued to burn, even through illness and adversity, waiting only for the chance to blaze again. This time has been different. There have been moments when uncertainty has settled over me, and I have found myself wondering when that old vitality will return.

Healing, I am learning, does not always proceed at the same pace in every part of the body—or of the spirit.

Yet the blessings continue to outweigh the setbacks.

I have Amy beside me. I have Marta’s experienced care. I have good physicians. I have friends who write and call. I have faith.

And I have Naomi’s voice, still echoing after all these years.

“Chin up!”

I can almost hear her saying it. 

The Healing Has Begun

After ten days of considerable discomfort following surgery on both my enlarged prostate and my bladder, the catheter is finally gone and I am beginning to feel better. During the operation, the enlarged portion of my prostate was removed through the urethra, while two large bladder stones were removed through a separate incision in my abdomen. For ten days, until last Friday, a catheter extended from my bladder, through my penis, into a urine collection bag that captured astonishing amounts of water tinged with blood. Thankfully, that chapter is now behind me.

My visit with the doctor was brief but encouraging. He was pleased with my progress, though he gently scolded me for being too active. He was dismayed that I had driven Amy and me to the appointment. Amy doesn't drive in the city, so I took the wheel. I admit it wasn't easy, but I tried to minimize every unnecessary movement.

The truth is, I remain weak and live with a constant low-grade ache. Blood still appears in my urine, and the surgical areas remain tender. But something remarkable has happened: my urinary stream is back to what I remember from earlier in life.

Even more significant, a major pain that had plagued me for many months has completely disappeared.

The doctor told me that this was the most difficult operation he and his team had undertaken in their careers. During the surgery, they discovered pus within my prostate. I had long suspected there was an infection, but I never knew exactly what it was. Looking back, it may explain the chronic pain around my anus and the radiating pain into my penis—both of which have now disappeared.

Now I find myself seeing life with fresh eyes and a grateful heart. I regret that I cannot yet care for my garden as I would like, but tomorrow a laborer will come to help. For now, healing itself is my work.

I am deeply grateful for Amy, for our dear neighbors Mayolo and Marta, and for the wonderful care I received from my doctor and his staff. I could not have asked for kinder companions along this road.

Healing, I am discovering, is not only a matter of the body. It is also an act of trust. And now, at long last, the healing has begun. 

One prayer has been especially meaningful to me during these days:

"Thy name is my healing, O my God, and remembrance of Thee is my remedy. Nearness to Thee is my hope, and love for Thee is my companion. Thy mercy to me is my healing and my succor in both this world and the world to come. Thou, verily, art the All-Bountiful, the All-Knowing, the All-Wise."   —Baha'u'llah

The Quiet Companion

Looking back to the moment of truth in the doctor’s office here in Oaxaca, Mexico, I can only say that the hand of fate was upon me.

The verdict came after a brief examination and a sonogram of my prostate: surgery.

I had resisted that word ever since the problem was first diagnosed nearly eight years ago. The risks seemed too great. If medication could keep me going, then so be it. But time has its own plans. The sonogram revealed something new—two stones in my bladder. The pain and discomfort had become impossible to ignore. It was crunch time.

On a deeper level, I liked the doctor immediately. A urologist in his mid-thirties, he possessed the quiet confidence and reassuring manner I needed. His credentials were excellent, and his referrals glowing. I asked a few more questions, and each answer strengthened my confidence. Before I knew it, a surgery date had been set, and I wired the money from the United States.

There was something else.

As the day of surgery approached and apprehension quietly grew, I experienced something difficult to explain. It was as though a spirit drew near—not with words or visions, but with a calm assurance that settled over me. The fear did not disappear, but it no longer held the upper hand. I accepted that whatever lay ahead, I would not face it alone.

That quiet encounter confirmed what my heart was already telling me: stay grounded in Mexico and trust.

The operation lasted a little over two hours. The enlarged portion of my prostate was removed through the urethra, leaving the outer capsule intact. The two bladder stones were removed through a small incision in my abdomen.

The first night was the hardest. My bladder was continually flushed with saline, and the urine flowing through the catheter was filled with blood. There was pain, discomfort, and very little sleep.

Amy received a surprise of her own. Shortly after the surgery she was informed that she would be staying with me overnight. In Mexico, it is customary for a family member to remain with the patient around the clock. She hadn’t come prepared and endured a restless night in an uncomfortable chair. Yet her presence comforted me, and afterward I could appreciate the wisdom of the tradition. Hospitals can be lonely places. I never felt alone.

Our dear neighbors, Marta and Mayolo, have been with us every step of the journey. They are deeply embedded in the fabric of our lives, offering support and love each step of the way.

Now, four days later, I am slowly recovering. A catheter still protrudes from my body and drains into a bag that must be emptied with surprising frequency. I take my medications faithfully, drink more water than I ever imagined possible, and patiently wait for my body to heal. Blood still mixes with the urine, but each day there is a little less. In another week the catheter will be removed, and, I hope, a new chapter will begin.

I have nothing but praise for the surgical team, the nurses, and the remarkable little boutique hospital where I was treated. With only five patient rooms, it felt less like an institution and more like a place where people genuinely cared.

As I reflect on these past few days, I keep returning to that quiet presence that met me before the operation. Some may call it intuition, others grace, and still others simply the workings of the mind under stress. I only know that it gave me confidence when I needed it most. I have learned over the years to trust such moments. They have appeared before at important crossroads in my life, and once again they carried me safely across.

Healing, I am discovering, is not only a matter of the body. It is also an act of trust.

The Narrowing Passage

 Seven and a half years ago, while in Luxor, Egypt, I had a medical emergency.

The problem had been building for some time, but I had become accustomed to it and dealt with the symptoms stoically. Prior to Egypt, I had been living in Venice, Italy. My habit was to walk many miles each day, wandering through the spiderweb of narrow passages and across countless footbridges, taking street photographs. I noticed increasing pressure from my bladder and found myself making frequent stops to urinate.

Then, while in Egypt, my Arabic brothers—who are like family to me—wanted to take me out for dinner and a boat ride on the Nile on Christmas Eve. The wives had prepared a wonderful meal, and the boat was ready to cast off, but I was in crisis. I could not urinate. The pain was intense, and I had to decline the invitation and return to my hotel room.

That night was excruciating.

Early the following morning I went to my friend Haggag. He took me into the city, and thankfully we found a urologist in a rather shabby office who nevertheless was kind, competent, and immediately inserted a catheter, allowing my bladder to empty. I don´t speak Arabic, but understood my prostate was enlarged. 

Although I had airline tickets to Ethiopia, I cancelled all my travel plans and returned to the United States with medications, a catheter, and a urine bag strapped to my waist.

Facing the prospect of surgery, I instead tried a course of medication that, within days, greatly relieved my symptoms and gave me back a more or less normal life.

Now the prostate issue has become an intrusion into normal living once again.

I live with discomfort every day. I continue to have annual examinations, usually in the United States, and thankfully there has been no indication of cancer.

Recently, I sought out a highly respected urologist in Oaxaca. After performing a sonogram in his office, he said that my prostate was considerably larger than normal and that he could see stones or calcifications within it. His opinion was that surgery would likely be necessary, though he explained that the stones could complicate the usual approach.

Since then have been a battery of pre-operative tests, all of which suggest that I am healthy enough to proceed if surgery is recommended. A CT scan provided much more detail. Amy and I also met with an internist to review the results. He was bright, kind, and exceptionally helpful. He has shared his evaluation with my urologist, and tomorrow I have another appointment to discuss the findings, review my options, and learn what the next steps might be.

Appreciated throughout this process is the level of attention given.

Because I am not fluent in Spanish, every consultation requires patience. Amy helps, and we often rely on our phones for translation. Yet I never feel rushed. I appreciate not feeling as though I am being squeezed into an artificial fifteen-minute appointment slot while someone watches the clock. The doctors take whatever time is necessary to answer questions and explain what is happening. 

From what I understand so far, the usual possibility is a procedure in which instruments are passed through the penis and up the urethra to remove obstructing prostate tissue and perhaps some of the calcified material. An epidural is administered to numb the lower half of my body—so I would remain awake but feel no pain. That thought is not exactly on my list of favorite experiences, but if it helps restore my quality of life, so be it.

I may still seek a second opinion if possible. I have written to my longtime urologist in Santa Fe, though so far I have not heard back from him.

All things considered, I suspect the total cost may end up being similar whether I pursue treatment here or in the United States. Medicare would cover much of the procedure in America, but there would still be travel expenses, lodging, and various incidentals. Here in Mexico, the operation itself is estimated to cost roughly one-quarter of what the same procedure would cost in the United States.

For now, I am gathering information, asking questions, and taking one step at a time—grateful for competent medical care, grateful for Amy's support, and hopeful that somewhere ahead lies a more comfortable chapter than the one I am currently navigating.

TOP IMAGE: 

"Changing Woman" by Navajo artist, Dennis Jeffy   70 x 70 inches, oil canvas,

collection of Amy Córdova Boone

An Empath

My two cousins in Dallas, Texas cut people open and chop out bones. They are orthopedic surgeons.

I could learn to be a doctor and perhaps do surgery, but I would have to overcome my sympathetic nervous system. I am a sensitive type—an artist, and also an empath. “The trademark of an empath is feeling and absorbing other people’s emotions and/or physical symptoms because of their high sensitivities. These people filter the world through their intuition and have a difficult time intellectualizing their feelings.” (From Psychology Today, Ten Traits of Empathetic People) I would “feel” some pain when cutting someone open, let alone cutting out their hip joint and tossing it in the trash. No matter that person is under anesthesia and asleep.

I could never be a bully because I sympathize with the other. I feel human anger, jealousy, fear and it hurts. I often will bend over backward for someone else at my own expense and have been taken advantage of by self-centered and unfeeling people. During times of peace and joy with another, I can feel elated. I replenish easily in nature, in wild fields, under open skies, among birds and beasts, by water.

I quickly tire of being in a crowd because I absorb too much. When I was young, if in a crowd or at a long meeting, I would often feel an urgency to use the bathroom—an escape mechanism. During eighth grade, the class elected me their president and I declined. 

Now, as I pass mid-life, I find I can travel alone for months, even a year or longer.

Too much togetherness can be difficult for me—I have been married three times. Perhaps I fear being engulfed and losing my identity and do not give myself easily to being a unit. Maybe I am not “domestic.”
Once when my mother visited me from her home far away, we were standing together in my yard and a terrible migraine came upon me, although I never get headaches. Mom always was tough—I felt I absorbed tension from a deep layer of being.
When my oldest daughter was seventeen, there came a time when I was waking at night with a feeling of dread, as if something was wrong but I could not discern what. Soon after, we discovered she had advanced cancer and would probably not survive. The cancer started in her hip bone, and for two years until the day she died I felt pain in my hip.

Usually I am healthy and without pains, but occasionally something will flare up for a short while. Yesterday I felt uneasy around lunch time—a bit nauseous and unsteady. I wondered at the unusual indisposition, but the discomfort passed as I focused on my artwork and gallery. Soon after, my dear friend and comrade talked with me and texted describing the sudden onset of her “stomach being on fire” and having digestion symptoms that necessitated medication. "Probably too much Thanksgiving leftover sweets," she said. "I am not used to the richness!"

Oh, and did I tell you that I often begin thinking of someone moments before they call me on the phone?