Speaking of Yellowstone, I missed Closing Weekend in its entirety, for the first time since I moved to Montana in 1997.  The weather on Saturday was very wintry, with sub-freezing temperatures, falling snow, and strong wind.  Given my early departure on Sunday morning, and the rotten weather, I opted to stay home.  I watched college football and packed for my trip to NIH.

November 6-9, 2011

On Sunday morning, Jane drove me to the airport.  We left home around 4:30 a.m., because my flight departure was scheduled for 5:50 a.m.  We had fresh snow on the ground and on I-90.  Fortunately, the closer we got to the airport, the less snow there was.  I felt confident that my flight would not be in jeopardy.  I had worried, because I had a 45 minute plane change in Minneapolis, which did not leave much room for a delay on the Bozeman outbound flight.

I was using carry-on for the first time in several years, in an effort to insure my luggage made it to Dulles on the same plane I was on.  I got through Security quite quickly.  The plane loaded on schedule.  Essentially, we were loaded, with everyone in their seat by 5 minutes prior to our scheduled departure.  We  just sat there, expecting the usual flight attendant safety presentation, but nothing happened.  At 6:00 a.m., the pilot got on the intercom, and announced that there would be a 20 minute delay, because we had to be de-iced.  That made me nervous, because we were already 10 minutes late.  I waited anxiously for each step of the process.  It took a good 10 minutes or more just to get the aircraft over to where the de-icing vehicles were stationed (quite close to the terminal).  It seemed they were only using one of the two trucks, so that took longer than usual.  By the time we had completed de-icing, it was closer to 6:30 a.m.  I wrote off the likelihood of making my connection in the Twin Cities, and started trying to figure out what I would do if the airline told me they couldn’t get me out of that airport for a few days.  With the overbooked flights and shrunk up schedules in this era, it is not unusual to be told that an airline can’t re-book you on a flight for at least 2 or 3 days.  I was supposed to be at the Admissions Desk at NIH at 7:00 a.m. on Monday morning, and this was Sunday morning.  I had tests scheduled on Monday!

On top of the de-icing delay, we had to taxi to the west end of the airfield, and that seemed to take forever.  We finally were in the air almost an hour after our scheduled departure.  I waited for the flight attendants to do their drink service, and asked what our arrival in Minneapolis looked like.  To my astonishment, they said they anticipated arriving on time!  I was more than a bit skeptical, but simply resigned myself to whatever fate lay in store for me.  When we landed in Minneapolis, I noticed we disembarked at least 5 minutes ahead of schedule!  Either that pilot broke some speed limit rules, or the schedule has a lot of fat built into it.

My flight to Dulles was a bit less exciting.  I was seated amidst what had to be a class trip to the nation’s capital by a high school or college class.  These kids were all hyper, chatty, and well-armed with smartphones, tablets, and laptops.  Everything went optimally upon arrival at Dulles.  I had an hour and a half to wait for the shuttle to NIH in Bethesda, so I looked for a place to eat lunch.  I found an appealing place that had the Washington Redskins game on TV, so I stopped in.  The menu was diverse, but expensive, so I opted for a bowl of tortilla soup and a glass of lemonade.  The Redskins were losing, which seems to be their lot these days.  The locals were not happy!  It was funny seeing former longtime Denver Bronco coach Mike Shanahan pacing the sidelines.  Eventually, I went outside to the lane where the shuttle picks folks up.  It was a gorgeous late autumn day.  The temperature had to be in the low 60′s.  I sat there from around 4:05 p.m. until 4:27 p.m., when the shuttle showed up.  It was scheduled to depart the airport at 4:30 p.m.  The driver had the football game on the radio, and seemed as concerned as the other locals I had encountered in the terminal.

We had to wait a few minutes before leaving the airport.  I think it was 4:32 p.m. when we finally pulled away.  As we moved onto the freeway, the driver announced that we would arrive at NIH well ahead of schedule, since it was Sunday, and the traffic was so light.  (He didn’t mention the potential impact of the Redskins’ game, but I’m sure it was also a factor.)  He told us it would take a half hour.  I timed it, and he was wrong.  It only took 28 minutes!  That was probably the fastest one-way trip from either Reagan or Dulles to the NIH campus.

I checked into the Safra Family Lodge and called my sister, Barb’s, cell phone.  She and her husband, John, were sightseeing in the city.  I caught them as they were wrapping up a tour of the war memorials, the Lincoln Memorial, and the Dr. Martin Luther King Memorial.  They were heading for the nearby Metro station, to catch a commuter train north to Bethesda.  Barb was going to join me on the unit for her two-year interval imaging and testing, a year late.  We had discussed the possibility of going to dinner at P.F. Chang’s.  Barb confirmed that they were still interested.  She asked whether they should get off at the Metro station at NIH, and meet me at the Family Lodge.  I suggested that would be a waste of time, and given that the P.F. Chang’s in White Flint was just two stops north of NIH, it would probably take me about as long to walk down to the NIH station as it would take them to get back north from the city.  We agreed to meet at the White Flint Metro station.  Whoever got there first would wait for the other party.

I figured it would take me 15 minutes to walk down to the Metro station, but I also had to allow for time to get out of the Family Lodge, and to purchase a ticket at the station.  All in all, I estimated it would take me between 25 and 35 minutes to actually catch a northbound train.  Off I went to the NIH Metro station.  Daylight was fading, but the air temperature was comfortable.  I estimated it to be in the vicinity of 60-62 degrees F.  My estimate of transit time to the Metro station was spot on.  Unfortunately, since I have not used the system very much, it took me longer than planned to decipher the ticketing system (actually very easy and user-friendly, once you get familiar with it).  I hurriedly made my way to the train platform.  There were a few other passengers awaiting trains in both directions.  I checked the electronic readerboard for anticipated arrivals/departures.  The southbound board showed 3 different trains en route, each one roughly 5 or 6 minutes behind the other.  The next one was due in two minutes.  Unfortunately, the northbound board was inoperable.  I had no way of knowing how soon the next northbound train would arrive.  Given the southbound schedule, I reasoned that the longest I would have to wait might be 5 or 6  minutes.  Within minutes, a southbound train pulled in, unloaded and loaded passengers, and resumed its journey.  It had to be at least another 4 or 5 minutes before a northbound train showed up.  I must have just missed the prior train!  I was surprised to see this train quite crowded.  The southbound train had been relatively empty.  After boarding, I ascertained the source of much of the crowd.  This train was packed with disconsolate Redskins fans.  It was depressing just being around them, but I put on my game face, knowing I had no emotional buy-in.

As we approached the station at White Flint, a youngish couple across the aisle got up and readied to disembark.  I stood up and waited right behind them.  I heard the woman ask the man if he knew where they were supposed to go when they got off the train.  I couldn’t make out his reply, but I got the distinct impression that they were as foreign to this environment as I was.  Upon reaching the platform, the couple hung a left, and swiftly started walking south.  I, on the other hand, hung a right, only to realize that the platform dead-ended in a few train car lengths.  Obviously, one had only one direction, i.e. south, to exit the platform.  These trains were fairly long, probably consisting of at least 8 or 10 cars, maybe more.  I was toward the front of the train, perhaps in the second or third car from the front.  I had looked around for my sister and brother-in-law upon boarding at NIH, but had not spotted them.  I thought it would be ironic if they were on the same train.  By now, I expected that they had caught an earlier train, given my futzing around with the ticket purchase system.  As I walked down the platform, I saw my sister and brother-in-law up ahead.  They had approached the couple from my car, asking them if they knew where P.F. Chang’s was.  I snuck up behind Barb and John, just as the couple were starting to explain that this was their first visit to White Flint.  I put one arm around Barb’s shoulder, and the other around John’s; and said “Don’t bother these people.  They are as unfamiliar with this place as we are.”  Barb and John started laughing, and the couple vacated the premises.

My sister and brother-in-law had indeed been on the same train I was riding, just several cars behind me.  We proceeded to the Metro terminal, where we found a pleasant young woman, who gave us explicit directions.  We just had to walk a couple blocks south.  I felt confident that I would recognize landmarks as we got close, because I have visited this restaurant at least 3 or 4 times in the past 2 years.

Upon arriving at White Flint Mall, where P.F. Chang’s is located, we realized there is a Cheesecake Factory right next door.  Barb and John had eaten dinner at the Cheesecake Factory in Bethesda the previous evening.  I was destined to eat dinner there on Monday evening.  We had a lovely dinner.  We were blessed to have the best waitress I have ever had the privilege of being served by at a P.F. Chang’s, and they have a lot of talented help!  Barb couldn’t resist taking a few photos to send back to the family in Colorado.

Turnabout is fair play, so I took a photo of Barb and John:

We rode the train back to NIH, and caught a ride to the Family Lodge with one of the NIH police.  It was considerably cooler outside, and the ride was appreciated.

Barb made it over to the Clinical Research Center (Building 010) on Monday morning well before 7:00 a.m.  She put my name on the waiting list to meet with the Admissions staff.  I arrived about 5 minutes late, just as they were calling my name.  It was a sweet experience, compared to times past.  I was whisked away by one of the folks that had admitted me earlier this year, either in May or July.  We were finished in a matter of 10 or 12 minutes.  Unfortunately, someone had screwed up on Barb, and not gotten her paperwork to Admissions.  Thankfully, that mistake was remedied fairly quickly, and before long, we were both off to 5-NW, the unit where we would stay for the next 3 days in my case, and 4 days in Barb’s.  John was with us throughout this preliminary stage.  He had a room at the Family Lodge for the duration of Barb’s stay, which was quite handy.

Having been through the routine twice before, the most recent having been in May, I knew that we would have to head back downstairs for the customary intake blood draw, along with a few other procedures (EKG included).  That is where our paths diverged.  We were both scheduled for many of the same scans and tests, but at different times or on different days.  John stayed with Barb as much as possible, which I am sure she appreciated.  I know how much I enjoyed Jane’s company on my two prior visits.

We were both given a new type of combination PET/CT scan.  Barb was told she would be the first patient from our research protocol to be run through the machine.  I was the second.  I asked the technician what the benefit of having one machine do both scans was.  He told me that it eliminates a calibration problem that exists when doctors or radiologists view scan results.  A CT scan and a PET scan done on separate machines are hard to overlay, but with the new machine, it is done automatically.  We were given carbidopa (AKA F-dopa), the marking agent that had turned up my carcinoid tumors in May.  It is the material that lights up on the scans in the presence of the tumors.  This particular diagnostic measure is only available at two institutions in the U.S., NIH being one of them.  We are hoping that my brother, Dan, who was the first family member diagnosed, will visit NIH one of these days to take advantage of this groundbreaking technology.  NIH is more than willing to host him, even if it is just for the benefit of this scan.  This technique will spotlight small carcinoid tumors early on, before they have a chance to cause trouble or spread to other parts of the body.  In my case, I was asymptomatic when this process identified my tumors in May.  (Actually, I was somewhat anemic, a condition which has been rectified by the surgery.)

On Monday evening, before I left the unit to meet my friend, mdmatt (Maryland Matt for you Yellowstone Loons), and do dinner at the Cheesecake Factory, I stopped by Barb’s room.  Both Barb and I had the trappings of the wonderful world of inpatient existence, e.g. I/D band, IV port(s), and remnants of our trip to the phlebotomists.  Barb asked John to get a photo of the two of us, sporting our recently acquired paraphernalia:

After the photo session, I hustled down to the gate near the Metro station.  Matt was parked in a small lot that is outside the security fence, but in close proximity to the Metro station and the security facility located nearby.  It was rush hour, and the traffic was backing up, as is customary that time of day, where the east side traffic tries to access Rockville Pike, AKA Rte. 355.  There were busses everywhere, along with private vehicles.  Matt and I were conversing via cell phones as I approached on foot.  It is hilarious how close we were to each other, without realizing it.  After a few minutes wasted overshooting the area where Matt was parked, I finally got it figured out, and jumped in his car.

We headed north to White Flint Mall, and the Cheesecake Factory.  I had not been in one of these establishments since I lived in Las Vegas in 1998.  Unfortunately, I was temporarily on a combination Low Histamine/Low 5-HIAA diet.  It really limited the types of foods I could indulge in.  I will make a long story short, and tell you that the waitress was incredible!  The dietician on 5-NW had recommended the Cheesecake Factory as a place that has a diverse menu and a willingness to make substitutions to accommodate exotic diets.  It took me 10 or 15 minutes to find something I thought was acceptable, only to have the waitress recognize that there was a constituent in that menu item on my “prohibited list”.  After going back to the menu, I solicited her input.  She suggested a type of salad that sounded good.  When it arrived, I noticed it had lots of baby spinach in it.  I love the stuff, but it was expressly forbidden on my diet.  The waitress took it straight back into the kitchen and substituted iceberg lettuce.  She did not seem the least bit frustrated.  Then came the entree.  That was another piece of work.  She, Matt, and I collaborated to select a particular dish, and then figure out how to have the kitchen use different ingredients.  The waitress did most of the brain work.  Needless to say, the waitress got a sizable tip, which she definitely earned!

Ironically, I had a roommate, who had just recently had the same surgery I did in August.  He was a good 10 or 15 years older than me, but in good shape physically.  His name was Eric, and he was a former naval officer.  He was from Boston, but his sister and brother-in-law lived in the Washington, D.C. area.  I met his sister, and found out she had presented with carcinoid tumors a decade or two before her brother.  She has been through the surgery and other treatments, including that administered through the trials under way at LSU.  She is well familiar with several of the physicians that my sister, Barb, sees periodically.  Getting those two together was a sort of “completing a loop”.  Here Eric and I were relatively new to this stuff, but these two women were “old hands”.

Eric’s big adventure was to be chosen as one of two patients representing 5-NW at an address being given by none other than Secretary of State Hilary Clinton on Tuesday.  Speculation ran rampant as to what she was going to talk about, and why she was visiting NIH.  Nobody got close to figuring out why she was visiting.  On Tuesday, Eric was taken down to a very large auditorium that must be in the old portion of the Clinical Research Center (because I am sure I would have stumbled onto it if it was in the newer portion).  He was told he needed to be down there by 10:30 a.m.  He left the unit shortly after 10:00 a.m., and waited until close to 11:30 a.m. in a mostly vacant auditorium, until the crowd started to show up.  Eventually, the place filled.  There were many dignitaries, including high visibility people from other countries and the U.N.  Secretary Clinton’s address had to do with the international fight against A.I.D.s.  From what Eric told me, it sounded like an update on many promising developments in the research and treatment areas, as well as a call for renewed efforts to battle the dread disease.

I was an inadvertent beneficiary of Eric’s presence.  Dr. Hughes, the surgeon who operated on me in August, was also his surgeon.  I got to see her, and chat with her on several occasions during my visit.  She is such a warm, wonderful person.  She has the persona of a soccer mom or a grade school teacher, but she does some amazing surgery for a living.  I feel so privileged to have met her.

While all this was going on somewhere in the labyrinth, I had the first of two consultations with the lymphoma specialists.  I had an MRI scheduled for noon.  I got there just in time for the technician to leave for lunch.  That turned out to be fortuitous, because the supervisor of the imaging area spelled him.  I got the chance to query him about the exotic new PET/CT machine.  He told me that as expensive and fancy as that was, the new PET/MRI machine was even more expensive and fancier.  I had gone 12 hours without food.  I was not allowed to have water after 11:30 a.m., due to being scheduled for a 5:00 p.m. CT scan.  The procedure has changed.  We are no longer thrown in with the outpatient and inpatient masses who frequent the CT area.  Now, the unit takes responsibility for doing the prep, and sending us down to the scan area within a half hour or hour of the event.  I had to take the usual 3 bottles of CT volumen, spread over an hour or hour and a half.  I missed out on sitting in the waiting area, doing intensive people watching.  I will not elaborate on what that people watching is like, but I will say that because it is at NIH, and a wide variety of patients are scanned, you get to see all spectrums of the American demography, not to mention eye-catching female doctors, nurses, and technicians.  Historically, it has been one of the highlights of my visits, but it is no more.  My scan session was classic CT scan.  It was over quickly, almost before I got comfortable.  It is so much faster than the other scans!

Once my CT scan was concluded, essentially, I was finished with my scanning and testing, with the exception of the last half of a 24 hour urine collection and a blood draw on Wednesday morning.  I still had dietary restrictions in place that evening, but at least, I was able to order dinner of some sort.  My flight was scheduled to depart Dulles at 7:05 p.m.  In order to catch that flight, I had to take the 3:30 p.m. shuttle.

On Wednesday morning, I had myriad visitors.  First, the phlebotomist stopped by for one last blood draw.  Then, the oncologist from the previous day and an oncologist I had met with in November of 2009 stopped by to let me know they had reviewed my latest images.  They also conferred with Dr. Wyndham Wilson, who leads the lymphoma research team.  Their collective opinion was that there is nothing visible that is cause for concern at present.  Essentially, this means that the disease appears to be stable, and not growing.  That is really good news!  I feel good about the fact that I will be seen again by NIH in May, 2012, November, 2012, and May, 2013.  That is some intense monitoring.

I can’t remember the exact order in which I was visited by Dr. Wank, Dr. Trivetti, and Joanne Forbes, but I know that eventually, all 3 of them were in my room.  Shortly thereafter, Barb and John stopped by.  It was a real gabfest, with multiple conversations going simultaneously.  I was told that the images confirmed that Dr. Hughes had gotten ALL of the carcinoid tumors in August, and there was no other areas of serious concern.  There was one relatively minor area that they addressed, which was the fact that my TSH (Thyroid Stimulating Hormone) level keeps rising.  It was slightly above normal in May, a slight bit higher in July/August, and a fair amount higher yet in November.  Yet, my thyroid gland seems to be OK, based on other indices.  The doctors recommended I mention this to my local doctor(s) when I see them next.  (More on this further down in this entry)

As long as Barb was around with her camera-equipped cell phone, there were always photo opps.  This time was no exception.  She wanted a photo taken of the two of us:

I’m going to throw in a photo that was taken of Dr. Trivetti, Barb, and Dr. Wank (l. to r.).  I’m not even sure whose room it was taken in, probably Barb’s:

I visited the folks that handle patient records, to place an order for a DVD with the scan results, as well as any appropriate paperwork.  I had a visit with my oncologist scheduled for December 5, and using my recent CT scan results would save me money and additional exposure to whatever radiation or rays come with the procedure.  That was a fairly quick endeavor.  I returned to my room, and ate lunch.  Before long, it was time to head for the airport.  Thankfully, we beat most of the rush hour traffic, so the journey was almost as fast as that on Sunday afternoon.  I had plenty of extra time to wander around the airport, which I did.  I got in a lot of walking.

The flight to Minneapolis was routine, although I remember getting progressively more uncomfortable in the tiny seat.  These commuter-size jets are fairly downsized, in terms of seat width and leg room.  They are all about being cost-effective, thus comfort suffers.  My stop in the Twin Cities was uneventful.  Unfortunately, the food break I had been so looking forward to turned into a bust.  Quizno’s pulled out of Bozeman last year, and I miss that cuisine big time!  I got to the Quizno’s in the airport shortly before their closing time.  I felt lucky, because I just made it.  I asked them to send the sandwich through the toaster oven twice, because I like it well done.  Sadly, what I got, when I unwrapped the sandwich, was just the opposite.  This sorry Classic Italian had not gone through the oven at all.  It was almost as sorry as what Subway serves up in this genre.  By the time I noticed the mistake, it was too late to rectify it.  I was stuck eating a super bland sandwich, and my dream was bordering on nightmare.

OK, so it could have been much worse.  I told myself that I would be home soon, and then I would be free to eat whatever I wanted, whenever I wanted.  I also was very much looking forward to seeing my lovely bride at the distant end of my journey.  She was going to pick me up around 11:30 p.m., and I was excited about that conclusion to my trip.

The homeward leg was easily the most uncomfortable of the trip.  I vowed I would not fly this route again in the future.  It is a shame, because the fare is significantly cheaper than the other airlines and other routes.  I just don’t want to feel so uncomfortable again.  I’ve never felt like that in an aircraft before.

I was never so glad to exit an aircraft!  I was thrilled to see Jane, and throw my arms around her.  I luxuriated in the relative opulence of the seat in her pickup.  It felt so spacious and accommodating compared to what I had been cooped up in.

You have patiently read through this long tome, and before subjecting you to the account of my December oncologist visit, I will treat you to a couple recent photos, taken on the Saturday of Thanksgiving Weekend and the Monday following.  Both series were shot with the camera on my Droid Bionic.  Saturday’s photos were taken after we finished taking care of the horses.  Monday’s were taken out front, looking down the driveway.

SATURDAY’S PHOTOS

Shadow (at left) and Doughboy eating grain as the sun sets

Almost Christmas card quality, thanks to a great sunset

Shadow and Doughboy again, with that killer sunset behind them

MONDAY’S PHOTOS

THE SHOW BEGINS

ZOOMED IN

ZOOMED IN FURTHER

December 5 & 6, 2011

My regular periodic appointment with the local oncologist was deliberately scheduled for a month after my NIH visit, to take advantage of the availability of NIH CT scans and other images, as well as the extensive blood work.  Jane joined me.  I was surprised to discover this was her first time accompanying me to the oncologist.

Initially, the newfangled PET/CT images were giving the oncologist trouble, but after playing with them a bit, he figured out how to toggle his way through the images he wanted to see.  He seemed satisfied that Adolph is a mere shadow of his former self, and not doing anything.  Checking the lymph nodes, with both a physical inspection and a look at the NIH images, he came to a similar conclusion as the NIH lymphoma specialists.

I mentioned the steadily increasing TSH levels.  Initially, he did not seem overly concerned, but over time, he appeared to be developing a strategy.  I have seen him at work before, two years ago, when we were debating what to do about Adolph.  This fellow takes time to deliberate findings and develop a cogent strategy.  I believe he is very good at what he does, but he needs a little time to deliberate all the evidence.  The worst thing someone could do would be to rush this guy.  I would be willing to sit in his office for hours, if that’s what it took, but it doesn’t.  He is thinking while he is conversing, constantly processing.  On this day, after giving the situation much thought, he decided to contact my primary care physician, and consult with him.  He explained that although my thyroid gland appears normal, there is cause for concern regarding the increasing TSH levels.  Over time, they could excite the cells of the thyroid, resulting in an eventual cancerous growth.  As soon as he mentioned the “C” word, I was 100% attentive!  I decided that whatever he thought was appropriate was the course of action I would take.

We decided that since I will be undergoing another battery of scans and tests at NIH in May, I should see the local oncologist again in June.  The appointment people decided it might be best if I just contact them after I get back from NIH.  That makes sense.

On Tuesday, the 6th, my mind was everywhere but on my medical situation.  I was wrapped up in work on the new business, watching the yo-yo action of the equities markets, and thinking about the impending 70th anniversary of the attack on Pearl Harbor.  Late in the day, around 4:30 p.m., I got a phone call from a nurse at my primary care physician’s office.  She told me that my regular doctor and the oncologist had communicated, and the decision was made to put me on Levothyroxine.  She called in a prescription to my pharmacy.  I picked it up that evening, and have been taking it since Wednesday, the 7th.  So far, there have been no noticeable side effects or even “effects”.  I have an appointment to see my primary care physician in late January, after having blood work done.  My understanding is that we will look at whether the current dosage is appropriate, or whether it needs to be increased or lowered.  From what I have heard from other folks on thyroid hormones, this is a typical course of action.

So, there you have it.  You are up to date on my medical situation.  Unless something of note occurs, or there is something big discovered in late January, I may not update the medical portion of this blog again until after the May NIH visit.  That sounds real good to me, because I would much rather blog about other goings on, including trips to Yellowstone.

Merry Christmas – Happy New Year

Ballpark

Much has transpired since my last blog post on August 24.  I will share what I can, but I have to mention that there are a number of subjects, particularly regarding the new businesses we are launching, that I cannot get too specific about.  Hopefully, with the passage of additional time, I will be able  to be more forthcoming.  We are midstream on one business creation, and just at the front end of the other.  There could be a third at some point down the road, but we are deliberately holding back on that one for now.

This started with a cluster of motivations.  First, Jane really likes having both her daughters in close proximity to her, not to mention her son-in-law and two granddaughters.  Second, the job opportunity in Alaska is not near and present, due to the order in which the hiring authority has opted to fill vacancies.  The position that a number of learned people are encouraging Jane to apply for will not likely be advertized until after the first of the year.  Third, relocating to Alaska would pretty much sever many of my ties to Yellowstone National Park, at least for the duration of my absence.  At some magic point in late August or early September, we jointly made the decision to create a grant-writing, grant-management, grant consulting business.  It is a natural for us.  Jane has considerable experience in writing research grants.  I have formal training in grant-writing, experience in multiple local governments writing and managing grants, and both formal training and experience in consulting.

Once word got out among Jane’s contacts, it did not take long for a number of people to approach her with business opportunities.  She is already working in a business that is only partially “created”.  We hope to have all the important parts of the business formation in place by week’s end.

In the midst of our work on this endeavor, a former business associate of Jane’s approached her about another opportunity, actually two different opportunities.  One we are pursuing, while we delay dealing with the other until we get these first two operations on their feet and flowing cash.  While these opportunities do not mesh perfectly with the grant business, there are a number of economies of scale that we can derive regarding web presence and other business infrastructure.

There is a third consulting opportunity that involves both Jane and I, each in different areas of specialty.  I am not at liberty to get into details on it at this juncture, but hopefully, the time will come when I can go public with more specific information.

If any of you have launched a new business, you have a feel for what we are going through at the moment.  I’ve done it several times in the past, so, thankfully, this is not uncharted territory.

The period of time between my return from Bethesda, in mid-August, and the end of my hiking/lifting restrictions on September 28, was frustrating to say the least.  There was so much that needed to be done, and I was consigned to sitting on the sidelines.  Thankfully, Jane’s daughters and son-in-law made themselves available to assist where and when needed.  One of the projects was the assembling of a new office workstation for me.  I am very grateful for the assistance provided by those Jane and I lovingly refer to as “the kids”.

Speaking of the kids, Sara started back to college in September.  She is pointed toward the nursing curriculum.  At the same time, Sara has been attending training and responding to calls with the Bridger Canyon Volunteer Fire Department.  She was also recruited to assist in training new EMT’s in Bozeman this fall.

Ryan has rejoined the same fire department.  He and Sara have responded to several structure fires in recent weeks, one of which unfortunately killed one of the residents.  Ryan has been recruited by his former employer to fill in when there are absences.  He has several other career opportunities in the hopper, and hopes to have a rewarding position closer to home soon.

While Ryan is playing “Mr. Mom”, Kassia has made a big splash with her employer.  This very successful newish business has been given recognition at the state level for their achievements.  Thankfully, the owners are very “employee-friendly” folks, who take care of their workers.  Kassia has been making a substantial contribution to business success, and has been rewarded for doing so.  Jane and I are very excited for Kassia and her career situation.

Layla and Nora continue to make great strides developmentally.  (It’s been a while since I have been so close to toddlers.  I guess I forgot just how fast kids grow their skills and abilities at that age.)  Nora has gone from standing shakily to walking a few steps, and now walking for many steps.  She celebrated her first birthday last week.  Layla is now spending a couple mornings each week in a pre-school setting, and she loves it.  Unfortunately, there is some sort of apparently viral illness making the rounds, and many of us have been victimized.  Layla has already recovered from her bout, but her little sister is still suffering from a fever and other symptoms.  (I had something similar, possibly identical, for 3 weeks, and I still see the occasional symptom, primarily sinus congestion or coughing.)

September saw the unfortunate news that Brenda, Jane’s sister-in-law, was found to have cancer.  Brenda is in her 50′s, and seemed quite healthy.  She has something bothering her, went to the doctor, and after a number of diagnostic procedures, she was found to have cancer in her thyroid gland and several places in her abdomen.  Brenda is now undergoing chemotherapy in the Everett-Seattle area, near where she and Jane’s brother, John, live.  Please remember Brenda in your prayers.  She is a very loving person, who deserves a better fate than to become another cancer statistic.

A few of you might have noticed I disappeared from Facebook.  I know a few folks saw my last Facebook post, and replied to it.  My reason for leaving Facebook was the realization that I was not a “good” or “typical” Facebook user.  I rarely posted anything.  I had quite a number of Facebook friends, but some were former high school classmates, who I hardly knew back then, and have not kept up with since.  Many other Facebook friends were Yellowstone Loons, who were simply networking with as many Loons as they could find.  I do not rely heavily on the Loon community for emotional support or conversation.  I have my own circle of Loon friends, who I e-mail with, and hike with when they come to Yellowstone.  Then, there were the hodgepodge of extraneous people, including youthful nephews and nieces, former co-workers, and friends of friends.  I found myself blocking a fair amount of the trivial communications being posted by my Facebook Friends.  (I’m sitting here, wrestling with two forms of cancer, unemployment, and the resulting cash flow problems, and it is hard to get excited about the emotional tribulations of 20-somethings that have their hearts broke because they rely on the bar scene to supply them with friends and lovers.)  The recent changes that Facebook sprung on their users were the straw that broke the camel’s back.  Suddenly, I could not access the posts of people I really care about, because a server somewhere in cyberspace decided that I should see certain posts, summarily declared to be more “popular”, simply because more users had clicked on them.  Then, I started getting Facebook spam, trying to further integrate me into that manufactured madness.  I dropped that piece of “cyber-baggage” like a hot potato.  I looked around, and realized that many of the most together people I know do not belong to Facebook, or for that matter, any other social networking site.  I have gotten invitations to LinkedIn, but have not responded to them.  I am waiting for something else to come along.  Who knows what that will be, but I know I don’t belong in the weird, wacky world of Facebook!  I have better uses for my time.

I am not sure if I ever mentioned this within this blog.  I have been participating in the Yellowstone Bison Citizen’s Working Group, which was created at the request of the IBMP partners in January.  If you are not familiar with the IBMP, don’t worry about it.  It is a complex creation, over a decade old, consisting of federal, state, and tribal partners, designed to address the problems presented by Yellowstone National Park’s bison migrating out of the park during the winter.  I’m just including this info in this post for those of you who follow the bison and brucella abortis issue.  Our group started out meeting for 2 or 3 hours on a weeknight, once a month.  Over the past 4 months, we have dedicated an entire day each month to working on our charge.  We have been exposed to the thinking of some of the finest minds that grapple with this gnarly situation.  Our last work meeting is scheduled for November 14.  After that, we present our recommendations to the IBMP partners at Chico Hot Springs on December 1.  The one key discovery that I have made is that having considered myself fairly knowledgeable on the subject, I have learned via this process that there are a whole bunch of people around here who are much more learned than I.  It has been a great learning experience.  I have a much greater appreciation for how complicated the issues are.  I just hope that within our group’s recommendations, the IBMP partners will find ideas of merit, which help move us closer to the ultimate solution.

The last thing I want to mention is that we have been blessed with incredible autumn weather.  In fact, August’s late summer weather transitioned to September’s early fall weather seamlessly.  We have had a few cloudy/rainy days here and there, but we also had 2 and 3 week periods of sustained sunshine.  This was reflected in the best fall color display I have ever witnessed in northern Yellowstone.  It started in mid-September, and as of last Friday, there were still aspens on the Northern Range that had a mixture of green leaves, orange leaves, and yellow leaves, along with some bare branches.  My Yellowstone Trip Report post will contain photos that bear testimony to what a wonderful autumn we have experienced.

Ballpark

My last post was August 24.  I am not sure I had received the paper copy of the pathology report and the operation report at that point.  I know there were no surprises in there.

My recovery continues.  I made it to the magic September cessation of hiking and lifting restrictions without any major slip-ups.  My oh so cute granddaughter, Nora, almost undid me twice, by putting her arms up in the universal symbol for “pick me up”.  She was 10 months old the first time, and 11 months old the second time, so I couldn’t have her arrested for “malicious intent”.  I guess there is no law against an infant being drop dead cute!

Jane was a recurring life-saver throughout my post-operative ordeal.  I can’t relate how many times she served as my “surrogate brain”, and saved me from myself.  Repeatedly, I would go on auto-pilot, and come close to performing some task that I have done hundreds or thousands of times before.  Thankfully, Jane would remind me that I was flirting with a hernia or some other dread consequence if I persisted.  My sweet wife would inspect my incision and change the dressing twice a day initially, later moving to once daily.  This was such a new and unfamiliar experience for me, but being a medical researcher, Jane knew exactly what was going on and why.  She reassured me that what was going on was actually normal, in spite of my occasional paranoid lapses.

At this point, the upper part of the incision is very well-healed.  Jane asserts that ultimately my abdominal surgery scar will be much less visible than hers, which dates back a fair number of years.  The lower half was the source of some post-operative “leaking”.  It is all close up now, but it is still healing underneath.  There is some hardening of the normally soft tissue, while it is “remodeling” (Jane’s term).  Once in a while, I will feel some minor discomfort, usually, because a large belt buckle was making its presence felt.

Unfortunately, in some respects, my digestive system has returned to near pre-surgery form.  In those early days after arriving back home, I was eating small meals throughout the day, typically anywhere from 4 to 6 times daily.  My bowel movements paralleled the meal frequency.  The return to normal was a step process, gradually reducing the number of meals, as well as the consequent voiding of waste, until, by early September, I was eating 3 meals a day and not wearing a path to the bathroom.  The bad news is that I have been slowly regaining the weight that was lost.  Even my return to hiking has not been adequate to stem the tide.  Eating Jane’s cooking, which is outstanding, has not helped.  My only salvation is our joint commitment to portion control.  I grew accustomed to the way my clothes were fitting my body, and I know how much of an improvement weight loss will make in my hiking and skiing ability, so I will keep working to shed pounds.

My 3 month follow-up at NIH is scheduled for Monday, November 7, through Wednesday, November 9.  I will fly to Dulles on Sunday, the 6th, which, unfortunately, is Closing Weekend for the interior roads in Yellowstone.  This will be the first Closing sunday I have missed in 11 years!

My sister, Barbara, will be at NIH the same week.  She will be there a few days longer than I will.  Her husband, John, will accompany her, so that should contribute to her comfort.

The Familial Carcinoid Tumor staff are supposed to be arranging for a consultation with the lymphoma research people for me.  I hope they can make that happen.

My use of CPAP technology continues.  It does wonders for my sleep apnea, and I feel much more rested on the same amount of sleep.  Jane says it has made a world of difference in me.

Barring some totally unexpected medical development, I would expect to be posting my next medical update shortly after my return from Bethesda in mid-November.

Ballpark

On the morning of August 3, a couple of good-natured, somewhat comedic fellows, from Transportation, showed up at my room on 5-Northwest (5-NW).  They had me hop onto a gurney, for the ride down to the pre-operative surgical area.  I remember vividly that there were heated blankets on that gurney.  Since I was just wearing one of those classicly-unflattering gowns, the extra warmth felt good.  Jane accompanied us, which was very important to me!

Upon arrival in the pre-op area, we were ushered into a hospital version of a “cubicle”.  It was a busy little place.  There were curtains that obscured any view from about 3 or 4 feet to the ground, but you could see out through some sort of thin plexiglass-like sheeting to the adjacent “cubicles”.  There were at least 5 or 6 of these little “rooms”, possibly quite a few more.  There was a little girl, probably 8 or 9 years old, across from me diagonally.  Her parents were with her.  She looked more than a bit apprehensive.  I did my best to give her a smile of encouragement, not having a clue what kind of surgery she was scheduled for.  (The children have their own unit, down on the ground floor, on 1-NW, and there might be others.)

We hung out there for probably 10 minutes or more, until one of the nurses showed up.  The first nurse seemed somewhat aloof, and a bit disorganized.  I was thrilled when she said something to another nurse about somewhere else she had to be, or something else she had to do.  The nurse that replaced her was a quantum leap more friendly, and seemed a whole lot more comfortable with what needed to be done.  I can’t remember all the fine detail, but I know they put two large I.V. ports on the back of each of my hands, near the wrist.  (They obviously had no desire or need to use the smaller one inserted up on 5-NW the previous evening.)  I was given the typical initial sedation, as well as the local anesthetic, preparatory to the serious stuff.  I was to have an epi-dural, essentially identical to that which is commonly used on women during childbirth.  It requires the placement of a catheter or needle into a very specific area near the vertebra.  If it is one vertebra too low or too high, you don’t get the pain deadening on the correct nerve bundle.  I remember having to bend forward, essentially doing the opposite of arching my back, to spread the space between the lower vertebra.  It seemed to take a bit of time to accomplish this procedure, but I know it was well worth it.  (Here is one of the best aspects of this relatively new approach to pain management for surgery patients.  Post-operatively, you are given a little pump that you can trigger, whenever the pain warrants it.)

It is somewhere in this time frame that my life changed irretrievably.  I moved from having a relatively scar-free body (my mediastinoscopy was done by a virtual Michelangelo, and is very hard to see) to possessing one of those lengthy, gawdy skin intrusions that small children find themselves staring at in locker rooms or at beaches.  Sometime, shortly after the epi-dural anesthesia apparatus was hooked up, someone or something put me under.  The next thing I remember, I was being woke up in one of the cubicles reserved for post-operative patients.  I had severe pain in my abdomen!  Someone was asking me to rate it on the classic 0 to 10 scale of pain, where 0 represents being pain-free, and 10 represents the worst pain you have ever felt.  I was scoring the feeling in my belly between and 8 and a 9.  It was constant and unrelenting.  I could hear several different people, most likely the anesthesiologist and one or more nurses, talking back and forth, as they worked to address what was apparently an abnormal situation.  It was at least 30 minutes, maybe closer to 45 minutes, before I felt substantial pain relief.  I had visibility to a clock, and was able to determine I had regained consciousness around noon, or shortly thereafter.  To say I was impatient to get the promised pain relief would be understatement, but I just laid there, suffering, answering their interrogatories whenever they asked for the latest pain rating.  I guess I should have told them that ordinarily I am much more pain resistant than the average person.  I have war stories that some folks would label “Bravo Sierra”.  (In one case, while engaged in a judo match, my opponent and I each had the other in a choke hold.  I was told by my sensei and my wife that I had turned bluish purple from lack of oxygen, when they finally stopped the match.  My opponent was the victor, if for no other reason than having a superior position over me.  I was laying on the floor, but convinced that I was slowly gaining the upper hand with my superior choke hold on him!)

Shortly after my pain seriously subsided, somewhere around 12:45 to 1:00 p.m., I was wheeled to the 3-NW unit, where I would remain from Wednesday afternoon until Sunday afternoon.  Later that afternoon, a person from the Anesthesiology department stopped by.  She appeared to be doing a routine post-op inquiry on pain management.  She was full of questions about my pain management immediately post-op.  I told her about how I was in major pain for quite some time, and had been told in the Pre-Anesthesiology Clinic the day before surgery that I would not be feeling such pain.  The woman seemed very upset about that.  She gave me the impression that they had a periodic problem in the Anesthesiology department that needed addressing.  She thanked me for my candid input, and told me that what I experienced was not the norm, and should not have happened.  She said that someone else would be up to collect more information.  It almost sounded like it would be an auditor type individual, conducting a quality control investigation.  Instead, the anesthesiologist appeared an hour or two later.  She explained that my sleep apnea had complicated the transition from surgical anesthesia to post-operative anesthesia.  Apparently, at one point, she could not launch the epidural, for risk of having my breathing interrupted, once they pulled the trach tube.  What she explained kind of made sense, but I wish someone would have warned me of the possibility the day before.  (I have included all this detail, for the benefit of anyone who reads this account, and has to undergo abdominal surgery, or knows someone else about to make the trip.  If they suffer from sleep apnea, it can be a complicating factor in the anesthesia; and they absolutely need to alert the anesthesiologist prior to surgery!)

Once the epidural kicked in, my life changed drastically for the better.  It really is something of a “wonder drug”.  Here I was, fresh from major surgery, and I was feeling plenty good.  There is a danger that one could feel “too good”, and start doing dangerous things, thus the nurses are contantly reminding you about lifting restrictions and other concerns.

Jane told me what she had already learned from Dr. Hughes about my surgery.  Later that day, Dr. Hughes and Dr. Beard (27 year old research fellow, and absolutely GORGEOUS), would stop by and deliver more detail, and answer any questions.  My incision was much longer than anticipated, because Dr. Hughes had to go searching for the suspicious-looking lymph node that had appeared on May’s CT scan.  She never did find it, but she did remove a lymph node.  We are still awaiting the pathology report on that little hummer.  Dr. Hughes found 9 (NINE) little carcinoid tumors, all in one little area in my midgut.  She did a 77 mm resection (about 2.5 feet).  Two of the tumors were larger than the others, but none were at or above the magic 2 mm mark, where there is much greater risk of them spreading the disease to other portions of the body.  It appears that the early intervention was successful!

There is another “story within the story”.  A few of you are aware of the significant event that occurred in my life on August 24, 1979, but most are likely not familiar with it.  I will spare you the lengthy details.  For all I know, it may appear in one of my books some day.  It is a story worthy of inclusion in a book.  On that fateful day, a Friday, I went hiking solo in the Indian Peaks Wilderness.  My plan was to hike from the old Hessie town site area to King Lake, ascend Rollins Pass from there, walk north on the Continental Divide, descend Devil’s Thumb Pass, and return to the trailhead via Devil’s Thumb Lake and Jasper Lake.  I was caught by a freak thunderstorm.  I tried to wait it out initially, tucked down on the Divide, but it would not move.  It just sat, off to the west, north of the Winter Park Ski Area, maybe around the town of Granby.  I eventually jumped up and took off, moving north rapidly, in a low crouch.  In my haste to get out of there, I dropped down the west side of the Divide a wee bit, probably to avoid being the highest object around.  The storm suddenly started moving toward me rapidly.  I knew I had to get down off the alpine tundra to the relative safety of the sub-alpine forest.  I crossed the Divide, and started descending.  It didn’t take long to realize I had overshot Devil’s Thumb Pass by a good half mile or so.  I didn’t want to backtrack up to the Divide and head south on top, so I tried to cross a steep snowfield that blocked my route to the lower portion of the Devil’s Thumb Pass trail.  I recognized that the height and pitch of the snowfield presented a significant safety hazard, but I believe that if I lost my footing, I would simply turn my back to the snow, and slide down the field feet first to the bottom.  About halfway across, that is exactly what happened.  Unfortunately, I had misjudged the pitch and length of that snowy expanse.  It was very fast!  My feet were kicking up a granular snow and ice rooster tail that soared well above my head, and probably landed about 3 body lengths behind me.  I had neglected to factor in the boulder field at the foot of the snow field.  I hit it at high speed.  I received a serious compression injury to my lower spine, which initially paralyzed me from the waist down.  I was destined to discover, 5 or 6 weeks after the fact, that I cracked the lateral transverse process on one of my vertebra.  I received sufficient enough injury to my pelvic area that my hips and upper thighs were a mass of colorful bruises that metamorphed from one color stage to another (blue/purple/black/yellow, etc.) over the ensuing months.  The concussion of hitting the rocks, combined with my velocity, propelled me face forward into additional rocks, varying in size from basketball to large backpack-like.  I cut up my face and received some serious blows to my chest.  I woke up, lying on my back, with raindrops falling on my face.  I could not get up initially, but after 10 or 15 minutes of trying, I managed to get to a kneeling position.  The feeling in my legs was gradually returning, along with an unusual pain in my pelvic region.  I remember thinking that it felt like I had been laying on my side on a road, and been run over by a truck.  It felt like everything around my waist and groin had been rearranged by blunt force trauma.

The story of how I extricated myself, and received additional help upon reaching the east side of Jasper Lake is the stuff books are made of, including terror, intense pain, shock, and even some comedy.  When I reached the emergency room at the local hospital late that evening, there was one young doctor on duty.  This was pre-CT scan era, and x-rays were about it for diagnostic imaging.  The doctor did not catch the fractured lateral transverse process.  I had been worrying initially, while I was still above treeline, that I might have cracked a rib or two, which could easily puncture a lung or my heart.  I stressed about the possibility I could be slowly bleeding to death from internal injuries, and not know it.  My blood pressure must have looked good that night in the E/R.  They sent me home, with instructions to take some over the counter pain medication as needed.  Over the next month and a half, I suffered from a large numb spot on one hip.  While everything else was healing, this was making virtually no progress.  I finally visited a chiropractor, who looked at the x-ray, noticed the cracked lateral transverse process, and expressed surprise that it had been overlooked at the hospital.  The chiropractor was able to slowly eliminate the numb spot via spinal adjustments.  (I should mention here and now, that I have been a believer in chiropractic since my first experience, back in the early 1970s.  I have a great chiropractor here in Bozeman, who does wonders with me when I cause grievous harm to my body via backpacking, falling, hiking, or skiing.)

If you have read the blog entries that speak of my May, 2009 trip to NIH (not sure how much I reported on this subject), or my May, 2011 NIH visit, you have seen mention of the sophisticated imaging in Bethesda showing my bladder being “distended”.  I remember the technician in May of 2009 telling me he did not believe I had urinated immediately before the octreotide scan, as instructed, because my bladder looked as big and bright as a full moon on that big old monitor.  In fact, I had, and I did so again, before the second scan.  The technician complained that although my bladder looked “better” the second time around, he could see it slowly filling throughout the procedure (via the radioactive isotopes that “light up” on the monitor).  In May of 20911, after getting the final readout on all the imaging and blood tests, the protocol doctor requested a consultation from the Urology department.  Thankfully, further diagnostics proved that my bladder was functioning normally, and I did not appear to have any prostate pathology.

The day before my surgery, I told Drs. Hughes and Beard about my traumatic injury on 8/24/79.  I asked them to look around while they had me open, and see if anything looked out of place.  Talk about needing to advocate for your self-interest in these matters———I was to find out post-operatively that Dr. Hughes noticed my bladder appeared to have signs of traumatic injury from long ago.  It had moved up in my abdominal cavity, and adhered to the upper portion of my right colon.  She theorized that it had ruptured, and self-healed by attaching to the other organ.  She gently separated it, and allowed it to go back into a more normal position.  Now I know why I can often go for an incredibly long time without urinating, in spite of the fact that I pound water substantially, as a means of combatting my gout!!  My coffee-swilling teammates at U S WEST could not understand how I could go for hours in staff meetings, without calling a break.  Now we know.

That first afternoon/evening was a bit of a personal twilight zone.  The pain was being mitigated via the epidural.  I had multiple I.V.’s going.  One was administering fluids.  I was not allowed to eat anything yet.  I had a catheter in my bladder to take care of urination, since the epidural would render me unable to tell when I needed to urinate.  I felt very “hooked up”, maybe even “networked”.  Jane was there with me throughout, and was a huge boost to my psyche.  She was able to spend the night at the Family Lodge, across the street, which once again relieved her of having to do the drive back and forth to Alexandria.

On Thursday morning, a bit of routine was established.  They had already gotten me started on an inspirometer, which is a cheap plastic toy that really helps post-operative patients exercise their lungs.  Apparently, it is common for post-op people to have residual anesthesia gasses or other unwanted “stuff” hiding in the recesses of their lungs.  If they don’t breathe deeply enough, portions of their lungs might atrophy to some extent from lack of use (my interpretation—-by no means a medical description).  You are supposed to inhale slowly, and watch a little plastic slide go up a column, until it maxes out at around 2,250 or 2,500 ml.  There is a quality control device built into the apparatus, which lets you know if you are breathing too rapidly.  I already knew I had a large lung capacity, developed from many years of endurance swimming (including long distance underwater), backpacking, hiking, and skiing at altitude, and participation in other aerobic activities.  They wanted me to do the breathing exercises at a rate of 10 times per hour, bare minimum.  I tried the thing a number of times, and found it was pretty easy to max it out consistently.  That spoiled me.  I had to force myself to use it over the ensuing days.  Pesky nurses aided the task.

I had been given quite a bit of information about what to expect post-operatively.  I knew they would try to get me up walking as quickly as possible.  I’m not sure I was really ready when they wanted to get me out of bed on Thursday, in the mid or late morning.  I did get out of bed, and had the metal I.V. “tree” on wheels, to use as a free-wheeling walker.  I managed to make it somewhere around 50 to 75 feet down the hall outside my room, at which point, I did a 180, and returned to the room.  I was somewhat shaky, which shook me up psychologically.  They got me up again, around 4:00 p.m.  By then, I was much better equipped.  I did one complete lap around the unit, which was probably the equivalent of doing a half lap around a quarter mile track.  At 8:00 p.m., we did the third walk of the day.  This time, my confidence and ability had grown considerably.  If I remember correctly, Jane may have already headed back to Alexandria.  I did 3 laps around the unit, my I.V. “tree” in tow.  I could have done more, but I think the nurse had other things to do than to watch me go in circles.

If I remember correctly, the doctors put me on clear liquids Friday afternoon or evening, which meant I could have broth, ice pops, Italian Ice, or a few other things.  On Saturday morning, they cleared me for solid food.  They neglected to tell me what to choose, and what to avoid.  I was hot to get back to some of my favorite foods, which includes spinach.  I was to find out later that I should avoid anything high in fiber, like fruit or veggies.  Actually, the preferred diet was the antithesis of healthy eating.  They wanted me to start on a low residue diet, which included lots of overly processed foods.

On Friday, Jane’s daughter, son-in-law, and granddaughters visited me, along with my lovely wife.  The kids went downstairs to the playroom for a bit, and gave that place a workout.  They came back upstairs to 3-NW, and talked me into accompanying them to the cafeteria, where they would eat lunch.  We got a wheel chair for me.  Layla helped her grandmother push it on the way to the cafeteria.  On the way back, Layla rode in the stroller.  I cajoled her into racing me, by  making VVRRRROOOOMMM noises, like an idling race car revving up its engine.  We were quite the sight, maneuvering through the NIH lunch crowd in the labyrinth of long hallways.

By the time we got back to the unit, it was time for the little ones to head back home for their afternoon naps.  Jane stayed on, and later in the day, we went for a walk.  We experimented with going off the unit.  I wanted something longer and more invigorating than doing laps.  We found an activity room across the hall from one end of the unit.  We walked through one of the glass-lined atrium walkways to another set of buildings.  It was not exactly off-trail exploring in the Yellowstone backcountry, but it was doing wonders for my self-confidence and overall psychological well-being.  I guess this is as good a place as any to mention that the doctors and the nurse practitioner, who works the research protocol, are well aware of my habit of aggressive hiking and skiing.  They kept reminding me that I am not to lift anything heavier than a gallon of milk for 8 weeks; and I am not to do any hiking.  Those of you who hike with me will get a giggle out of how I have negotiated my way between the need to do a lot of walking and the prohibition on hiking (emphasis on not carrying a pack, and NOT doing hills).  (Jane throws in the logic about not negotiating terrain that might cause me to trip and fall, which could really hose up all the work that Dr. Hughes did.)

Given my being tethered by the epidural, I.V.’s, and a urinary catheter, I was no big flight risk.  I had suggested to Jane on Friday evening that she pick one of the two weekend days to just stay home, and not make the roundtrip north from Alexandria to Bethesda.  I knew she had been burning the candle at both ends, and wanted her to get some rest.  True to her nature, she blew off my input, and opted to visit me both weekend days.

There are a few major events that occurred on Saturday.  By far, the most significant, is that I had my first post-surgery bowel movement.  With subjects of major abdominal surgery (laparotomy), the surgeons anxiously await the arrival of that first signal event.  Apparently, it signals no serious digestive tract blockage.  (I should mention that I am still uncertain about which day I started solid food.  I know it was either Friday or Saturday, and I lean toward Friday, because of what happened Saturday evening.)  By Sunday morning, I had already experienced 3 movements the previous evening, and I went several times that morning.  It was incredibly watery, classic diarrhea or worse.  Nobody else seemed overly worried, so I wasn’t either.

Jane and I did do another walk to the other building on Saturday.  I think we may have done it twice, but on the second one, I was  feeling a bit out of sorts.  What developed next has a lot to do with why I waited so long to update my blog.  I didn’t want to get a whole bunch of people all worried.  Besides, I was plenty busy just trying to maintain my sanity in the face of some unwanted adversity.

Jane did opt to delay her trip north on Sunday, taking advantage of the opportunity to sleep in a bit.  File this one under “no good deed goes unpunished”.  I had been told several times that the nurses on 3-NW were the best in the entire complex.  I was believing it, until I got stuck with a youngish nurse, who destroyed my positive image of that unit.

First, I should mention that the surgeons and someone from Anesthesiology would visit me daily after surgery.  Sometimes, Dr. Beard would come by without Dr. Hughes, but virtually always, both surgeons would show up later in the day.  On the weekend, that changed a bit.  Dr. Beard was the covering surgeon on Saturday, so she stopped by to check on me.  She brought one of the other fellows with her, who would be covering her patients on Sunday.  This may have been the first hint that something ugly was in the offing.  Remember, Dr. Beard is GORGEOUS.  The other fellow was a guy!

Because my pain management was doing so well, Anesthesiology was planning on removing the epidural on Sunday.  Since they almost always came by on their daily rounds (almost always, a different one from the days before), fairly early in the day, between 8 and 9:30 a.m., I anticipated having the epidural removed soon.  That had to be done before the nurse could remove the catheter.  If I remember correctly, the feeding I.V. was disconnected Saturday night or Sunday morning.  The removal of the catheter would untether me from the I.V. “tree”.  I craved the relative freedom that was coming.
A day that started somewhat OK slowly slid downhill.  First, the anesthesiologist did not show up until around 11:30 or 11:45 a.m.  Thankfully, she got the epidural out without any heroics necessary.  She said she would notify my nurse, so she could remove the catheter.  I anxiously awaited her arrival.  It took way too long, from my perspective, close to an hour.  When she did darken my door, she said she was going to remove the catheter, but she had some news I was not going to like.  She told me that they had an emergency need for my single room, and I would have to relocate to a semi-private room on the unit.  I knew I had my private room up on 5-NW, which was relatively uncrowded, so I suggested that rather than move me sideways for a day or two, why not just send me back to 5-NW.  She said she would have to query someone with more authority, but she would get back to me.  She pulled the catheter, which was the best thing that happened that day.  I called Jane, and told her I needed her presence ASAP, because I felt like I needed an advocate.  I felt like my needs were not being taken into consideration.  This accelerated, when the nurse returned, and told me that I was cleared to move back to 5-NW, but I had to get out of the room pronto.  She said I needed to have me and all my stuff out of there within 30-45 minutes.  Jane was already preparing to drive the 45 minutes to an hour to get to NIH in non-rush hour conditions.  I feared she would arrive after I had already vacated 3-NW.  What I did not realize was that leaving that God forsaken unit was the best thing that happened to me that day.

I figured out that I could use my wheel chair, which we had hung onto, as a means of transporting my belongings, so I would not violate the lifting prohibition.  Actually, in point of fact, I am sure I violated the rule a time or two, in the simple act of loading the chair.  I had to pack up my laptop, and the case had a lot of weight in it, besides the computer.  My travel bag was full of clothing and other paraphernalia.  It took me maybe 10 or 15 minutes to gather everything.  Thankfully, my largest items, like a large, hard-sided suitcase, had remained up on 5-NW.  Eventually, I rolled the wheel chair out of my room, and headed off the unit toward the elevator.  The nurse told me that I could take my belongings up there, but I couldn’t stay there yet, because there were certain changes that needed to be made first.  When I reached 5-NW, I encountered Rob, an amazing nurse, who actually fought with the Iranian Army against Saddam Hussein’s military in that long, nasty armed conflict.  He had left combat, and helped out with the wounded, and that ultimately led to his career in nursing.  This guy has seen many things that most of us, mercifully, will never see.  Anyway, Rob told me, in specific detail, what needed to transpire before I could return to 5-NW, although I was welcome to drop off my belongings.  There were computer updates that needed to be done, but more importantly, some number of reports needed to be generated on 3-NW, and forwarded to 5-NW.  Eventually, I would be carrying a raft of paperwork between floors.

I returned to 3-NW just in time to see Jane come out of my room.  She had been trying to find me.  The nurse told both of us to just hang out in my room, while we waited for the updates to be completed that would allow me to consummate the move to 5-NW.  We must have spent at least an hour, maybe more, before we finally got the go ahead to formally relocate to 5-NW.  The nurse told us that the emergency need for my room had been dealt with some other way or with some other unit, so there was no rush.  I had been referring to myself as one of the “boat people”, referencing the Cambodian and Vietnamese refugees that nobody wanted several decades ago.

Once I finally landed in 5-NW, Rob took over, and treated me like a patient, rather than some holdover tenant.  I was still having serious diarrhea, with a frequency of every couple hours.  He consulted with the covering surgeon, and announced that they wanted a blood sample, stool sample (for culturing), and a urine sample.  I had a fever.  What had started down around 100.5, had advanced upward to 102 or 103, if I remember correctly.  Thankfully, Jane decided she wanted to spend the night on the unit with me, if they would let her.  Rob interceded with the powers that be, and he located the one piece of furniture on the unit that converted to a bed.  Having Jane literally in my room was an incredible comfort to me.

Monday, August 8, had to be a classic Monday for Dr. Hughes.  She discovered that one of her surgery patients (me) had a C-Diff infection; AND he had been unceremoniously kicked out of his room on 3-NW.  I was informed that I had achieved a new status.  A sign was mounted on the door to my room, announcing a “contact exclusion”.  I was told that I was to wash my hands any time, preceding leaving the room.  I was not to touch anyone or anything outside my room.  Anyone entering the room had to put on gloves and a gown.  Apparently, the C-Diff infection is not all that uncommon in patients like me, who had been given large doses of antibiotics in their digestive tract.  Sometimes, it wipes out all or most of the good bacteria, and the protozoa that causes the infection casts out spores, which just take over.  It presents a real danger to other patients, particularly if they have compromised immune systems.  (Wouldn’t it have been GREAT if I had simply moved in with another poor soul on 3-NW, who could have contracted my infection!!)

When Dr. Hughes heard what happened on Sunday, on 3-NW, she was rather concerned/upset.  She told me she would look into it.  Her biggest concern seemed to be that (1) they had removed the very last I.V. port, which should not have been done, and (2) they let me move my own belongings, in the face of the lifting restriction.  Naturally, my being a fierce advocate for customer service, and having been exposed mightily to the teachings of gurus like Harvey McKay, Tom Peters, and others, I lectured the nurse practitioner on how I felt that good patient care standards had been violated down on 3-NW.  She tolerated my rant, but remained quite calm (at least on the outside).  (I will still have my say with the customer satisfaction survey that NIH always sends out.  It was waiting in my mailbox when I got back to Bozeman.)

I had intended to post a blog update as soon as I was free of the various “tethers”, but now, I had this new, unexpected complication.  It drove me to postpone the post.  I did not want to leave questions hanging in the air.  I was frustrated, and did not want that tainting any potential writing.  Once the C-Diff infection was identified, I was put on a medication called Flagyl, which many referred to as an antibiotic.  I was to take it 4 times a day for 10 days.  Whereas I had once fretted about the possibility of being released from NIH several days prior to my flight home, and have to foot the bill for a hotel room, I now worried that my Saturday night, 8/13/11, return to Montana might be jeopardized.

I am not going to try and reconstruct the day by day account of that second week at NIH.  It is somewhat blurry in my memory, and not all that important.  I do know that after having introduced high fiber into my diet (like spinach) prematurely, I was counseled to go easy, skip the fiber for a few weeks, and concentrate on easy to digest foods.  I have to say that it bothered me mightily to have to revert to a relatively unhealthy diet.  There was a routine that marked each day.  Sometime between 6 a.m. and 7 a.m., the night nurse would show up to check vitals, and give me a shot of Heparin (blood thinner).  I managed to work my Flagyl intake to coincide with those visits, thus minimizing the sleep disruption each morning.  Most days, someone from Phlebotomy would appear to draw blood somewhere in the 5:30 to 6:30 a.m. timeframe.  It went quickly, thankfully.  Between 7 and 8:00 a.m., I could expect to see the day nurse, who would check vitals, cajole me to practice on the Inspirometer, check my incision, and ask what my pain level was.  I was taking a fairly powerful pain pill for 3 days at one point.  They can’t give it to you for more than 3 days.  Otherwise, there is risk of liver damage.  They started me on a different pain pill after the epidural was removed, but I took myself off it, once I realized it was ineffectual.  That’s when the surgeons came to my rescue, and put me on the more powerful medication.  I think that ran from Monday to Thursday.  By then, I was plenty able to go without pain meds.

Each day was characterized by anxious waiting for the diarrhea to start improving, and the subsequent depression, when there was little improvement.  I know that Jane finally took a one day break from the daily routine of driving back and forth between Alexandria and Bethesda.  She had more than earned it.  I was much more mobile, and able to get out and about in and outside the main clinic building (actually an assemblage of buildings covering more thousands of square feet than I can comprehend).  I joked about living in “Frank’s House of Germs”.  I would welcome newcomers to “Frank’s House of Germs”.  I noticed that some folks were more fastidious in dressing appropriately for entry than others.  In one case, I caught someone just walking in, with no protective clothing whatsoever.  In my best Big Nurse voice, I asked the merry wanderer if he had seen the sign on the door, and told him I was under “Contact Exclusion”.  He jumped back like a phobic having seen a tarantula!  He profusely thanked me for alerting him.  Naturally, I said “No problem Mate.  Welcome to Frank’s House of Germs.”

In spite of the fact that the nurse practitioner asserted she had been unable to pursue my request for a room on the outside of the unit, which would overlook the north side of the campus, outside the main clinic, and my request for a private room, I had been given both.  I will never know if that was pure dumb luck, or the successful effort of a nurse practitioner, who did not want to take credit for her work behind the scenes.  All I know is that having that view of the street and the forested areas across it, as well as the Children’s Lodge, was a major factor in maintaining my sanity.  Checking the local weather forecast, I learned that the latest heat wave was predicted to give way to much more temperate weather, including highs in the 80s and much lower humidity.  I was now walking further and further each day.  One day, I persuaded a reluctant Jane to accompany me on a wander beyond the patient units to the old part of the clinic, where all the hard core research goes on.  I knew they had lab animals over there, and I was determined to get close to them.  I hoped, and still hope to eventually see a lab animal one of these days.  Unfortunately, the area where we entered the old building is under renovation.  Certain hallways are closed, and you are forced to use stairways to reach other floors.  Not having a trail of bread crumbs to follow back to 5-NW, I reluctantly agreed to turn back, after negotiating several hundred yards of narrow corridors, flanked with some really sexy-looking “super-freezers”.  Looking at the electronic temperature readouts on those devices got me excited about just what was inside.  I saw temps way lower than anything Mother Earth produces in the way of ambient air temperature, even at the Poles.

One evening, probably Monday or Tuesday, I ventured outside.  The sun hung low in the western sky.  The air was heavy with humidity, yet sweet with the fragrances of abundant flowers and trees.  I worked my way across the street to where a sidewalk would take me SW toward the street that exited the campus.  On the opposite side, the Family Lodge sprawled in architectural splendor (truly a very attractive-looking building).  On the near side, as you walked through a mixture of lawn and trees, you came to a fire station.  This particular night, I made it as far as the fire station, then retreated back to the Clinic.

The next afternoon, I went outside again.  The temperature was lower and so was the humidity.  I was feeling stronger.  I intended to lay down more mileage.  I had the urge to explore.  I retraced my route from the previous evening.  This time, when I reached the fire station, I kept going.  I reached where the security checkpoint is for vehicles entering the campus.  Off to the right, I saw a pedestrian entrance, which featured an amazing cage-like contraption that allowed individuals to enter or exit, but only after entering the “cage”, and inserting some sort of I/D into a badge reader.  I marveled at this creative use of technology to protect us from jihadis or others who would do us harm.  Looking further right, I saw a lengthy forested area that paralleled Cedar Lane (or Road or Street?).  There was an intimidating security fence separating the sidewalk that bordered the street from the interior of the campus.  There was also a somewhat odd-looking structure, resembling a cable (really thick, like 3 or 4 inches) type guard rail.  It was anchored every 5 or 10 feet, deep into the ground.  I figured this was a second layer of security, in case some really determined bad guys used explosives or a tank to blast through the outer security fence.  I decided to walk through the forest, in between the two fences.  It was probably 20 to 40 feet wide in most places.  It required some sidehilling, which was a new post-surgical experience.  I knew I was pushing the envelope somewhat, but I was not lifting any poundage, other than my own legs.  I was not carrying a pack or negotiating a hill.  From my perspective, I was not “hiking”.  I was still “taking a walk”.  It just happened to be off-trail, in a forest.  I was thrilled to discover that I could accomplish a triangular loop that led me to another security entrance, and back to the Clinic past the Children’s Lodge.  I noticed small signs well inside the interior security barrier.  They seemed to be asking people not to go into that section of forest, because revegetation was under way.  I smiled, remembering similar circumstances in heavily used sections of other parks, including national parks.  It was still pretty warm out, and only around 3 or 4:00 p.m., so I was much appreciative of the forest canopy that provided shade for the majority of this route.  I smiled, appreciating the irony that a mere 3 or 4 weeks earlier, I had been hiking solo, way off-trail, in Yellowstone, and encountered several wolves.  The wildest critter I saw this day was a squirrel, but it was very much appreciated.

Any off-unit activity had to be carefully planned and orchestrated.  My digestive system was still quite flaky.  I could count on going no further than an hour and a half to 3 hours between bathroom sessions.  I quickly learned to start walking immediately after a bathroom break.  Then, I had to pay close attention to what my innards were telling me.

I think it was Tuesday evening that my dear friend, Jim Mastin, and his high-achieving, oh so talented, and very attractive daughter, Jenifer, came by to visit me.  He was in town from the Norfolk/Virginia Beach area.  Jenifer lives in or near Alexandria.  Jane and I had them over for dinner, when they were in Montana earlier in the summer.  Jim and Jenifer were sitting with Jane out in the atrium, when I headed out there to meet with them.  Jim got up to shake my hand, and I had to warn him off.  That felt really crumby, having to refuse the hand shake of a close friend.  Jim is a very understanding guy, with a background in EMS, so he was not the least bit offended.  We had a great conversation, that wandered all over the usual terrain.  We discussed Yellowstone, the grizzlies of that park and its southern neighbor, and fire service politics.  Jim had me walk Jenifer through the saga of my 8/24/79 snow field adventure.  To their credit, Jim and Jenifer hung around until near dark.  I know they needed to get back to their respective worlds, but I much appreciated the visit.

Another close friend, who posts on the Yellowstone chat pages as “mdmatt”, had been e-mailing me, hoping we would be able to get together.  We have established a pattern of going out to P.F. Chang’s for dinner when I am in Bethesda.  Matt had talked about coming by to see me, and possibly bringing some of his family.  I know his wife and their 3 wonderful daughters.  Ordinarily, I would have loved to see them.  We have hiked Yellowstone together.  We typically see each other once or twice annually.  My chaotic schedule, where every time I turned around, some clinician of one discipline or another was in my face, did not lend itself to making solid plans for visitation.  Early on, I had hoped to be able to vacate the premises one evening, late in my stay, and meet Matt and any other family members for dinner somewhere to the north.  The C-Diff infection sure soured that possibility.

Late in the week, possibly Thursday evening, I took the most monumental walk of my stay.  The weather had turned decidedly nice.  It was around 7:00 p.m.  The temperature was supposedly in the low 80s, but did not feel that warm.  The humidity was almost Montana-like, down around 26%.  I walked out of the Clinic with the bearing of some employee, heading out at lunch to get some serious walking accomplished.  I did not cross the street this time.  Rather, I just followed the sidewalk toward the Family Lodge, but kept going as it turned toward the south.  I went block after block, until I reached the southeastern boundary of the complex.  I passed several large buildings, some of which had construction activity under way.  There were two very large construction cranes.  I walked beneath them, amazed at their length and how high up they operated.  Here and there, employees would exit a building, heading for a parking garage to retrieve their vehicle and head home.  I think I made more than one woman nervous, if nothing else, because I had a medical wrap on one bare arm, where an I.V. had been removed or blood drawn.  Also, I was obviously just out wandering around, and was not heading to or from a parking garage.  At the southeast end, I noticed a lovely bike/jogging path, made of cement, outside the perimeter.  It was beneath a serious forest canopy.  I could see stately homes just beyond it.  One of the nurses told me later what the name of the neighborhood was.  I’m pretty sure it is an older neighborhood, with homes that most of us would never be able to afford.  From that area, I struck out to the east, and eventually, northeast, effectively making a wide loop around the Clinic complex, using the main campus drives.  I was walking for close to an hour, and estimated I had traveled close to 2 miles.  I was proud of myself.  I knew that certain nurses would be wanting to know if I had been walking, and I took pride in being able to tell them I had walked places and seen things that they were unfamiliar with.  True story!  Most folks had no idea where the cranes were when I told them about my trek.

The primary surgical dressing had been removed on that first post-op weekend or shortly thereafter.  There remained some drainage from one particular part of the incision, down near my navel.  It was not cause for alarm, but I got a bit upset when some of it leaked through and stained one of my white t-shirts.

On Friday, August 12, both surgeons came by to accomplish some very important tasks.  Dr. Beard removed the staples that had closed up the exterior of the incision.  Apparently, they used some sort of sutures that eventually disintegrate on the interior portion of the incision.  Dr. Hughes was present to administer the post-discharge instructions.  Thankfully, their arrival was followed by Jane’s, within a minute or so.  I very much wanted that extra set of eyes and ears present to absorb what was said.  There was heavy emphasis on the lifting prohibition.  I was told I was not to drive until such time as I could slam on the brakes immediately, without pain, in the event a child darted out in front of my vehicle.  Dr. Hughes explained something that really put it together for me, regarding the lifting restriction.  She told me that having strong abdominal muscles and being used to heavy lifting can actually work against a post-op patient.  You have that tendency, and the ability, to physically heft a bunch of weight, but, unfortunately, the fascia, or tissue lining that overlies your abdomen, beneath your skin, has been seriously weakened by the incision.  If you go exercising those strong muscles, you risk producing a serious hernia.  I heard lots of war stories about big macho guys showing up with half their digestive system protruding through the abdominal wall, after doing something stupid.  Dr. Hughes made a profound impression on me with that explanation.  Later in the day, the nurse practitioner, who was also present, commented that she got a lot out of that explanation.  She had never heard it put quite so appropriately.

By that Friday, I was starting to see small improvement in my digestive disorder, but I was still as nervous as a long-tailed cat in a room full of rocking chairs.  Jane was her usual incredibly calm, reasoned, and caring self.  She kept evolving plans and strategies for how we could manage the multiple night flights home on Saturday.  One involved a type of wipe that I now treasure.  Another involved the use of Depenz and a spare set of clothing in our carry-on.  (Thankfully, I would manage to make it to Bozeman with a bathroom break at Reagan International and the MSP airport, and not need to change any clothes.)

I was struck by how empty 5-NW was on Saturday, August 13, as I walked out of that place.  I think it might have been partially due to the doctor who runs the familial carcinoid protocol being on vacation.  It might have been that many other clinicians were on vacation as well.  I just know it was plenty quiet, and fairly empty.  This was the first test of Jane’s ability to do ALL the heavy lifting for both of us.  I was so worried about whether the sheer weight would overwhelm her, or worse, cause injury.  She had told me more than once that she is a tough woman.  If you see all the chores she has to do at her home, including the horse feeding and maintenance, which includes hefting hay bales in the cold months, it makes a believer out of you.  Jane was magnificent in her handling of the suitcases and other luggage.  I marveled at how craftily she maneuvered the behemoth suitcase of mine (weighed in at 51 pounds at the airport) into the car.

It was the first time I had been in a vehicle in almost 2 weeks.  It felt funny, out of place.  Once we departed the complex, I started feeling a bit of a return to the “normal world”.  I was intrigued by seeing all the locals going about their typical Saturday activities, everything from lawn-mowing to shopping, playing golf to sunning themselves.  It was SO different from the world I had inhabited for 2 weeks!

The plan was to rendezvous with the kids and grandkids at the apartment in Alexandria, then head for Reagan International Airport.  I had done the drive numerous times in recent years, both as a driver and a passenger.  In many ways, this was by far, the most enjoyable!

We arrived just in time to see the Ryan’s taking one of the largest pieces of furniture out to the rental truck.  The apartment had that “organized mayhem” look, so common to the late stages of moving.  Jane did her best to help the kids in the last half hour or so that we had, before we needed to depart for the airport.  It wasn’t long before we were engaged in a two car procession.  Jane and I were trying to work out the logistics on the fly.  Since I was not allowed to lift anything above 5 pounds, she had to take responsibility for my heavy suitcase and both pieces of carry-on, in addition to her own belongings.  Thankfully, Kassia would have Ryan to assist at the unloading point with her and the girl’s luggage and stroller.  We lucked out.  It was Saturday afternoon, one of the lightest travel loads of the week.  We were able to pull up in front of where the Delta skycaps were stationed.  There was minimal line.  We were able to get all the checked baggage up to the skycap check-in position fairly easily.  (Easy for me to say, since all I was doing was “supervising”)  Jane had alerted Delta Airlines to the need for a wheel chair for me.  They had one ready to go.  Our logic was twofold.  I could use the wheel chair at each airport to roll around in, OR we could use it like a baggage cart, much like I had done during my migration from 3-NW to 5-NW.  Outside the terminal, once we were checked in and had our boarding passes, I got in the wheel chair.  Jane opted to keep my two carry-on with her and the rental car.  She wanted me to be able to get around, with the wheel chair, and stay with Kassia, Layla, and Nora.  Ryan bade everyone a fond adieu, saying he would see us in “a couple days”.  I knew it had taken 3 or 4 days for him and Ben to drive east in August of 2010, so I was skeptical of any plan that might beat that time.  Jane headed to the rental car facility to turn in the trusty Camry that had been ours for over two weeks.

This was the first time in my life that I actually sat in a wheel chair without someone else pushing me and doing the steering.  Thank God I had watched my old pal, Michael Smithson in his chair over the years I was volunteering at Rocky Mountain National Park.  I took to it fairly quickly.   Turning sharply was tricky initially, but I got the hang of it fairly quickly.  Inside the terminal, we had to negotiate one slightly downhill section.  Suddenly, I was having to control my descent, or risk accelerating out of control, and doing a repeat of the 8/24/79 incident, but this time, crashing into a concourse wall, with its windows facing the tarmac.  I got my hands good and dirty, trying to manhandle those wheels.  To this day, I don’t know if wheel chairs have some sort of braking mechanism that I could have used, much like what you have on a bicycle!

We rode an elevator to another floor, trying to figure out the most expeditious way of meeting Jane, upon her arrival.  Kassia was “wearing” Nora in one of those way cool wraps she uses.  (I don’t remember anything like that being available when I had infant progeny.)  Layla was seated in the stroller.  We easily filled any small elevator on the premises.  Thankfully, since we looked like refugees from a pediatric ward and an assisted living facility, most folks would virtually jump out of our way to give us access.  I felt a little guilty, particularly at one point, when we were having trouble navigating some tight spot.  I just jumped up, out of the chair, and watched an 8 or 9 year old boy’s eyes get as wide as saucers as he watched the “cripple” suddenly doing an O.J. Simpson airport move.

Jane hooked up with us, and suggested we head away from the direction of our gate, to visit the Smithsonian Institute store.  It was similar to what we had seen at the Smithsonian, two weeks earlier, but possibly with a few additional items earmarked for air travelers and their lucky beneficiaries.  This go-round, it was the granddaughters who scored big.  Jane is such a pushover for little kid toys!  We selected a dinosaur doll for Layla, and some other doll for Nora.  I think Layla also got a book if I remember correctly.  At some point, Layla handed me her new dinosaur doll, which resembled a Tyrannosaurus Rex.  Instantly, I got this juvenile idea to put “Rex” up to my face, making motions and noises like he was eating my face.  Layla, ever fast on the uptake, just loved the concept.  Periodically, on the way back to Bozeman, she handed me that doll, expecting me to go through the “T. Rex is eating my face” routine for her entertainment!

Thankfully, there was minimal line at the security checkpoint.  This was the part I had been dreading.  In preparation, I had removed all metal objects from my clothing before leaving the hospital, and had put it in a zippered pouch in my laptop bag.  I was trying to make my passage as easy as possible.  Poor Jane, she had to manage two CPAP machines, taking the humidifier section off each, and had to take each of our laptops out of their respective bags.  I think it took 8 or 9 of those plastic tubs to fit all the junk we were taking on board.  Meanwhile, Kassia and the girls were going through, either right behind us or right next to us.  We were a motley crew, but we made it.  I was astounded at the pleasant attitude of many of the screeners.  Perhaps, late Saturday afternoon is as nice for them as it was for us.  One young gentleman hovered over us like a guardian angel, making sure everything went smoothly.  You would have thought he was our son!

Upon reaching our gate, we found we had plenty of time before departure.  Kassia enlisted our assistance in watching the kids and their belongings, while she went foraging for something to feed the little ones.  After she returned, it was Jane and my time.  We cruised the concourse, and eventually settled on McDonald’s.  I was not about to put any solid food in my stomach.  Believe it or not, at one point, I had stopped eating solid food on Thursday afternoon, just to prepare for this trip!  I was wearing Depenz, just in case, and I had that extra change of clothing in my carry-on.  I preferred not to have to use it.  I got a soft ice cream cone at Mickey D’s.  Jane got some sort of small treat as well.  There was a group of military folk hanging out in close proximity to us.  I was amazed at the build on some of those fellows.  For all I knew, they could have been Special Ops troops.  There were several female members of the military, and wow, did they look STRAC!  My heart swelled with pride, just seeing these professional soldiers.  I thought back to what we looked at during the Vietnam War, recognizing that today’s military is so much more professional as a result of abolishing the draft.

Boarding the aircraft went reasonably well, although by virtue of having sat on the far side of the concourse, we were late to the gate.  Jane was in a window seat, with Layla in between her and Kassia, who was on the aisle.  I was on the same aisle, across from Kassia.  I had a woman next to me who I got to know fairly well on the flight to Minneapolis.  She was living proof of why I have a tendency to chat up my fellow air travelers.  You never know who you might be sitting next to.  We started out talking medical “stuff”, since that was why I was traveling, and she had a sister who was having medical issues.  After beating up health care topics for a good half hour or more, we started talking about airports and destinations.  I discovered that this young woman, ostensibly in her mid to late 30s, had spent 9 to 10 years oversees, most of it in Africa, but some in Europe.  She was part of a U.N. effort to address the needs of the homeless and starving in such garden spots as Eritrea, Somalia, and the Sudan.  She had recently returned to the States, and was now involved with the Gates Foundation (Bill and Melinda).  I know just enough to be dangerous, where billionaire “giving back” is concerned, but I have followed the work of both the Gates’ and Ted Turner fairly closely.  I am also aware of a few other philanthropists, like Arthur Blank, who grew up in my folk’s neighborhood in Queens, New York.  This woman was quite knowledgeable on the subject, and we had quite the conversation.  It made the flight to the Twin Cities go much faster.

Actually, we landed almost a half hour ahead of schedule.  It was a good news/bad news  story.  The good news is that the kids had one less half hour on that first flight.  The bad news was that they were both still awake, well past their normal bedtime, and they needed “management”.  Kassia got Layla something to chow down on, which helped.  Jane and I went for a walk on the concourse our Bozeman flight was scheduled to depart.  I think we had close to 2 hours between flights.  I was tortured, passing some of my favorite restaurants, knowing I did not dare succumb to the temptation.  Since Bozeman lost its Quizno’s, I have craved a Classic Italian sub sandwich.  Here was Quizno’s, calling to me.  There were other temptations, equally alluring.  I used to fly in and out of the MSP airport frequently, in the 1990s, before I took the vow of poverty, and moved to Montana.  I remember the airport being somewhat bland.  It has obviously gone through one powerful overhaul.  I think it might be most favorite airport, from a concourse facility and restaurant standpoint.  I can’t wait to fly through there again, when I have the luxury of dining in one of its fine establishments.

The second flight proved to be the most challenging.  On this one, we were separated.  Jane and I had a window and middle seat, with a young fellow seated on the aisle.  Kassia and Layla were on the opposite end of the row, with an older woman (maybe 50′s) on the aisle.  Kassia put Layla on the window seat.  This became a severe test over time.  These poor kids were up many hours past their bedtime.  Jane and I had scheduled our flights long before we knew Kassia and the girls would be joining us.  We based our flight selection on price.  It was one of the worst possible choices for those little ones!  Kassia was put through some serious maternal “character building”.  About the time she would get one of the kids settled down, the other one would start fussing.  The woman next to her tried to help.  At one point, the aisle folks participated in a baby version of a bucket brigade, passing Nora to Jane.  That only brought short-lived, temporary relief.  Eventually, one of the flight attendants came up from the galley, and asked if she could take Nora to the rear of the plane for a bit.  She and her co-worker tried to settle Nora down, but eventually, had to bring her back.  I was feeling sorry for the kids, sorry for Kassia, sorry for Jane, sorry for myself, and sorry for all the passengers nearby.  There was little I could do, given my physical situation.  I was engaged in a never-ending battle against my digestive system, which wanted to eliminate that damn ice cream cone and teach me a lesson.  (This might be “too much information”, but I err on the side of oversupply.  I did take advantage of the rest rooms at both Reagan and MSP to preempt any sudden moves my innards might make.  Thankfully, it worked.)  Eventually, we landed at Bozeman, and were treated to an impromptu tour of the new terminal facility.  It is GORGEOUS!  Auntie Sara was there to greet us.  I could swear I saw angel wings sprouting from her upper back.  She had parked Jane’s pickup, child safety seats and all, in the parking lot, and had brought her truck, knowing we couldn’t all fit in Jane’s truck.  In short order, we were “outta there”.  Jane and I had done the best we could to get my old bedroom and the bedroom Layla would be sleeping in ready for the anticipated late night arrival.  It still required some tweaking, but before long, the girls, their mother, and their auntie were horizontal.  Jane and I headed out to her place, stopping at WalMart to pick up a pizza.  (I had been starving myself for almost 2.5 days at this point, and by jove, I was going to eat something.)  We reached Jane’s homestead at around 1:30 a.m., 3:30 a.m. east coast time.  I think we finally got horizontal around 2:30 a.m. MDT.  I wish I could say this was a storybook ending, but we were to discover the next day that mom and auntie had a rough night.  One or both of the girls still had trouble sleeping, and that created an impossible situation for long solid sleep.

I told Jane, as we went to bed, that in a few short hours, the Ryan’s would be hitting the road in Alexandria.  I’m a great one for making ironic observations in stressful situations.  (“Hey, doesn’t that stretch of desert resemble a long plate of potato chips?  I sure wish I had remembered to gas up the car back at the junction, or at least remembered to bring water.”  “Whoa, I think that shark is trying to spell your name with its dorsal fin.  I sure wish I had a camera, but it went down with our boat.”)

Anyway, to make a long story short, and get this posted (this is Day 3 of the writing), the Ryan’s drove straight through from Alexandria, VA to Bozeman, MT.  It took them 40 hours, switching off driving duty.  They arrived on Monday evening, around 9 or 10:00 p.m.  Being an old “epic drive” kind of guy myself (Philly to Denver straight through with no sleep, solo AND non-stop from Seattle to Denver, one day layover and non-stop back to Seattle solo, as examples), I stood in awe of their accomplishment in a rental truck, pulling a trailered vehicle!

The ensuing days were filled with trips into town, trips to restock the larder via grocery stores, Costco, and WalMart, trips to help out with something at the kid’s place, and, unfortunately, one trip to see a local surgeon.  On Sunday evening, Jane noticed that my incision seemed to be infected in one particular spot.  I knew it had been “leaking” some yellowish “stuff” while I was back at NIH, but I trusted the nurses and doctors to be taking care of it.  Now, we were on our own.  Jane, with her characteristic calm under pressure, said we better contact Dr. Hughes and the nurse practitioner.  We debated going to the Emergency Room, but opted to wait until morning.  When we got in touch with my local physician’s office on Monday, they recommended we see one of the surgeons.  That dovetailed with the input we got from NIH.  I’m pretty sure we got an afternoon appointment for Tuesday.  We lucked out and filled a cancellation space.  The good news is that the local surgeon looked at the wound, cleaned it out, asked a few questions, and announced that it did not appear to be infected.  That was a well-wished for piece of good news!  He put some sort of wicking material, almost like a white strip of tennie lace material in the wound to wick out the discharge.  He covered it with a gauze bandage to absorb whatever the wick delivered, and instructed us to do likewise once or twice daily until the hole slowly closed up.  At this writing, 8 days later, we are still undergoing this ritual.  Thankfully, the hole continues to heal and shrink, but I am getting very frustrated with the long time frame.

Once the kid’s belongings arrived, a wee bit of normalcy settle in, but the granddaughters remained out of sorts for most of that first week.  It was apparent that the stress and strain of those late night flights and being in a new home was taking a toll.  The domino effect was stressing mom and auntie, who were desperate for some semblance of normal sleep.  Since Kassia is still nursing Nora, AND had to start her new job on Tuesday, 8/16/11, there was little “rest for the wicked”.  As you can imagine, the guys were pretty well fried, also!  These were not the very nicest people to be around early in the week.  Certain individuals bore an uncanny resemblance to ZOMBIES!

Thankfully, as the week wore on, things and people moved steadily toward an even keel.  There were a few dinners at Na-Na Jane’s.  I took the Ryan’s to Yellowstone on Thursday, 8/18/11, since Ryan Battle had not been there before, and had voiced considerable interest in seeing the place.  We were blessed with great weather.  We concentrated on what I refer to as “The Lower West Side”, between Madison Jct. and Old Faithful.  We did the Southern Loop, visiting West Thumb Geyser Basin.  Unfortunately, it was a very quiet day for wildlife.  The most exciting sight was that of a black bear crossing the road behind our car on Firehole Lake Drive.  It was a “rear view mirror” affair, with no chance at a photo.  We finished up with a drive over Dunraven Pass, where we got stuck in a bear jam along Antelope Creek.  It was one of those extremely vexing events, where no rangers were on the scene yet, and visitors were stopping their vehicles in the middle of the road, with no shoulder on either side.  It was occasional start and stop, in between periods of sitting still.  Ryan Battle swore he could see the black bear at one point, but I never noticed it.  We did sample the fare at the Corral Drive-In in Gardiner.  Helen is deceased, I am told, but her son is running the business.  The food is every bit as good as I remember it, but the prices are considerably higher than a decade ago, when I frequented that establishment quite regularly.

On Saturday, Jane and I headed to Yellowstone.  We had a cabin reserved at Lake Lodge for Saturday night.  It was one of the artifacts of last winter, well before we knew our summer would be disrupted by my health issues.  The kids were originally planning on coming down for the day, but they decided to delay until Sunday.  There were things they wanted to show Ryan Battle in Bozeman.  When Sunday rolled around, all or most of them had bad colds, probably a gift from the recirculated air in the planes the previous weekend.  Jane and I were destined to spend the weekend alone (well, along with thousands of fellow Yellowstone fans).  We were treated to hours of grizzly bear observation in Hayden Valley, where a bison carcass lay in the river, close to the near bank.  We saw 7 bears Saturday night, and observed a mother griz with 2 yearling cubs for hours on Sunday.

Now, we are nearly current.  I am woefully behind on e-mail, bill-paying, other financial duties, and numerous other chores.  I hope to be caught up on web-based and financial “stuff” by Thursday evening.  I hope to spend at least one of the coming weekend days in Yellowstone.  I would love a chance to get out walking on some relatively flat terrain.  On last Thursday, I estimate I walked close to 5 miles, with all the boardwalk and paved trails we navigated.  It felt WONDERFUL!

My C-Diff infection is gone.  My wound is slowly healing up.  I started driving again a week ago.  My only remaining restrictions are the lifting prohibition and hiking with a pack or up/down hills, which lasts until September 28.  I am so psyched to get after it in late September and October!

I had lost 15 pounds between late May and late July, prior to surgery.  Since surgery, I have lost another 15 pounds.  Believe it or not, I could lose another 30 pounds, and that would put me right around my ideal weight.  Actually, I think, because I am big-boned, and have a fair amount of muscle mass, due to hiking and skiing, I can probably get away with being a few pounds above the ideal.  My long term goal is to shed another 20 to 25 pounds, maybe even 27.5 to be exact.  Hopefully, I will not have the assist of someone surgically removing a portion of my anatomy.  (Truly, the weight loss is much more the consequence of all the days I ate very little or nothing, rather than the removal of 77 cm of small intestine and a few lymph nodes.)

Just today, I received the news on the pathology reports on the removed tissue.  On the carcinoid tumor front, we have good news, overall.  Dr. Hughes thought there were 9 tumors overall, resident in the removed length of digestive tract.  It turned out there were 11, ranging in size from 5 mm to 1.5 cm, which is below the magic 2 or 2.5 cm mark, at which serious spreading seems to commence.  There was no evidence of the carcinoid tumors having penetrated the exterior of the intestine or beyond.  Ten of fourteen lymph nodes taken from close proximity to the resection showed some exposure to carcinoids, but nothing alarming.  A mykotic test (sp?) showed that the tumors are very slow growing.  HOORAY!!

Dr. Hughes did go down deep, below the upper organs, and grabbed a lymph node or two to test for the presence of follicular lymphoma in the mesentery (abdominal cavity).  Elaine Jaffee, the noted pathologist, says it is follicular lymphoma.  At this point, I will request a copy of the pathology report, so I can get it into the hands of my local oncologist and my primary care physician.

I need to schedule a 3 month follow-up at NIH for early November.  That will be followed by six month follow-ups for 2 or 3 cycles.  Actually, by May of 2013, I will be due for the bi-annual visit for the research protocol, so that will dovetail quite nicely.  I will be given a CT scan, an MRI, a 24 hour urine collection, and one other procedure, which I can’t recall.  It might be simple bloodwork.  It appears that I might be able to time my visit to coincide with that of my sister, Barbara, who is entertaining a possible visit in that time frame.  Barb is a hoot, when she gets in a funny mood, very much fun to be around.  It might be fun to try and get her laughing so hard that she pees her pants!

I hope to be posting a little trip report on the Up Close and Personal Yellowstone Chat Page about our last weekend, and the kayaker bust we witnessed in Hayden Valley (a historic first for me, seeing a kayak heading north on the Yellowstone in the south end of the valley).  The rangers were justifiably stressed out.  There were grizzlies converging on the river bank a mile or two downstream, and there was an ALS call at the Canyon Stables, competing for resource.  Ahhhh, it was nice to be back in the midst of mayhem, where I was not center stage.

Jane and I are thrilled to have the kids and grandkids back in Montana.  Unfortunately, one day, while a bunch of us were sitting around, last week, it dawned on us that out of 6 people present, only two had jobs.  Sign of the times?  Anyway, Jane and I are moving on to our next great adventure, as we look for work locally, look at creating our own business, and get ready for the possibility of a geographic relocation of our own.  To say these are exciting times would be understatement.

I do need to thank all of you who have expressed concern and well wishes.  I also need to thank those of you who exhibit patience, when I virtually disappear for a while.  I truly was quite busy at NIH, even though I never expected so many demands on my time.  I had grandiose plans for web-based research I was going to conduct on a possible business opportunity for Jane and I.  I never got to it, still haven’t.  That is something that is going to be front and center in short order.

At this point, I have no idea when my next blog post may be.  If something noteworthy surfaces, relative to my health, I will post an update.  If something of note occurs, regarding our occupational status, I will definitely get the news out.  Right now, we are blessed with wonderful weather.  It is dry and warm, day after day, and I am so thankful for being in southwest Montana.  I am more in love than ever with my wonderful, talented, bride, who is taking excellent care of me!

The USOpen tennis tournament starts next week, and will partially dominate my existence for the following two weeks, like it does every year.  Then comes college football.  I guess if you have to take it easy somewhat, you might as well have professional tennis and college football to occupy your time when necessary.

Go Rockies!

Ballpark

I am told I will wind up in either the ICU or the post-op surgery unit, rather than my “home unit”, where I am at the moment.  Eventually, I will return to this unit, once I am sufficiently recovered.

Jane was here until around 9:30 p.m., when she headed across the street, to the Family Lodge, where she will hopefully get some shuteye.  Her presence has been incredibly valuable.  There is the obvious emotional/psychological benefit that I derive.  Another contribution Jane makes is to employ her health care background to assist me as an advocate, as well as an extra set of eyes and ears.

I hope she comes through these next few days without too much wear and tear.  The last couple of months have been very tough on her!  In early May, she got the bad news about her position at MSU.  In late May, she was here at NIH with me, when I got the bad news about my test results.  We got back to Bozeman with just two weeks to plan out the details of our wedding, and get ready to host visiting family.  The wedding and other festivities were fun, but also required considerable energy/time output.

Then came July!  It started with a semi-fun visit to Cody on 4th of July weekend.  What was mostly a great time with family and friends was tainted by an incident in Yellowstone.  I am not posting details here, pending resolution of a formal complaint we filed with the appropriate people.

After that weekend, we began preparing for this trip and the consolidation of our households.  It has essentially been like two house moves, but harder in many ways, because it is not a full move, but, rather, a “combining”.  There have been a lot of long days and nights, filled with packing and carrying heavy boxes.

The good news is that Kassia, Layla, Nora, and Ryan will be moving back to Montana, and Bozeman specifically.  We are thrilled at that development!

Oh, I almost forgot.  A week and a half ago, I was diagnosed with obstructive sleep apnea, in the wake of an overnight formal sleep disorder test at the local hospital.  I am now using a CPAP machine at night, to combat the interrupted breathing that robs my hemoglobin of much-needed oxygen.  Thankfully, the local doctor sped up the process, in recognition of my impending surgery, and the consequent need for improved oxygenation of my blood to aid my recovery.  You would not believe how bad my numbers were, in terms of percentage of oxygenated red blood cells.  I have a bad case.  The good news is that the CPAP machine is making a significant difference already.  I wake up feeling much more rested, and don’t find myself nodding off during the day.

I need to wrap this up, and get ready for bed.  I hope to be back with the story of what they find tomorrow as soon as possible.  It will likely be at least 2 or 3 days, given what I have been told about what kind of shape I will be in after the anesthesia and surgery.

Here is one piece of good news.  After hearing the bad news in late May, I resolved to drop some pounds before the surgery.  I lost 15 pounds in two months, and intend to lose more over time.  Hiking in Yellowstone and watching my caloric intake has worked wonders.  I can’t wait for the passage of time to free me from the post-operative restrictions on my hiking.

Thanks to everyone who has sent their expressions of encouragement.

Ballpark

After returning from Bethesda, we had to scramble to get everything ready for the wedding.  Of course, our return coincided with the arrival of many Yellowstone Loons.  There were Loon social events and hikes, which also occupied our time.  Then there was the arrangements to be made for our trip back to Bethesda for my surgery on August 3.

We had lots of family on both sides in town for the wedding.  I hope to post some photos someday down the road, but I’m not in a position to post any yet.  We lucked out on the weather.  The forecast called for thunderstorms.  We had plenty, but we had a window right around the time for the ceremony, so we did not have to move the event indoors.  The best aspect of the wedding was getting to see so many family members, who had traveled a long ways to be here.  Jane’s daughter, son-in-law, and granddaughters were here from Alexandria, as were her sister and brother-in-law from Seattle.  Her aunt and uncle drove over from Powell.  My parents drove up from Colorado.  My brother drove up from Grand Junction.  My sister drove over from Bend, Oregon.

Now, Jane and I are in scramble mode once again.  We are combining households and preparing for the relocation of her daughter, son-in-law, and granddaughters to Montana.  That is a big event that many have been eagerly anticipating.

Jane and I are both in the midst of trying to chart a new career course.  There is much going on in the background that I am not at liberty to publicize.  The story will unfold over time.

I have been attempting to hike at least once on the weekend and once during the week, but the aggregation of other needs and tasks has been thwarting my plans.  I did manage to get out during the week last week, and it was great.

This past Saturday, we did the “History of Yellowstone Bear Management” interpretive hike in Hayden Valley, which encompasses the early days of the park, the bear feeding grounds, the days when the bears ran amuck on the roadside, the old Trout Creek Dump, the use of culvert traps, the Craighead era, the consequences of the management changes of the early 1970s, and the recovery of the Yellowstone grizzly since.  We saw the female grizzly with two yearling cubs whose territory includes southern Hayden Valley.  We visited Carcass Canyon, which is home to numerous small caves, which would make ideal bear dens.  The hilltop that we refer to as “Craighead Hill” rises above the canyon.  There is much evidence that Frank and John Craighead used this vantage point to observe grizzlies and use radio telemetry to track the bears.

Ironically, while we were doing our trek, hiking as a group of 5, a couple from Bozeman in the northern part of the valley were charged by a grizzly with a cub.  They had to use pepper spray on the bear at close range.  The one rather odd aspect of this incident is that the bear was not making any noise.  The bear I sprayed at close range in 2000 started huffing loudly as soon as she discovered our presence, and continued huffing until she had returned to her cubs, after having been sprayed.

The irony continues.  Just yesterday, a couple from Torrance, California was hiking the Wapiti Lake trail.  According to NPS press releases, they were charged as they were returning to the trailhead, roughly a mile and a half away.  The husband told his wife to run.  The bear attacked and killed him.  His wife either fell or decided to play dead.  The bear picked her up via a pack on her back, and dropped her.  She came out of it relatively uninjured.  Neither of them had pepper spray.  If anyone reading this is not already aware of commonly accepted (and researched) protocols for dealing with aggressive grizzlies, you NEVER run.  They will ALWAYS outrun you.  Plus, it makes you look like food!  You should always carry pepper spray in the backcountry, if you are in grizzly land.  If an aggressive bear is not deterred by the pepper spray, then hit the ground, face first, with your hands clasped over the back of your neck.  Anchor yourself to the ground with your slightly spread elbows and legs, so the bear cannot flip you over, and gain access to the soft tissue in your abdomen.  Even when you think the bear has left the area, stay put for a while longer.  Research shows that a second attack by a bear is almost always more vigorous than the first attack (Steve and Marilyn French).  The bear that conducted the recent attack had no history of being a problem bear.  It had no radio collar or ear tags.  It likely perceived a threat to its cub, and reacted accordingly.

Jane, her mother, Joyce, daughter, Sara, and I drove over to Cody on Sunday.  We had dinner with Joyce’s brother and sister-in-law at their farm in Powell that night.  On Monday morning, we watched the Cody Stampede Parade, which was amazing.  It lasted for over an hour and a half!  It dwarfs the little parade that Livingston puts on.  Later that day, we went back to Powell for the traditional 4th of July barbecue, which is attended by numerous nationally renowned paleontologists and a few geologists.  There is a long, oh so interesting history, that goes back to the 1920s or 1930s, when paleontologists were first digging up all sorts of remnants of past life in the American west.  It involves the family and the farm, where they were able to get water and logistical support in the days before cell phones, sat phones, and SUV’s.

This morning, I had an appointment with my oncologist.  Unfortunately, the I/T people at the hospital had not gotten the images uploaded from the DVD I dropped off yesterday.  The oncologist will view the pictures from NIH once they are available.  He does not think we have anything to worry about.  NIH had told me that they could see the mass, but it was smaller.  The oncologist says it is not unusual to have some residual tissue there, but it is likely scar tissue or something similar.  My next appointment with him is October 6, which will be two months after my surgery at NIH.

There are a number of negative things that have happened, but I will not elaborate on them in this space.  We are grappling with a host of situational problems, which will be resolved over time.

As has been the case for a while, I am not sure when the next opportunity will arise for me to update this blog.  It might not be until after my August 3 surgery.  Hopefully, I will have good news.

Ballpark

We made it to Layla’s second birthday party.  Her father’s family was there, so I got to meet them for the first time.  It was so wonderful to see Layla, after a gap of over 9 months!  Then there is her 6 month old sister, Nora, who just cracks me up.  This little urchin has an incandescent smile that would melt an iceberg.

On Sunday, we visited several memorials in D.C., while heading north to Bethesda.  We caught the Vietnam War Memorial, the Lincoln Memorial, the Korean War memorial, and the World War II Memorial.  It was very emotional, looking up the names of fellows we knew that did not make it back from Vietnam.

We spent Sunday night at the hotel that NIH was using for a research grant proposal screening that Jane was participating in on Monday and Tuesday.  On Monday morning, I caught the shuttle to the National Institutes of Health (NIH) complex.  The security screening you go through seems fairly intense, but I left my suitcase on the shuttle bus, and to my knowledge, I don’t think it was checked.  My laptop and its case, as well as a small travel bag,were searched.  I could have hid a small thermonuclear device in that large suitcase, and nobody would have found it.  I’m sure many of you have scratched your head, while watching TSA pat down an elderly woman, while tough-looking young men go zipping by, without suffering the same treatment.

Rather than provide a boring blow by blow description of each day’s activities, while in an inpatient status, I will merely give you the important info.  I was scanned, using CT, EKG, MRI, and PET technology.  I had numerous blood tests and a 24 hour urine test.  I had to ingest “Go Lightly”, the same lovely drink familiar to colonoscopy patients throughout the land.  It cleaned me out, so I could swallow a pill that contained a camera.  NIH refers to it as a “video” camera, but my impression is that it takes many thousands of still images, which produces a video effect.  (Actually, video really is just a high density collection of still images taken rapid fire.)  This camera is very important, because you cannot reach the small intestine, where carcinoid tumors tend to develop, from above with endoscopy technology, or from below with colonoscopy tools.  I had to wear a belt pack with receiving gear that was recording the images over a 12 hour period.  Early on, the nurse practitioner, who works with the lead researcher, turned on a powerful little laptop in close proximity to my abdomen and the beltpack.  She had to ascertain whether the pill was traversing the digestive tract, or whether it got stuck up above.  Thankfully, my cam was moving through my system.  We were able to watch the stream of images, and it resembled slow motion videography.  My stomach was rumbling periodically.  Between the 24 hour urine test and its strict diet, and the fasting associated with the video pill placement, I had gone well beyond 24 hours since my last solid food.  At one point, while the nurse practitioner and a unit nurse were observing, I noticed a clear bubble form from the dark recess that the camera was headed toward.  I had to laugh, and made a joke about “watching myself pass gas”.  I said I could imagine Al Bundy with such a setup in his living room, so he could watch himself fart on a big screen TV.  The nurses were laughing so hard, they had tears streaming down their cheeks!

When I saw my schedule for the week, on Monday, I got excited, because it showed my tests being completed on Wednesday.  The “wrap up”, a discussion of the findings with the lead researcher and the nurse practitioner, was scheduled for Thursday morning.  Then I would be discharged.  Jane and I started making plans for Friday.  We hoped to tour some more sights/sites in D.C., like maybe the Smithsonian or the Supreme Court.

We had dinner scheduled at P.F. Chang’s with md matt (Matt Willems), who lives north of Bethesda, on Thursday evening.  Unfortunately, on Thursday afternoon, I was told that given the results of my scans and tests, I might opt to stay over into Friday.  I was to find out soon what was up.  Jane was present as Dr. Wank and the nurse practitioner walked me through their findings.  Each of the three major findings sounded serious.  Dr. Wank wanted me to see a subject matter expert from elsewhere within NIH on each of the discoveries.

It turned out that one of the three, which is bladder and prostate-related, is not a problem.  It only looks like a problem.  My annual exams and PSA tests have been negative for prostate cancer for many years.  An ad hoc blood test at NIH supported that, even though there are some scary photos.  A urologist stopped by Friday morning, after examining the images from various scans.  Based on my medical history, the blood test, and a sonogram administered by the unit nurses, the urologist determined there was nothing to worry about.  That was good.  One of the three big concerns was eliminated early on.

I should mention that we were able to join md matt for dinner that Thursday evening.  We just had to move the time out about an hour and a half.

One of the other major findings was that the scans revealed that my mass is still present in my chest, although it is much smaller.  There are also some lymph nodes in the upper torso that look enlarged.  That may or may not be a problem.  My local oncologist will keep an eye on that.  There is one lymph node in my upper abdomen that is enlarged.  It is located near the aorta.  Dr. Wank recomended I get a biopsy to ascertain what is going on there.  He figured the third major finding’s remediation might present the opportunity to get such a biopsy.  He contacted the lymphoma research people at NIH, who sent a specialist over to interview me and collect all sorts of information.  He went back to his area and consulted with the lead researcher on lymphoma, then returned to give me their considered judgement.  Jane and I thought the readout on that sounded confused.  Essentially, they were saying they did not understand how this biopsy would be obtained or  why.

The third major finding was the discovery of a tiny carcinoid tumor in my small intestine.  It was the PET scan, taken with a machine so exotic that only one other exists in the world, that nailed it, employing a real exotic dye marker that really lights up a scan image when it infiltrates a carcinoid tumor.  Thankfully, this tumor is very small, and likely very new, since it did not show up two years ago.  Dr. Wank gave me the option of having the tumor removed surgically at NIH or at my hospital in Montana.  I opted for going the NIH path, since the surgeon is very experienced with carcinoid tumors, and that is a rare specialty.  The NIH surgeon, Dr. Hughes, met with us on Friday evening.  She is a very busy person, yet she took as much time as we needed to make sure we understood the nature of the proposed procedure, and got any questions answered.  We solidified a plan.  The surgery is scheduled for Wednesday, August 3.  Jane and I will fly to D.C. on Saturday, July 30.  NIH wants me on hand on Monday and Tuesday, before surgery, for blood tests and a meeting with the anesthesiologist.  They will have me recovering in the usual unit that I am well familiar with.  If all goes as planed, I would be released after 9 days, possibly a day or two earlier.  We will likely book a flight home for Saturday, August 13.  This will be abdominal surgery, not the real major variety, but much bigger than laparascopic procedures.  The doctor will have to be able to get her hand inside my abdominal cavity.  She will have to trace out the entirety of my intestines by hand, searching for any and all carcinoid tumors.  She will then resect any areas with carcinoids.  While in there, she will also do the biopsy on the suspicious lymph node.  Then Elaine Jaffe will take a look at the tissue and render a judgement.  Elaine is one of the foremost pathologists in the nation.  I will be restricted from any heavy lifting for 8 weeks after surgery, so that will be tough.  It also means no vigorous hiking until October.

Beyond the three major findings, my blood work revealed that I need to shed a bunch of excess pounds.  I am bordering on being Type II diabetic and my good cholesterol is too low.  I need to get back in the gym.  Hopefully, the combination of significant weight loss, healthier diet, and regular exercise will eliminate those concerns.

Meanwhile, we have a wedding to produce a week from Saturday.

I hope to have the time to post photos and a report on the wedding.  Beyond that, look for updates on Jane’s job search, which could take us to Anchorage, Alaska.  I’m very excited about the possibility of going where the really big bears hang out!

Ballpark

It has been 2.5 months since my last post.  The large gap is due to a combination of factors, which include being very busy, being visited by repeated snow/wind storms at the rate of between 2 and 4 per week, extended nasty colds that impacted both Jane and I, traveling with Jane on her business, and wedding planning.

I am flying to Washington, D.C. tomorrow morning with Jane.  I have my 2 year follow-up at the National Institutes of Health (NIH) in Bethesda next week, from Monday the 23^rd through Friday the 27^th.  I will post an update with the findings as soon as I get a chance on the 27^th or 28^th.  We will visit Jane’s daughter, son-in-law, and granddaughters, who live in Alexandria.  Her daughter and granddaughters will fly back to Bozeman with us on Saturday, May 28.  Our wedding is planned for Saturday, June 11, and the girls will be in Bozeman until the weekend after the wedding.  Jane’s son-in-law will fly to Bozeman the day before the wedding, and the entire family will fly back to D.C. a week later.

Here are the updates on what has been going on over the past 2.5 months:

1.) Busy-ness

I am a member of the Yellowstone Bison Citizen’s Working Group, which was formed by the IBMP partners, IBMP being an acronym for the Interim Bison Management Plan, launched in 2000.  Partners include the U.S. Forest Service, the National Park Service, the Montana Department of Livestock, Montana Fish, Wildlife, & Parks, and several Native American tribes.  The IBMP partners created the working group in an effort to cast a wider net, in hopes of finding some “silver bullet” solution to the ongoing Yellowstone bison controversy that might have been overlooked.  There are close to 50 citizens participating in the working group.  We meet monthly, for four hours, although we may be increasing that time commitment.  We also get homework, consisting largely of reading assignments.  Our last meeting was in Gardiner, so it included a fair amount of “windshield time”.

We made the decision to get married on Saturday, June 11.  The initial plan was to have a small ceremony, with just family present.  Then, a week later, on Saturday, June 18, we would have a large party/reception, with numerous family and friends present.  We were hoping to have a pig roast and a disc jockey playing tunes for dancing.  This plan has since been amended as will be explained later.

2.) Continuing winter weather

The weather only got worse in many respects in March and April.  There were numerous weeks when literally FOUR separate snowstorms would pass through, each one dumping new snow, and most accompanied by high winds.  Sometimes, the wind would blow east to west.  Other times, it would blow west to east.  The net effect was steadily larger drifts.  For many weeks, the dogs could escape their yard by simply using one of the numerous snowdrifts to cross over to freedom.  The poor horses were cut off from their pasture, and were restricted to a small area near the barn.  You know it’s bad when your horses get “cabin fever” or Seasonal Affective Disorder (SAD).  The ski areas extended their seasons an extra week or two, yet they still had bases well over 100 inches at the end of April, when they finally shut down.

Readers who stay current on Yellowstone National Park are well acquainted with the drama that has been playing out down there.  The smart money is betting on substantial river flooding once we get the seriously warm weather that so far has evaded us.  We had 2 or 3 sunny days last week, where the temperature went into the low 70’s.  That is the only time we have been that warm since last September.

3.) Illness

Jane contracted an intense cold in late February or early March.  It was a week or two after she flew to and from Indianapolis on business.  (I’m always suspicious of the recirculated air in aircraft cabins and the number/proximity of diverse passengers from all over.)  I remember having a cold a year or two ago that had 3 distinct week-long stages.  This malady was characterized by a similar series of phases, but they seemed to be 2 weeks each in length.  It was 3 or 4 weeks after Jane started experiencing symptoms, when I started into the pattern.  One of the “features” of this illness is a persistent cough that develops after the initial week or two.  My cough lasted for a good 5 or 6 weeks before it disappeared slowly into the sunset.

4.) Business travel

The travel to Helena continued in March, with at least one more trip.  Then there was a journey to Great Falls.  We also traveled to Spokane and Seattle for meetings relevant to Jane’s work.

5.) Be careful what you wish for!

Shortly after meeting Jane, I learned that she was in an acting capacity at Montana State University.  She was hired on a one year contract in 2009.  It was renewed again in 2010.  The University of Washington side of the WWAMI program was anxious to see a permanent director named for the Montana program.  Montana State University wanted to postpone that process until a replacement Provost was selected.  That individual’s organization included the Health Sciences division, which WWAMI is part of.  When the new Provost came on board in January, one of the premier issues presented to her by those associated with WWAMI was the need for permanent leadership.  For many months, there were a few meetings, but precious few hints as to what was in store for the program.  Eventually, on May 2, the Provost announced that the Health Sciences division was being dismantled.  Several piece parts were being moved into other existing organizations.  Montana WWAMI will be a standalone organization.

The other news was that Jane’s contract would not be renewed at the end of June.  The Provost announced her intention to commence a search for a Montana WWAMI director in the near future.  Jane might be able to apply for the position, but we don’t know how soon the search will begin.  Given all the uncertainty attendant in this situation, Jane is having to explore other career options.  There are not many positions in the Bozeman/Livingston area germane to someone with her background.  This decision came as a surprise to both Jane and I.  We were midstream on all sorts of plans that have either been changed or suspended, in light of the new situation.  The prospect of both of us being unemployed, come July 1, is more than a little scary!  I won’t bore you with the details of the impacts, but I can tell you that it affects quite a few people, beyond Jane and myself.  We already find ourselves having to look at employment opportunities outside Montana.  There are many University of Washington Health Sciences and WWAMI leaders who think very highly of Jane, and her many accomplishments in her short tenure at Montana State University.  They are on the outlook for any vacancies that might be a good match for her.

Given the impending cash flow situation, we made the decision to cancel the June 18 party/reception.  That is money we cannot afford to spend, given the revised circumstances.  We have expanded the guest list for the wedding to include a number of our close friends

Philosophical observation

The more I ponder the recent developments, the more I feel like there is an unseen hand steering our fate.  I strongly suspect that many years from now, we will look back and say, “wow, that was fortuitous”.  I have had a number of those events in my life, and the only transitions I have any angst about are the few where I know I made the wrong decision about something.  Every time events beyond my control have redirected my life, it has led to a net improvement in my circumstance!  I’m a big believer in karma.

New Year’s Day

I had every intention of posting a full-blown trip report of our New Year’s Day trip to the Indian Creek campground via snow coach from Mammoth.  I wanted to experiment with a new way of creating the report, so it would simultaneously be easy to post on Yellowstone chat pages.  It took me several weeks to get started on it, and progress was painfully slow.  The past two months have been incredibly busy.  Some of that will be apparent as you read the narrative of what has been going on in the first two months of 2011.  I have yet to complete the New Year’s Day trip report, so I am going to do a rather abbreviated version, with a few photos.  To be honest, I don’t know if I will ever get around to finishing the larger version.

We lucked out.  There were no passengers on the 8:30 a.m. shuttle.  We had reserved 8 seats on the 10:15 a.m. shuttle.  Frank W. reserved 1 of the remaining 2 seats.  We were the only people transported to Indian Creek that day.  I guess everyone else was up late on New Year’s Eve, and couldn’t tear themselves away from the parades and bowl games.

Loading the Bombardier at the Mammoth snowmobile hut

Handing equipment up to our driver, Darla to load the roof rack

We normally ride in a Prinoth snowcoach with a trailer, but this day, we rode from the Mammoth Hotel to the Mammoth snowmobile hut in a van.  Then, we transferred our gear and ourselves to one of the old Bombardiers.  I had not ridden in one of them in 19 years.

Unloading at the Indian Creek warming hut

We had 4 nordic skiers, 4 snowshoers, and 1 skate skier along.  The snow depth and snow condition was mid-season in nature, in spite of how early we were in the season.

Hare and tortoise (skater and snowshoer)

We lucked out.  The Xanterra trail condition report had shown the Indian Creek area had been groomed on Christmas Eve or Christmas Day.  When we arrived that morning, Point was busy, grooming the campground loop.  We had pristine groomed conditions.

The skiers take advantage of the fresh-groomed track

The guys try to catch up to their wives

We were blessed with blue skies, but the temperature was plenty low.  I can’t remember the exact temperature, but I think it was single digit.

Ironically, in spite of the recent grooming, the snowshoers spent a lot of time off-trail and breaking trail away from the campground loop.  Frank W. and Sara took to the trees between the entrance road and the campground loops.  They came upon a cow moose.  Her tracks were everywhere.  We were using FRS radios to stay in touch, so Jane and I were able to keep abreast of their goings on.  We noticed moose tracks criscrossing the groomed track, as we made our way toward the campground entrance.  Once there, we took the spur trail that parallels the creek.

Yes, that's a picnic table in the foreground, buried under mucho snow

Looking west toward Quadrant Mountain

We were following a ski track, but did not want to trash it, so we had to break trail alongside it.  The snow was deep enough to slow our progress considerably.

Jane poses patiently, in spite of the intense cold

We went a short ways out the Bighorn Pass trail to presurvey the hills before you reach the power lines.  We could see bison on the low hillside, north of the creek.  After retracing our route back to the trail junction on the west side of the campground, we paralleled the ski track south, along the west side, back to the warming hut.

By the time we reached the warming hut, everyone else had finished their lunch, and were ready to head back outside.  That was fine with us.  We had the building to ourselves.  I took some photos to show others what the interior of the warming hut looks like.

Looking north, with the wood stove on the right

Looking WNW from the front door

Looking north to south, as my lunch buddy enjoys the shelter

As our 4:30 p.m. pickup time neared, the various subgroups started returning.  Suddenly, our quiet little “cabin in the woods” was a beehive of activity.

There goes the neighborhood!

Mike poses outside the entrance, sporting an icicle encrusted moustache

Darla had told us she would likely be a bit early for our pickup, since she had no other passengers.  We were surprised to see her pull up in a mattrack van.

Our "ride" home

The ride back was comfy and quieter.  I had not gotten sucked into the “romance of the Bomb”.  I rode in those things plenty, back in the 1980s and 1990s!  I also knew we would likely be riding in Bombardiers again during our trip to Old Faithful.

Once back at Mammoth, we gathered for a group portrait before heading down the hill to meet Carolyn at Cowboy’s for the traditional New Year’s Day dinner.

The group assembled in the Map Room in the Mammoth Hotel

Xanterra could not accommodate our request for a table of 10, unless we waited until somewhere around 8:30 or 9:00 p.m.  With most of us coming from Bozeman and Livingston, that was unacceptable.  Luckily, the new restaurant, Cowboy’s Lodge & Grille, in Gardiner, was able to meet our need.  Carolyn joined us, and we enjoyed an excellent dinner.

Major announcement

Most of you already know this, but for those who have not heard the news, Jane and I became engaged to be married in early January.  As you can imagine, this produced a flurry of additional activity, as we started planning a wedding, in addition to all the other things already on our plate.

Jim and Darlene visit – 1/6/11

My good friend, Jim, the retired City of Livingston Fire Chief, was in town, with his lovely bride, Darlene.  We got together for a day of cruising the north end of Yellowstone.  This was a Thursday, so Jane had to work.  She would join us in Livingston for dinner at Montana’s Rib and Chop House.  Ironically, I missed the Park County Fire Council meeting, taking place right across the street, at the Rural 1 fire station.

Thankfully, the weather was warmer, although cloudy.  Critters were abundant.  We did not see any wolves, but we had 3 red fox visible simultaneously in the vicinity of the confluence of the Lamar River and Soda Butte Creek.

Mousing along Soda Butte Creek

After a while, we realized that there were 8 or 9 bull elk bedded down at the base of some cottonwood trees near the confluence.  A red fox was hunting nearby.

Bemused bulls watch the fox seeking lunch

On the hillside above the confluence, several bighorn rams searched for something to eat in snow that was uncharacteristically deep for so early in winter.

A coyote takes the easy route near Pebble Creek campground

We proceeded to Buns ‘n Beds in Cooke City for a late lunch.  It was great to see Jan and Leo, the proprietors.  I was able to clarify the rumors that they were trying to sell the place.  They showed us some interesting photos that many believe portray the grizzly that raided the campground outside town last summer, with her cubs, killing one person and injuring another.

On the way back to Livingston, we stopped in Lower Mammoth to visit with a ranger friend and his wife.  Dinner was, as always, outstanding at the Rib and Chop House!

Quick trip to Las Vegas/Mesquite – 1/14/11 – 1/17/11

My parents had departed Colorado for southern Nevada around Christmas.  We wanted Jane to meet them, so we took advantage of the cheap air fare and lodging offered by Allegiant Air.  We spent more time shopping at the factory outlet stores than gambling.  The visit with my folks was pleasant.  We were treated to a very nice dinner in a hotel in Mesquite.  This was one of those trips where time just flew by, and the next thing you knew, we were back in Bozeman.

Wendy’s visit – 1/17/11 & 1/20/11

Wendy, our friend from NYC was in town the third week of January.  She joined us for dinner at Jane’s home on Monday evening, the 17th.  A few days later, on the 20th, if I’m not mistaken, she and I snowshoed down to a ridge that overlooks the Yellowstone River in Little America. I was amazed at how much additional snow had fallen since my last foray into northeastern Yellowstone, 2 weeks earlier.

Trip to Carmel/Monterey-1/26/11 – 1/30/11

This was a business trip for Jane.  She was attending a conference in Monterey.  We stayed in Carmel-by-the-sea.  I had been in the Bay Area numerous times, but had never made it to this scenic geography before.  I came with high hopes for completing the New Year’s Day trip report and doing a blog post.  The first full day dawned sunny, with unseasonably warm temperatures.  I couldn’t resist  the siren’s call to go exploring.  The next thing I knew, I was hiking a trail along the coast at Point Lobos State Reserve.  I fell in love with a place called Blue Cove.  I fell in with some amateur whale watchers, and we found 3, possibly 4 different pods of California grey whales, heading south for mating season.  After a while, the whale activity slowed, so I headed south, down to Big Sur.  For 5 or 10 miles, I could periodically spot whale pods in the distance.  I had observed two of them long enough to recognize repeated behaviors.  I was able to track them moving south for an hour or more.

On Friday, Jane and I visited the marine aquarium in Monterey.  It was wonderful!  They have an amazing sea horse exhibit.  While snacking outside, a very crafty sea gull actually stole a potato chip out of my hand, and I had no intention of offering that morsel to any critters!

On Saturday, Jane and I headed to Point Lobos, where we watched whales for a while, then walked the hiking trail to Blue Cove.  I had spotted harbor seals in the cove on Thursday.  They were hauled out on a number of rocks, once again.  Jane spotted some sea otters, and thus began some outstanding marine wildlife watching.  We discovered several species of marine birds, and watched one sea otter in particular haul out on a rock that was already occupied by two harbor seals.  The one bummer about this trip is that I forgot to bring my camera.  Distraught, we purchased an el cheapo camera in a drug store, which we used to snap some images on Saturday.  Unfortunately, we did not have very good light, and this device lacked the powerful zoom that my Nikon P90 possesses.  I tried to download the photos we did take this evening, but apparently, it is going to take some horsing around with loading software.  My photo editing software couldn’t locate the device.  Next year, I will be sure to bring my camera and bring back some photos to share.  (I learned one thing through observation.  Photographing those whales is an exercise in frustration.  They rarely present more than a spout or possibly tail flukes.  I watched a lot of people with tripods and big lenses invest considerable time for minimal return.

Trip to the Old Faithful Snow Lodge – 2/3/11 – 2/6/11

We arrived in Bozeman on Sunday, the 30th.  On Wednesday, the 2nd, we headed south to West Yellowstone to spend the evening at a hotel.  The next morning, we caught an 8:30 a.m. snow coach to the Old Faithful Snow Lodge.  It had been 19 years since I had been to the Snow Lodge in winter.  Jane had never been there in winter, and very much wanted to check it out.

The last time I stayed here was 1992, which was well before the new Snow Lodge was constructed.  The very first time I stayed here in winter was in 1986.  Rather than stay in a hotel room, we had booked a cabin.  Given the choice, Jane opted for a cabin on this trip.  I was pleased to find that Xanterra is using the same cabins, but the interiors have been upgraded since my first visit.  One of the unique pleasures I remembered from 1986 was skiing back and forth to the Snow Lodge for meals.  I remember sticking our skis and poles in the pile of snow right outside the front door.



Fast trail, as long as you are on snow



Jane skis past Fan and Mortar, just north of Riverside Geyser

We watched a herd of bison on the far side of the Firehole River work their way down to the river’s edge, where they crossed over to our side.  We spent some time just sitting on the bench at Morning Glory Pool.  We pretty much had the place to ourselves, although a few people skied or walked past while we were there.  After a while, we realized it was time to head back.  This was an afternoon of “just missing” several predictable geysers.  We had seen Grand Geyser go off from just north of the Visitor Education Center.  It was far enough away that I didn’t even pull my camera out.  We were about 10 minutes late for the eruption.  We missed Daisy Geyser by about 10 minutes as well.  It was just one of those stretches of bad luck that occur in geyser basins from time to time.  On our way back south, we did see a feature erupting that I had no familiarity with.  It lies on the east bank of the Firehole River, just downstream from the bridge between Castle and Grand.

Unfamiliar feature in eruption - Grand Geyser behind and to the left

Friday, February 4, 2011

We were up so late on Thursday night, and had gotten so little sleep on Wednesday night, that we slept in Friday morning.  By the time we got out of the cabin, it was time for lunch.  We stopped by the Geyser Grille, grabbed some food, and headed over toward the Old Faithful Lodge.  We stopped for some photos at the southeast corner of the huge parking lot.

The weather station and parking lot web cam

Closeup of the trail sign and my Sweetheart

The Old Faithful Lodge, closed for the season

We skied east along the south end of the Lodge.  We noticed an area on the south end of the building where someone had been sawing snow blocks and sliding them off the roof.  It resembled the work of winter keepers, like Jeff Henry, which we see every spring.

Someone had sawed snow into blocks, apparently to protect the HVAC system

From there, we did a quick loop through the cabin area, then headed up onto Geyser Hill.  We were warned by some other visitors about a tricky area, where the boardwalk near Aurum Geyser had a deposit of blue ice.  They never mentioned the usual icy deposit at Beehive.  At least, I knew to expect it.

Beehive Geyser, with the Old Faithful Inn in the background

Ice buildup on boardwalk by Beehive Geyser

Old Faithful Geyser and the Old Faithful Lodge behind it

Heart Spring, illuminated by late day cloud-filtered sunlight

Visitors on Geyser Hill, with new Visitor Education Center in background

When we got around to Aurum Geyser, we saw the treacherous ice aggregation we had been warned about.  I looked and looked at that blue ice, and then decided to find a “creative” way around it.

Scary ice at Aurum Geyser

Zoomed in, it looks even scarier!

We took our time wandering back to the cabin.  Unfortunately, in circumventing Aurum Geyser, Jane tweaked her knee.  That prompted her to bail on the plan to ride the 11:00 a.m. skier shuttle to the Spring Creek dropoff the next day.  She told me to go ahead and do the outing.   She would hang out at the Snow Lodge with her laptop, and catch up on some things.  Ironically, the Colorado Mountain Club group from Denver had arrived the same day we had, just later in the day, since they had to come in from Flagg Ranch.  They tied up the 8, 9, and 10 a.m. shuttles, all heading south to the Divide Lookout and Spring Creek drops.  I wound up riding the 11 a.m. drop with one other passenger, a young woman who works in the Bear Den ski shop.  I decided that since Jane wasn’t participating, I might as well go all the way to the Divide Lookout trailhead.

I opted to simply ski down from there, and skipped the side trip to the top of the ridge.  I have been up there so many times, and I didn’t want to leave Jane alone for too long.  I had forgotten that the Divide Lookout trail goes uphill pretty much the whole way to the ridgetop, so I did a short uphill run for a couple hundred yards, until I reached the junction, where the Spring Creek trail started heading downhill toward its intersection with the Lone Star trail along the Firehole River about 4 miles away.  We had gotten a dump of new snow overnight.  Most of it had fallen in the early morning.  Snow was falling as recently as 8 to 9 a.m.; and it was cloudy until we left the Snow Lodge.  I finally had some good luck.  I had a well tracked trail in fresh powder ahead of me, and blue sky/sunshine.

Meeting the Spring Creek spur trail at the picnic area

Privy with substantial snow loading at picnic area

Spring Creek trail, headed down

The woman from the Bear Den caught me from behind probably halfway between the picnic area and the intersection with the Lone Star trail.  That never would have happened 20 years ago, but that was then, and this is now.  Throughout the descent, there were periodic drops of accumulated snow, when the wind would stir tree branches.  Every once in a while, there would be a particularly strong gust, or a heavily laden tree.  Briefly, you would have a “snow cloud”.  I tried to time my passing through those zones, but occasionally, I got dumped on.  It was reminiscent of times skiing from Bierstadt Moraine down to Hallowell Park in RMNP, after late season storms.  I would play games with my kids, pivoting my poles upward to knock snow off tree branches, which would “bomb” them if they were close enough behind me.
Eventually, I reached the Firehole River.  It was a strange feeling, after all those miles alongside a frozen, snow-covered creek, to suddenly see so much open water.

The Firehole River, photographed from the bridge on the Spring Creek trail

At the junction, I encountered a woman who was waiting for two of her compadres.  They were Colorado Mountain Club skiers, who had been dropped off via one of the earlier shuttles.  They had skied out to Lone Star Geyser, and were heading back to Old Faithful.  She was full of questions about where I had come from.  When I told her I had been dropped off at the Divide Lookout trailhead on the 11 a.m. shuttle, she was almost incredulous.  When her friends arrived, she made a point of telling them.  Apparently feeling like I had caught them from behind, they said something about having broke trail for me.  They must have been from one of the early shuttles, because the fact that they had skied the additional half mile or so to Lone Star Geyser, and waited for it to erupt, didn’t seem to ease their pain.

The Lone Star Geyser trail/road seems somewhat "cosmopolitan" after the solitude of the Spring Creek trail

I opted for a route back from the Lone Star trailhead to the vicinity of the Snow Lodge that I had not skied before.  I simply skied the road to where the Fern Cascades trail intersected it, then skied down into the complex.  After eating a late lunch, we went by the Visitor Education Center, then headed back outside to catch a late day eruption of Old Faithful.

There was a small herd of bison over near the Old Faithful Lodge.  Initially, they were clustered on the dry ground, close to the Lodge, but as we watched, they started clambering over the boardwalk, and moved closer to Old Faithful.  It was as if they were aware of the impending eruption, and wanted to get a better view.

Bison moving closer to witness the eruption

Eventually, the geyser erupted.  I think it was 10 or 15 minutes late.  The sun had set, and the cold was setting in.

Old Faithful in eruption

Shortly after the eruption, we noticed that although the sun had gone behind the hills to the west of us, it was still illuminating the clouds to the east and southeast.  I will post a few of the better shots I took of the bison herd, with the glowing clouds above them.

Zoomed in on that warm glow

About the time the warm glow began fading, a cow bison, presumed to be the herd leader, began moving toward us.

Bison on a mission

Apparently, this cow bison was looking for a good dinner spot.

It was slim pickin's, but she found something to eat

This may not have been the dominant cow in the herd.  The others were slow to follow her lead.  As the light continued fading, I took a few shots of this hungry critter, who showed no fear of humans.

Our last night at Old Faithful

We were booked on an early afternoon snow coach to West Yellowstone, so on Sunday morning, we packed up our gear, made arrangements to have our luggage brought to the Snow Lodge, and went over to the Visitor Education Center.  We ran into ALR, BonnieCO, and ALR’s husband.  I knew they were in the park, but I didn’t know they were at Old Faithful.  Ironically, they were heading back north to Mammoth about the same time we were going back to West Yellowstone.  We heard Beehive’s Indicator called, so armed with that information, we headed over toward a good vantage point to watch the impending eruption.  Jane and I were excited, because we had not seen any of the large geysers go off, with the exception of Old Faithful and the long distance view of Grand.

A very steamy Beehive Geyser

Beehive Geyser in all its winter glory!

Old geysers don't die. They just fade away.

Shortly after Beehive went off, Old Faithful put on a performance.  It seemed much more steamy than the night before.  It might just be a difference in wind direction and our observation position.

Old Faithful Geyser --- one last blast

Once the Old Faithful show ended, we wandered back toward the new Visitor Education Center.  I was taking photos of it, when an idea popped into my head.

Powerful reflective properties of that new glass

Someone was wondering where the web cam was situated.  It is behind the expanse of glass, on the upper right.  I thought we should get a web cam group portrait taken.  I called my buddy, Daryl (Bison).  Luckily, he was home, and willing to take our photo.  He posted it on the chat page.

ALR’s husband had opted for the indoors, so the photo just included the four of us.  In this first shot, you can see who the “rookie” is (the one on the left, not waving).

Wave Rookie. Wave!

I was on the phone with Daryl while he saved a series of shots.  The web cam updates every 25 or 30 seconds.  After saving 3 or 4 images, Daryl asked us to move closer.  We complied, and he got the shot that he posted on the Up Close and Personal chat page.

Now, Bonnie is the only one waving

Jane and I headed back to the Snow Lodge for lunch, and ran into our Loony friends in the lobby, shortly before we loaded our respective snow coaches.

ALR and Bonnie seated - ALR's husband and their snow coach driver standing

This was the last photo I took on this trip.  Our trip back to West Yellowstone was quick and uneventful.  Our snow coach driver was anxious to get back to Old Faithful to see as much of the Super Bowl as possible.  We had a similar interest in getting back to Bozeman.

BLIZZARD(S)

It was either that night or the following night that we had a major snowstorm.  I was amazed that a Blizzard Warning was not issued, because it had all the usual factors, cold temperatures, high winds, and heavy snow.  We have had a number of these storms this winter.  Several in February and one in March have featured strong winds, which have scoured certain areas and built large drifts in other places.  Since I did not photograph each event, the photos associated with this storm will have to satisfy for reporting purposes.

The neighbor's driveway

The drifts in the photo above were created by a combination of both east and west winds (both in the same storm).  West is to the right.  This particular storm produced enough snow and drifting that they hired someone with an industrial strength rotary plow to clear their driveway.  Their tractor-towed rotary device was undersized for this challenge.  Since this storm, there have been two more that built those drifts up even higher.

Drifts start climbing the fences at Jane's place

In the aftermath of this storm, several of the dogs realized they could escape the backyard by going over the fence into the horse corral.  We could no longer open the gate each evening to feed the horses.  I spent several hours digging trenches in the snow along that particular fenceline  (not in this photo).  The most recent storms have built the drifts up even higher.  There is now snow higher than my head in select drifts near the barn.  (The snow in northeastern Yellowstone is twice as high as I’ve ever seen it.  I was not around to see the winters of 95-96 and 96-97.)  We have had to install a temporary electric fence above the drifts to keep the dogs from breaking out at will!

Plowing has transformed from "fun" to WORK

You can see the old plow line on the left side of Jane’s driveway.  The recent storms have worked to narrow the driveway.  The Kubota just bounces off the old, dense, hardened snow.

This series of photos were taken on Tuesday, February 8, shortly before I drove Jane’s sister, Jean to the airport.  She had been staying at Jane’s, and going through some of the family “archives” (photo albums), trying to identify some of the “old timers”.  There are some early Yellowstone photos that blow my mind.

Jean and Joyce on 2/8/2011

My apologies to both Jean and Joyce for the poor photo quality.  Even with my Photoshop Elements, I was unable to get rid of the white glare.  I find indoor photography particularly challenging.

Jackson Creek Ski Trip – 2/12/11

I conjured up a plan for what would be a romantic way to celebrate Valentine’s Day.  The idea was to use either the Saturday or Sunday before Valentine’s Day (Monday) to go skiing and have a sumptuous feast afterward.  My original hope was to spend one or two nights in Gardiner or Mammoth, but our friends were not able to get away for that length of time.  I checked Chico Hot Springs as a dinner option, but they were booked solid (not surprising, if you are familiar with their fine dining).  Even the Mammoth Hotel dining room was a bust.  We were looking at reservations for 6, and Xanterra has real problems accommodating groups of more than 4.  I went to the 2nd Street Bistro in Livingston as an alternative.  That proved to be a hit with our friends.  They wanted to bring their dog, which eliminated Yellowstone as a ski venue, so we looked around for a national forest alternative.  The folks at Timber Trails in Livingston suggested Jackson Creek, which just happens to be a couple miles from Jane’s place.
Unfortunately, that Saturday morning dawned quite cold, with a strong west WSW wind.  I had been told that Jackson and Kjirsten had a “dog or two”.  At the trailhead, we discovered that they had 3 dogs.  With Mike and Cindi’s dog, and our Keeva, we had 5 dogs along.

Excited canine companions meet and greet each other

Cindi, with the Bridger Mountains behind her

We were exposed to a quartering wind initially, but after the trail made a turn to the east, the wind was mostly at our back.  After a mile or so, we entered a canyon, which choked the wind down considerably.

This was a two track road most of the year, so it was nice and wide for a ski trail.  Since snowmobiles also use the trail, it seemed almost groomed.  The fact that several snow machines had been up there since the last snowstorm helped us out.

Keeva and her pals approaching

The dogs were having a ball.  Keeva in particular was thoroughly enjoying the opportunity for a romp in the snow.  She would occasionally dive off the trail into snow banks.  I never did figure out what that was about, unless maybe she was mousing.  She has been catching mice outside all winter.  She loves flipping them into the air, and watching them free fall back to Earth.  She can’t figure out why her little play toys don’t last long.

We skied about 3 miles to an open area, where most of the snowmobiles had turned around.  Only one set of tracks continued on.  Some of the dogs were tiring from all the running back and forth.  We took a break that eventually became our turnaround point.

Mike dug out a makeshift snow “couch” to sit on.  It looked pretty comfy.

Jane, Mike, and Cindi (l. to r.) luxuriating on the snow "couch"

The dogs were pretty tuckered out by the time we got back to the trailhead.  I’m betting Keeva traveled a mile for every 500 feet that we did.  She would run back and forth between the lead group and the rest of the group.  When Jane and I were in separate groups, Keeva would range back and forth between us.  She got a good workout!

Dinner that evening was quite nice.  Anyone that has dined at the 2nd Street Bistro needs no convincing!

Lamar Valley – 2/13/11

These will likely be the last photos of this report.  Jane and I made a trip to northeastern Yellowstone on the Sunday after the Jackson Creek ski outing.  I had seen how snowy northern Yellowstone was getting on my trips with Jim and Darlene; and with Wendy (Diane), in January.  Jane was not with us.  The drifts in the Blacktail area, where the NPS had to bring in a front loader to keep the road open, were already so high that you could not possibly see over them.   They were easily as high as I had ever seen them.  They are much taller at this writing!
We entered Lamar Valley, and were surprised to see an amazingly sterile landscape.  It was just white everywhere.

No critters visible

We stopped at Dorthy’s Knoll, and tried to spot wildlife.  There were no bison or elk visible in the valley bottom, which is a rarity for this area commonly referred to as “The Serengeti of North America”.  Eventually, I spied one cow elk, standing in deep snow in a small grove of cottonwoods.  As we drove toward the distant end of the valley, we spotted a sprinkling of bison, somewhere between six and eight in all, on the south-facing hillside east of the Buffalo Ranch, above the old picnic area.  That was the sum total of our wildlife “census” in the valley.

Thankfully, once we got around the corner, and reached The Confluence of the Lamar River and Soda Butte Creek, we found the usual bighorn rams on the hillside, a herd of bison in the valley bottom, and even some bull elk bedded down.

Frosty and quiet, nothing above the snow in motion

Later in the day, as the sun headed for the horizon, hope gathered that we might be treated to one of those occasional killer sunrises that occur in Lamar Valley.  I started photographing the surrounding hills, as the last rays of sunlight illuminated them.

The dark of the pavement provides vivid contrast

The sun has already set on the north-facing hills and the valley bottom

Frequent visitors to Lamar Valley will recognize these trees above the Fishermen's Pullout

We had the company of another photographer for a bit at Dorothy’s Knoll, who also had high hopes for a great sunset.  It never did get “great”, unfortunately.  The next two images were the best I could get, under the circumstances.

As good as it got

As good as it got - zoomed in

President’s Day Weekend – Trip to Logan

On February 18, Jane and I drove down to Logan, Utah after Jane got off work.  We were going to assist Jane’s daughter, Sara, in moving back to Bozeman.  Thankfully, our drive was blessed with good weather.  The only snow-covered roads were through the west side of Yellowstone on Hwy 191, through West Yellowstone, and down Hwy 20 through Island Park.  By the time we reached Ashton, Idaho, we were on dry pavement.
On Saturday morning, we picked up a rental trailer that we hooked to the back of Jane’s pickup.  We spent the afternoon loading the trailer and the bed of the pickup.  We had most of the load on board, but Sara was running out of gas.  The decision was made to finish loading on Sunday morning, and hit the road.  Jane and I went out for dinner at a Mexican restaurant.  Afterward, we stopped at an Arctic Circle for some ice cream.  While inside, the forecast snow storm blew in with a vengeance.  By the time we exited the restaurant, several inches of new snow had fallen, and it was coming down sideways, driven by a stiff wind.  This was very wet, high density snow.  We had a heck of a time driving back to the hotel with that heavy load pushing the truck.  Stopping at traffic lights became a scary proposition.

Sunday morning dawned cold and gray, but at least, the storm had blown itself out.  We went over to Sara’s to finish loading.  The large deciduous trees in the neighborhood were coated with thick wet snow.  There were large tree limbs on the ground here and there.  We were periodically pelted with falling snow “bombs” as we labored to complete the loading.

We were on the road sometime between 11 a.m. and noon, but not without a few stops and retreats, as we discovered Sara had forgotten a few items.  Later that day, we would find out that Sara’s wallet and driver’s license were still in Logan!

The drive back to Bozeman started out fine, as the roads in Utah and southern Idaho were wet initially, and later, dry.  Unfortunately, as we approached Ashton, we found icy stretches, where the wind had been playing fast and loose with the snow accumulations on the flat lands.  From there until almost Big Sky, we were driving in icy conditions, thanks to the latest storm.

Sara had adopted a second dachshund since returning to Logan, so now she has 4 dogs, which means there are SEVEN dogs at Jane’s place these days.  Oh, I almost forgot.  She also has a cat, named Bandit.  She is a very pretty kitty.

Other February/early March activities

There have been many WWAMI activities over the past month or so.  The legislature is in session, and Jane has had a variety of duties associated with that.  As her occasional “driver”, I have been in Helena three times in the past month.  I won’t bore you with the details.
I was supposed to host a friend from Great Britain a few weeks ago, but his girlfriend took sick shortly before our day in Yellowstone.

Another friend, Gary M., from California, was in town last week.  We spent one day together in Yellowstone.  We visited Cooke City, and marveled at the height of the snow berms along the road.  We spent time gabbing with Jan and Leo at Buns ‘n Beds.  It was fun, listening to Jan’s grizzly stories.  If you haven’t seen the grizzly photos gracing her refrigerator door, and heard the stories, it is worth a stop in next time you are in Cooke City.  We also stopped off at the new Community Center in Cooke City, which is funded with the resort tax the locals voted in a few years back.  It features nice public rest rooms.

The evening prior to my day with Gary, I had attended the monthly Park County Fire Council meeting in Livingston.  While there, some of the responders were paged on a vehicle versus bison incident north of Gardiner.  The bison was deceased, and there were injuries to someone in the vehicle.  It is fortunate I was aware of that event, because it prompted me to drive slowly in the section of Hwy 89 between Corwin Springs and Yankee Jim Canyon.  While straining to see any large black shapes on or near the road in the distance, I failed to see a yearling whitetail deer, running across the road from left to right.  I hit the deer at a speed of maybe 45 or 50 mph.  Normally, I woud  have been going 65 or 70 mph through there.  I have damage to the lower bumper shroud, which will have to be replaced.  The driver’s side headlight is out of alignment.  The vehicle is driveable, and will be repaired soon.

There are a few things I can’t talk about, due to confidentiality concerns, but they will be made public over the course of the next year.

For now, I must say that I have learned a lesson about getting behind on blog posts.  It is tough to play catch-up ball.  So, I am not going to make any commitments that I might not be able to meet.  I will just say that I will try hard to post more frequently.  My ability to do that will depend somewhat on the unknowns that lurk out there in the murky future.

It has been a long winter.  I am dreaming of Indian Wells tennis, spring baseball, and the opening of Mark’s in Livingston.

Love to all,

Ballpark

I will be visiting the National Institutes of Health (NIH) in Bethesda, MD in late May for a two year follow-up.  My local oncologist agreed to not have a CT scan run in conjunction with today’s appointment, given that I will have a CT scan at NIH in May.

My next local appointment is July 7.

This post is short and sweet, because I have a whopper of a January/February 2011 post in the mill.  Actually, I have been working on it, off an on, for the past several weeks.  I hope to finish it today, but if I don’t, I will have it mounted within the next couple days.

Ballpark Frank