Meditation Furthers

Medicine Buddha
Medicine Buddha
Medicine Buddha Thangka at Pine Street

Mala and I went in to see Dr. Meng on Thursday last week for a cystoscopy. This was one week earlier than expected. The news could not be better!

The equipment at UCSF was more sophisticated than here in Marin and the procedure went very smoothly, including the lidocaine. The cystoscope seemed to be thinner than the one in Dr. Neuwirth‘s office and it was connected to a high resolution monitor.

We were able to watch the entire procedure on the monitor.

Dr. Meng showed us around my bladder, including the entry areas for the ureters and the prostate. He then exclaimed, “I don’t see anything that I would want to biopsy. Come back in three months!

We still have to wait for the cytology analysis of the urine, but I don’t think they will find anything.

Go here to read about how meditation furthers.

Thank you all for your wonderful prayers, visits and support!

 

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Discussing The Options

On January 10, 2014, we visited Dr. Maxwell Meng.

Dr. Meng is now considered the “go to guy” when it comes to radical cystectomy – the removal of the cancerous bladder and replacement with an artificial one. If you have followed my story, you know that this was the “gold standard” of bladder cancer treatment back in 1997. It still is! As Dr. Carroll once said, “[Bladder removal] is a piece of cake!”

We discussed the types of artificial bladders, but I won’t go into details. The bottom line is that I was told that I need to have a radical cystectomy. Period.

One possible option is to have neoadjuvant chemotherapy prior to the surgery. For this, we were to consult Dr. Charles Ryan on January 16.

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Hospital Stay

The surgery (TURBT) took place on January 7 and I was in the hospital for three days and two nights.

On the evening of January 7, I suffered a severe pain in my left kidney. Some say it was because I didn’t let the nurses give me enough pain killer medication, but it could have happened even with it. The pain went away soon after a nurse injected some medication in my IV.

The pain has not returned and I made it through the rest of the hospital stay without incident.

It was a blessing to have Rachael prepare kitchari – an Aruyvedic composition of mung beans, rice, vegetables, and spices. Each day, she brought an new kitchari and they were all wonderful. You know how atrocious hospital food can be!

Visitors made my stay in the hospital much more comforting.

On the morning of January 9, Dr. Neuwirth came into my room and announced quite confidently, “You have muscle invasive bladder cancer and you should go see Dr. Maxwell Meng at UCSF” – all in one sentence.

By some miracle or perhaps a sense of urgency, we got in to see Dr. Meng, with CT scans and biopsy samples, the very next day.

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The 2013 Episode

Welcome to those of you who have been invited to view this page and other pages related to the 2013 Episode.

What is the 2013 episode?

I have a new muscle invasive bladder cancer that revealed itself at the end of 2013.

Throughout the ensuing period, my mindfulness practice has kept me positive and open to new possibilities. By now, three months have passed and mindfulness remains my true home and my refuge.

I am convinced that I will be able to maintain a mindful attitude, no matter what happens.

Here are the events that have occurred to date. I’ll try to keep my comments brief.

On this day, November 21,2013, I had a cystocopic exam by Dr. Neuwirth, my urologist of 17 years. I like to have my exams just before Thanksgiving so I can relate the good news to my family and friends.

Dr. Neuwirth did not see anything at all! We celebrated together.

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Less Good News

I had my meeting with Dr. Neuwirth this afternoon. The news was not that good. The two polyps were actual T1 tumors, which he removed during the TURBT last week. The good news is that BCG treatments should be quite effective against further tumors. The bad news is that it is my bladder that has to undergo these treatments. Dr. Neuwirth seemed hopeful, however. I start the BCG treatments in two weeks and I have to go once a week for six weeks.

BCG (Bacillus Calmette-Guerin) is a bacterial preparation of a strain of tuberculosis vaccine.  It is instilled in the bladder with a catheter and needs to remain there at least two hours. The last instillation in 1998 lasted 12 years. So if this works as well as the list time, I’ll be 82!

I felt like I had just lost an important tennis match – kind of down and low energy. Fortunately, Lady Catherine (my daughter’s best friend) came for dinner and took a lot of the sting out of the news. After she left, I spoke with Mala and the girls and could feel their love and concern. Their reaction was surprisingly calm, as they have a lot of love for me and know that my mindfulness practices and integrative medicine with get me through.

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Pre-op Exam

I had an appointment today with Dr. Nagar in Sausalito. She is a young woman (compared to me!) with a lot of knowledge and enthusiasm who speaks very rapidly which is typical of Indians. I like her a lot. She had a hard time believing that I was 70! My exam was mostly uneventful and included an EKG, but I have to give more blood tests tomorrow for determination of liver function, thyroid, and other conditions not measured by Dr. Neuwirth’s tests. No big deal! I’ll go tomorrow at 8:00 and it will be done with.

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Cystscopy

As mentioned in the introduction, I had my annual checkup this day. It was actually six weeks past one year, but I was prepared to even wait longer to go in, due to twelve years of a clear bladder. For the first time, Dr. Neuwirth found two small polyps in my bladder. I was surprised when he removed the scope without taking samples for biopsy like he usually did. He told me to get dressed and he would come back and talk to me. When Mala came into the room, he told us that he found the polyps and that I would need a CT scan and a TURBT (transurethral resection of the bladder tumor). So we go busy making plans for a CT scan on Friday and out-patient surgery one week from Friday.

The combination of Mala’s infection and the dense material I saw in my urine had led me to prepare for something like this. I had resumed my imagery and mindfulness practices around a healthy bladder, so I didn’t take it too badly.

When we got home, I started down the road of research on bladder polyps and called Michael Broffman. Michael was encouraging and said that in his experience, the polyps are usually benign. We’ll see!

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The Brain Revealed: From Chemistry to Mystery

The Institute for Health and Healing (IHH) sponsored the Roberta E. Neustadter Mini-Medical series on The Brain Revealed: From Chemistry to Mystery. I attended the two previous evenings, so this was my third. The second talk was given Allison Shapiro, who made a remarkable recovery from a nearly fatal double stem stroke. I had met her about a year ago at a Saybrook event and we spoke for a long time.

The main highlight of Allison’s talk was her paying attention to the slightest movement and making an effort to enhance the healing possibilities resulting from that attention. When our client heard this, she was very touched.

After the talks, I went to the rest room and noticed some dense fluid flowing more quickly than the rest. I knew it was time to call Dr. Neuwirth to schedule my annual cystscopy. This actually also come coincidentally with my wife’s urinary tract infection, which was treated with antibiotics.

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Two Years Later

On January 19, 2000, I had a cystoscopy which resulted in atypical cells in the wash. However, I did not find out about this until several weeks later because I went to India on business and then to France for vacation. While in France, I went to Plum Village, where Thich Nhat Hanh (lovingly call Thay – beloved teacher) lives for most of the year. Plum Village consists of three hamlets: Upper Hamlet, where monks live; Lower Hamlet, where nuns live; and New Hamlet, also where nuns live and guests stay.

In India, I trained programmers at Cybermedia and visited the Osho Commune. This is a place where I had been in 1975! There were a lot of changes to the grounds of the ashram, but, even though Osho died, the atmosphere wasn’t very different from 1975. My wife had been there as late as 1978. If you go there, you’ll find lovely grounds and gardens, and workshops on just about any spiritual, psychological, or physical discipline you wish! I found it very much fun and enjoyed the food there so much.

Plum Village was another story. I arrived there during the Tet celebration of the Lunar New Year. The monks and nuns were immediately hospitable and welcomed me with open arms. The next several days were filled with feasting, consulting of the oracle, visiting the rooms of the monks and nuns, and talks by Thich Nhat Hanh. I found Plum Village to be one of the richest spiritual experiences of my life. I have such great respect for the sangha (community of monks and nuns) and this brought me even closer to Thich Nhat Hanh.

During one of the oracle readings, Thay spoke about how someone who thought they had cancer could be having a wrong perception and therefore talk themselves into the disease. After the session completed, I approached Thay with the question I had about my friend who was suffering with glioblastoma – the worst form of brain cancer. We took each other’s hands and Thay said to me, “Perhaps you can consult the oracle!” Little did I know that the results of my cystoscopy were not negative.

A little while later, in the room of the abbess of Lower Hamlet, one of the senior monks answered the question for me. He said that the person should live her life as fully as possible in each moment. Five weeks after I returned home, my friend passed away. On the afternoon before her passing, she went out to lunch with her daughter. She fully lived up to the monk’s response.

When I got home from my travels, my wife told me about the results of the cystoscopy. I went into a mild depression, knowing that I asked Thay about my friend, when, perhaps, I should have asked about myself! I wasn’t ready to deal with a recurrence. Is anyone ever? On Wednesday, March 1, 2000, I went into the hospital for a biopsy under surgery, as recommended by Dr. Neuwirth. Two days later, I found out that all the tests were negative. I could breath a sigh of relief!

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