CPT Cancer

A journal about the intersection of military life, cancer, and being a single dad.

Tag: medical

  • Prologue Part 7: Famine

    Work Smarter, Not Harder.

    I was being wheeled down to the MRI in my bed by one of the Internal Medicine LPNs, a junior enlisted soldier like most of the LPNs on staff during my visit, and greeted by three ladies that made up the MRI night shift from 11-12 February. I know I’ve referenced the “MRI” a few times now, but for the unacquainted:

    “An MRI (Magnetic Resonance Imaging) is a medical test that uses strong magnets and radio waves to create detailed pictures of the inside of your body. Unlike X-rays or CT scans, it doesn’t use radiation. MRI is often used to look at soft tissues like muscles, organs, and the brain. It’s especially helpful for diagnosing problems that might not show up clearly in other types of imaging.” -ChatGPT

    They needed to take a look at my liver to make sure the unknown mass seen in my PET scan was benign, or part of my cancer. If it was found to be part of my cancer my survivability odds would tank dramatically.

    At this point I hadn’t eaten or drinken anything save a few ice chips in 24 hours. For someone with a strong metabolism like me this was hell; compounded by the physical and psychological toll I’d endured over the last four weeks with random fasting and diet restrictions laid on by different imaging instructions or procedural rules.

    The MRI ladies adopted a, “work smarter, not harder” approach as well as a “let’s not fuck this guy up anymore than required” and my appreciation was eternal once I realized this. Despite being doped up by an injected painkiller that should have covered me for the duration of the MRI experience, I was alert and lucid.

    A cloth gurney of some sort was laid under me, and the MRI team used it to gently slide me over from my recovery bed to the MRI tray. This really highlighted the stark contrast between men and women, even in the medical field: the men were going to brute force me as much as medically possible and insist I participate in some sort of capacity, but the team of smaller women (all three were petite and of various Asian ethnicities versus the aforementioned team of four large dudes from my last post) realized they needed to use mechanical advantage to not just physically move me but also make it as smooth as possible.

    Once in the MRI tray I was packed in with all sorts of blankets and braces as I was to not move and they needed pictures of one specific part of me: the midsection.  I don’t get claustrophobia but what I do get is nausea. About halfway through the imaging session I felt nausea rush into my head quickly.  The neat thing about an MRI is it has a microphone so you can communicate with the staff. I quickly informed them I was going to be sick and that I needed to get out now (I literally couldn’t move my head to puke if I’d wanted).

    The MRI team jumped into action and rolled me out just in time to remove some of my restrictions and put a barf bag next to me. I tilted my head to the side and began to dry heave; I had nothing to give.

    Dry heaving requires a tremendous flex of the abdominal muscles, as I remembered far too late. Each heave sent me into spasms of pain as I involuntarily flexed my ab wall as hard as I could to meet the needs of my digestive tract trying to return something to sender.

    Just as quickly as the nausea came on, it subsided and I felt perfectly fine. We gave it a few minutes and reset; they only had about 15 minutes worth of work left to go. Back to the grindstone (I contributed nothing other than breathing in and out when the voice told me to).

    Just as I had been smoothly transitioned into the MRI tray, so I was slid back into my hospital bed. These ladies were true masters of their craft from top to bottom and this was probably the highlight of my hospital stay from a customer service perspective.

    After being brought back up to my spot in the Internal Medicine Hostel of Excellence I was escorted to the bathroom and was alarmed to find the large volume of ice tea leaving my body, or at least that’s what the color of the urine suggested. I complained to the LPN that I was obviously dehydrated and the answer provided to me was a cup of ice chips. At this point I’m assuming ice chips are the Motrin of the LPN world.

    I, figuratively, crushed that cup of ice chips. One after one I put them into my mouth to be dissolved, crushed, and swallowed; right as I finished I was brought yet again more useless oxy, an antibiotic, and an anti-nausea med… all to be taken orally on my terminally empty stomach. They gave me water to accompany these pills and no sooner did I swallow the pills did my body immediately reject them. I began to vomit medicine, water, and ice chip remains into my barf bag. I filled this bag nearly halfway with water and anything else my stomach could find to send up the hatch. I was getting pissed off now, they were not listening to what I was telling them this entire time- or at least not doing any critical thinking about it. I looked at the 2LT RN on shift and said, “Get me a Doctor, LT.”

    Now, anyone who has been a Lieutenant knows that the inflections of “LT” are very important to interpreting the meaning behind what’s actually being said or asked.  The inflection I used in this instance was intended to be interpreted as, “I’m done talking to you, go get a fucking adult.”

    The night shift resident came to my bed and introduced himself. My mother departed several hours ago when visiting hours ended: this was mono y mono. He asked very simply, “What’s going on.”

    “My piss looks like ice tea, I haven’t eaten or drank anything I could keep down in over 24 hours, giving me more medication on a completely empty traumatized stomach isn’t working. So why don’t you guys use this IV port in my arm to hydrate me and administer IV medications? Is that unreasonable?” I said, asking questions that we both knew the answer to.

    “Those are both very reasonable requests, I will put in the order.” He said, and was gone just as quickly as he appeared. I’m hoping some mentorship occurred at the nurses station, but I’ll never know- perhaps they all made fun of the Captain dying of dehydration and turned me into a meme in their groupchat. I know that is probably ethical sacrilege, but it adequately describes my growing mistrust in my surroundings at this point in the story.

    ============

    A Rogue Blood Vessel.

    Once the IV drip began and they shot the anti-nausea meds into it, I knew I was probably going to be ok. Despite all the pain and shenanigans up to this point, someone finally listened to me and addressed my needs. I don’t sleep on my back, so I had to list a little to my right and bring my knees toward my chest to form a modified recovery position. I dozed for a few hours at a time; only waking when my subconscious detected a nurse coming in to take vitals.

    When I was awoken for the final time, around 0630, it was by the same IR doctor that inprocessed me the previous morning. He wanted to see how everything was holding together and how the pain was. The pain had significantly subsided as long as I remained still, and he checked their handiwork and started to talk about care and maintenance I was too tired to pay attention to. I spoke about the food situation from the day prior, and he said he’d talk to someone about it on his way out (he didn’t). 

    Before he left, however, he mentioned that my MRI came back, and that the spot on my liver was consistent with an enlarged blood vessel, a hemo-something, that was common in many people and typically only found if that person has a PET done. This means it was benign and not related to my cancer. This was a solid piece of news and lifted some large grains of stress off of my shoulders.

    “You know, one less thing.” -Forrest Gump

    The new LPNs rotated onto shift as well as a new doctor, right around the time my mother returned for visitor hours. The new doctor understood my predicament from the day before and said he’d change my order to reflect getting some solid food.

    The social worker, the inpatient case manager, the nutritionist, and the outpatient case manager all happened to come by during the time it took to actually get food- a roughly four hour span. Progress was glacial, but eventually they gave me a shot of anti-nausea meds and placed a tray in front of me; I dug in immediately.  I ate the cookie first because it felt like an act of civil disobedience. I know it made no difference which order things were eaten in, but it still felt good to push back on the norms of society in this place. After finishing all my food, plus four hours, I was finally discharged from Internal Medicine at 1630. Thank you eight pound, nine ounce baby Jesus.

    The views and opinions presented herein are those of the author and do not necessarily represent the views of the Department of Defense or the U.S. Army.

  • Prologue

    Introduction

    Starting a blog is something that’s always been floating around in the back of my mind, but never a thought executed because I found it to be high-risk behavior in my line of work.

    See, I’m a “Public Affairs Officer” (PAO) in the U.S. Army.

    If you’ll allow me to paint with a broad stroke: A PAO’s responsibility is being the Army’s spokesman at the unit level; to be the tip of the spear (or in many cases, a shield for feces to be flung at because of poor/controversial command decisions) in the “information environment.”  If you’re a rational person, you can see how publishing a blog of personal thoughts could put me at odds with the position I hold at work, and my employer’s expectations of me in that role.

    So, in short, this page’s name isn’t just alliterative: I’m actually an Army Captain. As the title of this page also suggests: I have cancer. 

    You might think to yourself, “Wait, you said you are a Captain right? You can’t be old enough to have cancer…”

    You would be wrong in that assumption, although I wish you were right.

    ============

    High Risk Behavior

    More than one PAO has become persona non-grata in the career field, or in their individual workplace, for publicly airing a little too much of their personal feelings on some subjects. I’m not trying to create one of my own moments like that here, but I’m an active duty officer undergoing cancer treatment in the military medical system- from time to time things might slip out. I’m going to call them like I see them.

    Never fear, Congress of Colonels, I will always add the customary “The views and opinions presented herein are those of the author and do not necessarily represent the views of the Department of Defense or the U.S. Army.” so that you and the Army can wash their hands of any of the goofy shit I say here in a media Response to Query (RTQ) or Holding Statement if I go terminal and let loose some unhinged rants.

    “The elites don’t want you to know that PPM rates have been cut by 50%!”

    I do not plan to go terminal, but only so much of this outcome is in my cognitive control. And as the popular staff officer saying goes: no plan survives first contact with reality.

    ============

    1000 PST – 20 December 2024

    (Author’s note: I’m using military date and time conventions because they make more sense and I’m going to force it down your throat like cancer forced its way into mine)

    I was two days removed from my return to my home in Tacoma, Wash. from Sagami Army Depot, Japan. I’d just completed the largest staff exercise my unit had ever partaken in, and in conditions that are best described as “the worst glamping trip you’ve ever been on.” 

    I was looking forward to playing hockey outdoors for the first time in Winthrop, Wash., at a rink on the eastern edge of the North Cascades, for a weekend-long veterans scrimmage tournament. It was projected to snow and while my little Corolla Hybrid is trustworthy and faithful to its purpose, its purpose isn’t driving in blizzards through mountain passes. This is how one of the heroes of our story makes their first appearance.

    Nicolette is a military contractor, and despite this handicap an all around good human. She’s the office therapist, financial counselor, honorary warrant officer, continuity, and dating coach. Like me, she is also overflowing with candor; we were natural friends from the start.

    We’d arranged to swap cars so I could, you know, not die crossing the Cascades to go play outdoor hockey for a weekend. See, Nicolette had just bought a brand new Subaru (sorry ladies, she’s straight and taken) which was the far superior option to my compact hybrid.  I’d arranged the swap for the morning I was supposed to leave. We were standing at her desk, chatting before I was to swap cars and hit the road, when she said it. The phrase that brought this story to life.

    “Hey, what the fuck is wrong with your neck?” she said, frozen in place across from me.

    “What do you mean? Nothing’s wrong with my neck. What’s wrong with your neck? Fuck you, Nicolette.”

    Then, I felt my neck, “Oh, shit, I don’t know, do you think I should go see the medics?” I said with a little surprise.

    “Yeah, dude, you should. Remember that time you thought I was gonna die when my face got itchy? This feels like one of those moments,” she said, showing genuine concern.

    In this instance, a few things happened that many people in the Army are not always accustomed to:

    1- The medics were actually in the aid station instead of the clinic. 

    2- A provider was actually in the aid station instead of the clinic.

    3- The aid station was actually open the Friday mid-morning before holiday block leave.

    Granted, I’m in a large headquarters and our medics are very communicative about their hours and duty locations, but I’ve seen too much of the other half of Army life, and my expectations of anything having to do with military medicine were still set, by default, at “hilariously low.”

    (Author’s note: I will not be referring to my medical team by their real names in this blog)

    CPT Bennett is an ER doctor by trade, but I’ve learned that the Army by and large doesn’t give a shit what your speciality is when they assign you to a unit as the provider; she happened to be the provider in the aid station when I walked in there to be seen about… whatever the fuck was going on with my neck. 

    After a screening exam she came to a shocking conclusion: my neck bulging out on the right was not normal. I could sense that this was going to be one of those moments where I see myself getting ready to limbo underneath that aforementioned low bar, but then something different entirely happened: She ordered labs and an ultrasound. She showed genuine concern. She eliminated every possible emergency scenario before cutting me loose. She was treating this seriously.

    “Will I die this weekend?” I asked as I put my shirt back on.

    “Probably not,” she said, “but never say never.”

    Fuck it, good enough for the government I work for. I’m gonna go play some hockey.

    I went to the military clinic I’m assigned to and got my labs done, since it was more or less on my way out of the gate. The ultrasound referral would have to wait until at least Monday, but whatever, that was a future me problem. It was probably nothing anyway.

    The views and opinions presented herein are those of the author and do not necessarily represent the views of the Department of Defense or the U.S. Army.