JUST CHECKING IN (part 2)

Look at this picture. Is it a unicorn? A real unicorn? The scientists – Italian scientists, I think -- quoted in the story say it’s a genetic mutation that they are studying in the laboratory.

You have to take my word for this I guess, but based on my 35 years in the newspaper business: IT’S A SCAM, YOU IDIOT! I can’t exactly tell you how it was done. Maybe they welded a horn onto a cow’s skull. But it is a fraud. Guaranteed. I’ve seen it before – but usually the ones perpetrated by Ringling Bros. are a little more artful.

But it is a scam – just like global warming, but on a smaller scale. (Incidentally, have you ever asked yourself exactly when Carbon Dioxide became a greenhouse gas? I always thought it was a natural part of Earth’s atmosphere, like nitrogen and oxygen. Plants need it to live. When did it become a bad guy? I’ve seen absolutely no scientific evidence at all that CO2 is contributing to the greenhouse effect.)

Sorry for the rant. It’s been a long week.

Incidentally, I’m weighing in at 252.8 lbs. It’s been steady for over a week now.

I also wanted to show you this pix of John McCain taken over the weekend. Reporters immediately asked if the dressing on his head were the result of another skin cancer operation. McCain laughed it off and said he had bumped his head on a car door. Fashion your seatbelts everyone, it’s going to be a rough campaign.

With that in mind, a brief acknowledgement to Cousin Marty: Our thoughts and prayers are with you and Phyllis. God bless both of you. That's the only important thing I have to say.

JUST CHECKING IN

I went to the hospital yesterday and had my post-op checkup and esophagram. I wasted five hours waiting for 5½ minutes of medicine but the results were so positive I could give a shit. Everything’s installed and working normally and I weighed in at 258 lbs! I believe that’s 50 lbs since the start of the liquid diet. Fifty pounds in five weeks. Life is good. I can do things I haven’t done in years – like tie my shoes without hassle, get up off the couch easily and walk up the stairs without losing my breath. And my knees don’t hurt anymore.

The most enjoyable result so far is that I’m about three feet back into the “thin clothes” sitting in my closet. I’ve had to change belts twice. But I’ve gotta keep in mind I’ve got a long way to go.

The next few weeks will be especially tough. I’m still on mushy foods but I’m cleared to go back to regular food this weekend. The challenge is that the lap band around my stomach hasn’t been activated yet. And it won’t be until the middle of July. Even though news the quote is from the doctor, I have to avoid believing it is now “party time.”

It could be a lot worse.

Anyway, here's something beautiful:

It's a lightning storm over an active volcano -- in the Andes, I think. No one knows why thunder heads form over volcanoes, though I suppose it has something to do with super-heated gas pouring out of the crater. But until someone figures it out, we can just enjoy the beauty of it.

And now here's the case of the worst of man repaired by the best of man.

Some stupid hunter, drunk I think, took a shotgun and shot down a bald eagle, blasting off its beak and leaving it to die a slow death.

But someone cared. They cared enough to capture the bird and keep it alive for months until it was strong again.

And some craftsman who cared worked long and hard to design and build a plastic beak that was tough enough for the bird to eat with.

And it didn't end there. Now that craftsman is working on a titanium model that can be permanently installed on the eagle.

Just when you think we couldn't get any lower as a species, you hear a good version of Beethoven's 9th symphony and things look a lot better. How could anything so stupid and clumsy conceive of something so brilliant and graceful?

I hardily recommend spending some quality time with old Ludwig van. If your life is so busy you can't find the time, just listen to the last movement. You'll be glad you did.

Good night everyone! Drive safely.

I'M HUNGRY! LET'S HAVE SOME FUN

It's been a week since the surgery and I seem to have temporarily plateaued at 262 lbs. And I'm hungry, tired and I feel a bit sorry for myself. Nothing seems to be shaking at least until I get my post-op X-ray and exam on Monday. So let's just fuck-off tonight and have some fun. Maybe I can forget how hungry I am and if they make someone else smile -- or even think -- we're all ahead of the game. I found these pictures during the past few days, and even though none of them have anything to do with food, I thought you might get a kick out of a few. Here goes...

Above: Our founder and hero

Above: This is such a great photo that it doesn't really need any explanation. It's sort of like watching a car accident, isn't it? Actually, it's what happens when a drunk driver plows into an oncoming bike race in Mexico. I don't know why the idiot was drinking at 8 a.m. All I know is they called off the race.

Above: I don't know why this picture fascinates me. I'm not sure if I should be so obsessed with it. It's Barack Obama (on the right, with the ears) when he was seven with his mother, step-father and their daughter in Indonesia. It makes me want to know a lot more about Obama's late mother -- beyond the story he tells all the time about how he watched as she died of cancer and how it inspired him to come up with his plan for universal health care. I also look at her and see a new industry if her son is elected president.

A PROMISED ACCOUNTING

MONDAY (+ 3 days) – Okay, I’m gonna do it. I'm finally going to release those long-secret numbers and admit how fat I had become.

I didn’t go to work today because I just couldn’t get it together. I’m going to get there tomorrow and stay there as long as possible.

But I promised you I’d come clean here. At my worst point, October 2007, I was a bloated and miserable 332 pounds. The number that popped up on the scale at Dr. A’s office stunned me. “Can’t be true,” I thought. Right away, I started with the excuses. The steroids. The chemo. The insulin. My genes. My big fat stomach and even bigger mouth.

But it wasn’t until Dr. R, the Wizard, gave me a good old-fashioned bitch-slap that shoved me into motion. He said I should take “a years vacation from cancer doctors and just lose weight.” He said if I dropped 100 pounds or more, “85 to 95 percent of what your complaints would go away.”

No scare tactics, just the cold logic of the truth that woke me up.

I immediately started the long process of getting approval for the surgery I had last Friday. At the same time I changed some eating habits – mostly salads at lunch and Marcia helped me with smaller portions at home.

By February, I broke the 300 pound mark and by the time I finally got the go-ahead from Dr. F, I was at 296. But following Dr. F’s advice, I put off the operation until after my 60th birthday and Florida vacation in April. I used that time to have some great last meals/feasts. By the time I started my pre-surgical period, I was up to 308.

Two weeks later, I was 269 when I walked into the operating room. This morning, I weighed in at 262.

That’s a total of 70 pounds lost – so far.

My goal is 200. So I’m a little more than half-way. Actually, I’d like to get to 180, then celebrate with a week in Paris and settle at 200 and see how life is. The changes are already incredible.

WE’RE BACK. IT’S DONE.

SUNDAY (+ 2 days) – First of all, I’m sorry I haven’t added to the blog for a critical few days but it’s been a little strange. Allow me to explain.

Friday was paced on hospital time. Marcia got me there promptly at 6 am and even though the same clerks were on duty and greeted me “Not you again!” we still had to fill out the same paperwork we filled out 24 hours earlier. It was 6:45 before the anesthesiologist showed, looked at our tests results and said we could be operated on. Dr. F, the surgeon, rolled in around 7:15, He had on a freshly pressed gray suit and a pink dress shirt unbuttoned to the waist and at the cuffs, He asked about the anesthesiologist and then said “Cool.”

I walked unassisted into OR #3 at exactly 7:45. It was unusually cold but they quickly put a warm blanket over me. A quick prick on the top of my left hand and the next thing I know I was in a nice warm, bigger room and Nurse Nancy was talking to me.

“Is it over?”

“It’s over,” she said. “It went very smoothly.”

“What time is it?”

“9:30.”

“Can I see my wife?”

Seconds later, there was Marcia. I can’t remember seeing anyone so beautiful. I tried to give her a huge smile. She was with Joan. They were both kicked out of the recovery room too few minutes later. I wasn’t transferred to a recovery unit on the 13th floor until about 1 pm. The nurses there were all professional but they all warned I would be released the following morning.

From the beginning the pain was tolerable. In the beginning, whatever they gave me when I complained, more than did the trick. So far, it’s gotten better every day. Dr. F finished a long day of surgery and showed up in the ward at 7 pm. Wearing exactly the same outfit (yeah, right down to the unbuttoned shirt cuffs) he took one look at me and said: “Marc, you look cool. Go home. Get out of here.”

I was gone before they had a chance to give me all the necessary prescriptions.

Back home, Marcia has been a Saint e. There’s no way I would have survived without her support.

I slept until 4 pm Saturday. I slept until 2 pm today. I expect to go to work tomorrow. (It depends when I can wake up and get dressed.)

I feel better every day. And, oh yeah, I weighed in at 263.4 lbs, today.

Tomorrow, I think I’ll have the nerve to give up a complete accounting.

YOU’RE NOT GOING TO BELIEVE THIS!

THURSDAY (still 8 hours to go) -- It was all going so well.

I had checked in without effort or delay, I’d been interviewed by interns, residents, nurses and physician assistants all without incident. I had my plastic bracelet installed on my wrist identifying my body. I had paid my $300 co-payment. The doctor had visited and said all was go. The operating room nurse had visited and said all was go. I had changed into the hospital’s dehumanizing open-front robe. And I was still psyched! Let’s get it on!

Then the monkey wrench made its entrance in the guise of the operating room anesthesiologist. The anesthesiologist said he would not let me go ahead with the operation because my cardiac clearance form wasn’t good enough for him. He said he wanted more tests. An echo-cardiogram and a stress test. I was floored. So were Marcia and Joan. So was Dr. F, the surgeon.

After about 10 minutes of shouting, disappointment and accusations, Dr. F intervened, called Dr. U, the cardiologist, and negotiated a deal. I was to go uptown to Dr. U’s office, have an echo-cardiogram, and if I passed, would come back Friday morning at 6 am and be first on Dr. F’s list of lap band procedures. The doctor even promised me I’d be discharged from the hospital that same night if I was okay.

Of course, I passed the test, e-mailed the results to the hospital and was placed at the head of the line.

The sad part is that I’m getting used to all this. I’m saving it all up for my next rant – about how I’ve discovered that the real villains of the U.S. medical system are in the front office. They hold jobs like the doctors’ secretaries, receptionists, insurance negotiators and telephone operators. I know I said the opposite was true earlier in this blog, but I’ve changed my mind. That’s right, I’ve changed my mind. Fuck you! Sue me!

p.s.: Let me know your front office horror stories.

Meanwhile, we’ll all do it all over again in a few hours. Wish me luck – again.

WOW, WHATTA DAY!

WEDNESDAY (12 hours to go) – I don’t want to go through another day like today. Looking back, I’m sure Marcia, the secret weapon, turned the tide. When the surgeon’s assistant called this afternoon, she said: “Marc, you really owe me one -- and you better tell your wife!”

With any luck, tomorrow will be nice and calm. I think I’ll sleep most of the day.

I want to thank those of you who called and wrote and e-mailed their best wishes. Thank you all.

I’m going to try to blog from the hospital tomorrow. See you then.

SUCCESS! APPROVED, WE GO TOMORROW!

***** BULLETIN ****

NEW YORK (AP) --- Eager lap-band surgery patient Marc Kalech announced Wednesday he has been approved for the procedure by his all-powerful insurance company.

A spokesperson for Kalech said the decision was handed down at 4:28 p.m. and the operation will take place sometime Thursday. The hospital, Tisch Hospital at the NYU Medical Center on the tony East Side of Manhattan, will release the time later in the day, the spokesperson said.

A spokesman for the surgeon confirmed the approval at 4:44 pm, but no one from the insurance company could immediately be reached for comment.

###

CLIFFHANGER (continued)

WEDNESDAY (who knows how long to go) -- here's an update:

3:45 pm -- I call insurance nurse. "Marc, I'm so glad you called," she says. "I forgot all about you." She then checks her computer and, finding no answer, gets up to check on the status of my life. "I'll call you back."

3:55 pm -- Nurse calls back. "It's with the medical director. They expect a decision by the end of the day, which means 5 or 5:30" How long will you be there? "Oh, I leave at about 4:15. Good luck!"

3:59 pm: I call the surgeon's office and tell then what I know and ask them what time I should arrive for surgery in the morning. "Oh. don't come in at all at this point," she says. "What we have to do now is to call the insurance compasy and tell them we need a decision right now. We have to tell them we need a decision now. We have to complete the OR schedule." She tells the other secretary to make the call.

WILL HE OR WON'T HE?

WEDNESDAY (1 Day to go?) -- Here's my day so far:

9:36 am -- The surgeons office called and said they didn't get any paperwork from Dr. K last night and so the operation would be rescheduled. I freaked and said it was their fault and i was being punished after being on a liquid diet for 2 weeks. They said there was nothing they could do. i said there had to be and suggested i call Dr. K and find out where the paperwork was

9:49 am -- I call Dr. K and leave a message on her cell and at her office.

9:52 am -- i can't believe this is really happening so I call in the nuclear option. I phone Marcia.

10:00 am -- Marcia calls back and says she has got Dr. K's office to find her and tell her of the problem.

10:02 am -- Dr. K calls me and says she's talked to the surgeon's office and everything is okay.

10:04 am -- I call Marcia and give her an update.

10:14 am --Marcia calls back and says she just spoke to Dr. K who said she had completed all the forms and has sent them to the surgeon.

10:16 am -- I call the surgeon's office. They say they haven't got everything yet and it's now too late, the operation would have to be rescheduled.

10:17 am -- I call Dr. K and tell her. But she says she got off the phone with the surgeon's office and they had got everything and were sending it to the surgeon's office.

10:35 am -- Dr. K calls and says not to worry, the surgery will go on as planned. "You're on the schedule," she says.

11:59 am -- Marcia calls to say she's done everything she could and she says we have to "stay aggressive and pull out all the stops on this."

1:15 pm -- I call the surgeon's office to find out what was going on. I leave a message.

1:37 pm -- I call the RN at the insurance company assigned to my case and bring her up to date. She calls up my file and sees someone is working on it "as we speak" and would speak to her and call me back.

1:43 pm -- The nurse calls back and says they're still waiting for another piece of information from Dr. K and then would have to run it by the chief of surgery for the insurance company. She promised to follow it closely but says "It's out of my hands."

1:46 pm -- I call Dr. K's secretary and tell her to tell the doctor the insurance company is looking for her.

1:52 pm -- Wrong number calls. Idiot!

2:07 pm -- Surgeon's office calls and says they just got off the phone with the insurance company and everything is in. They are all awaiting insurance approval.

2:15 pm -- I call Dr. K's office. "Never mind."

THE MONKEY WRENCH IS THROWN

The monkey wrench

TUESDAY (2 days to go) – Well, with 48 hours left on the clock, the whole thing threatens to come apart. At the last minute, a series of calls from the surgeon’s office revealed that they had never bothered to clear the operation with my insurance. They clumsily tried to put the blame on me but I lost it. “Time after time, as recently as two weeks ago just before I started on a liquid diet,” I said. “I asked you if the insurance was squared away and you said: ‘Yes, you’re ahead of the game.’ ”  

It occurred to me that I might have struggled through this stupid diet for nothing. I think my reasoning prevailed and we managed to set in motion the machinery needed to get it done. My doctors all responded like champs. But there’s only so many hours to go and the firewalls of a gigantic and unfeeling insurance company to breech. It’s going to take a Herculean effort on the part of a few overworked young ladies to get it done.

I’m down. I feel defeated by the system although I’ve played by all its rules for so long. I’m not sure what went wrong, but I know it wasn’t my fault. We’ll have to wait for tomorrow -- and it’s going to be a cliffhanger. Shit!

Waiting on the sideline is my secret weapon. Marcia is primed to go and chomping at the bit. But I don’t want to send her into action until I’m sure she’s needed and the people involved deserve to die. She takes no prisoners. But she’s to be considered a nuclear weapon and must be used with care. But if the time comes, I won’t hesitate to use her.

Speaking of those who deserve the wrath of God, someday I’ll tell you about Sirius Satellite Radio.

At this point I’m hoping against hope. I must tell you, the odds don’t look good.

NECESSITY, THE MOTHER OF INVENTION

MONDAY (3 days to go) – The steamed vegetable dish is still evolving but has already impressed Marcia and myself so that it will undoubtedly become a steady part of our low-calorie diet when I can eat solid food again.

It’s getting to be crunch time now, but, if anything, I feel less pressure and I’m more resolved than ever to go through with the op and lose weight. My weigh-in this morning was down another 8 pounds. I was real good all day – let’s see what I weigh tomorrow morning.

MEMORIAL DAY WEEKEND

SUNDAY (4 Days to go) – I’ve just finished watching HBO’s “Recount.” It’s a great piece of work. It’s amazing what that production company can produce. I can’t help thinking about the “Hail to the Thief” sign my father stuck up in several places after the election and Marcia mentioned in her great TV eulogy.

Otherwise, it’s another day of diet shakes and steamed vegetables. It seems to be especially tough on the weekends when you a can about it. But I got a break yesterday when we went out to dinner with Norman and Elaine Lison. We went to a Turkish place in Roslyn with the especially exotic name “Chicken Kabob.” Always great food despite minuscule prices.

You might ask: “Why would I go to a restaurant on this diet.” I don’t know the answer and when I sat down, I felt like a masochist. But I had an unsweetened iced tea, a small cup of lemon chicken soup, a tiny piece of crisp pita bread and a medium sized Greek salad with no dressing and just a sprinkle of feta cheese. Between the food, jokes, conversation and company, I had a great time and left full. It made Saturday easy.

With only few days to go now, I beginning to obsess over details, like in what order I’ll be rolled into the operating room on Thursday. Originally, I was to be first unless there was someone with allergies scheduled later in the day but I had to change the date at the doctor’s request a month ago. I won’t know until Wednesday afternoon when they call me with the time I am supposed to report to the hospital. I’ll be happy if that’s all I have to worry about. I’ve really tried to do everything I can to get ready for this operation.

And yes, I do think Willie Randolph should be fired. Only an arrogant ex-Yankee would not intentionally walk a batter in that situation: tied game, bottom of the 13th, two out, runner on second with their best batter up. What bad could have happened, you idiot?

SNAG OVERCOME

FRIDAY (5 Days to go (eh, make that 6) Correction, 6 Days to go) – I’m certified. After running at least a half-dozen tests, Dr. U was enthusiastic about the idea. My blood pressure was 120/68! Not bad for a fat guy. I called Dr. K with the good news like a kid calling his parents with a good report card, something I never had the pleasure to do.

I gotta say that sticking to the all-liquid diet was the toughest today as it has been all week. It’s like three in the afternoon on Yom Kippur all the time. I’m hungry. Those four bottles of Ensure disappear a lot faster then I thought. There’s just no way they come close to filling you up. And the veggies just give your teeth something to do. They’re fun at first, but it quickly wears off.

I’m especially hungry in the morning, when I’m usually not hungry. Today I admit to giving into the dark side and having two pretzels behind closed doors in my office.

But I’ve been certified and I’m more psyched then ever. Next stop: The 6^th floor of NYU’s Tisch Hospital and the operating room.

A SNAG?

THURSDAY (6 days to go) -- It started as a real good day today. When I weighted myself this morning, I found that I lost another 6 pounds and I so I tried to fit into what used to be my favorite Zegna suit. It hasn’t fit in five years and three weeks ago when I tried to put it on, it wasn’t even close. But this morning it fit beautifully and I was comfortable all day.

I was hungry during lunchtime for the first time so for the first time I ate more than shakes for lunch. I ordered a small salad with lettuce, carrots, tomatoes and lots of cucumbers without dressing. Not only did it taste good, but it satisfied me. Everything seemed to be going well.

Not on the medical front. Dr. K called this afternoon and I completely expected her to say the rest of the tests and come back and she had certified me ready for surgery. But my confidence was shattered when her first words were “Don’t hate me, but…”

“Oh no!” I said.

She claimed she was just being over-protective but she would feel better about it if a cardiologist joined her in certifying me. With any other doctor I would be suspicious of his reasons. But I trust Dr. K and so I tried to make an appointment with my cardiologist, Dr. W, who saved my life 15 years ago and then saved my father’s six months later. Dr. W is on vacation until a day after the scheduled surgery but his partner, Dr. U, agreed to see me tomorrow morning – in 12 hours actually – after I explained what I need.

One last thing: When I got home this evening, my left foot, the one that is weeping, hurt like hell. I mean singles-like pain: Seven on a scale of 10. Nothing I did or took helped and it looked real raw – like of volcanic surface of Io. I was stumped and in agony. Then I got an idea that it might/must be an allergic reaction. Sounds crazy, I know, but 10 minutes after taking 30 mg of Benadryl it started getting better. And, starting at the top and moving down, it began to look better.

I don’t know, but I have a bad feeling about tomorrow. So I guess this ends as a cliffhanger. See you then.

A GOOD DAY

WEDNESDAY (8 days to go) -- My visit with Dr. K went well. I’m officially down a total of 44 pounds from my highest weight. She was appropriately pleased and said if I come close to my goal weight I will be able to stop taking insulin, probably stop taking all diabetes drugs and be able reduce many of my blood pressure drugs. I’m thinking that if I can get down to a dozen from the 2 dozen drugs that I take every day, then taking care of me might become a part-time job from the full-time career it is now. Already, I’ve had to reduce my insulin dose by 25 percent and it appears that it’s not enough.

I was tempted to raid the pretzel jar at work today but resisted. For dinner, I had Brussels sprouts, onions, red bell peppers, mushrooms and parsley steamed in water laced with salt, pepper, habanera pepper hot sauce and garlic. It seemed was really good. I think my taste buds are dying.

But the best part of the day was that four people actually and independently told me I looked thinner. And I was able to comfortably button and wear all day a pair of chinos that I have not been able to put on since 2003. Just one small downside: my best belt is on its last hole.

Stay tuned.

SO FAR, SO GOOD

TUESDAY (9 Days to go) -- Doctor K, my endocrinologist, primary care physician, general contractor for major medical problems and all-around guardian angel, called early this morning. Apparenly, the system sent her a request for medical clearance to go ahead with surgery and being one of the best representatives of this country’s medical establishment, she wanted to actually see me before the operation. I agreed to see her tomorrow afternoon (Dr. K is one of few medical doctors I’ve ever looked forward to visiting).

I have to remember to ask her how I’m going to take the 24 different drugs I take every day after the operation. We need to discuss which are mandatory to take during the two weeks when I’m not able to swallow anything solid.

I still can't believe I've gone five days now without eating anything solid. Basically, the only solid foods I’ve had since last Thursday afternoon’s pastrami on rye has been some low-calorie veggies and a few pretzels I ate in my office yesterday during a rare moment of weakness. This evening, for example, I had a cup and a half of raw carrots, broccoli, cauliflower and celery with a couple of tablespoons of “Green Mountain Gringo” roast garlic salsa. Except for being incredibly hungry, it hasn’t really been so bad.

But I think Dr. K will be happy with my weigh in tomorrow. (Noted: Dr. K is the only human I allow to weigh me on a regular basis.) I like to make her happy. When she’s happy, it means I’m getting better.

BACK TO THE HOSPITAL

MONDAY (10 days to go) – I spent most of this morning in the hospital being poked, probed and generally humiliated to see if I was healthy enough to be cut open and exposed. It’s not really the hospital employees that you come in contact with, it’s the system that scares you. In fact, when I got lost in the same basement labyrinth that I got lost in five years ago (see “The History of Medicine” below), a friendly young woman actually went out of her way to ask me if I needed directions. And the anesthesiologist, nurse, and X-ray technician who tested me were efficient, professional and reassuring. But it seemed like the system, maybe the actual building that held everything, was trying to frighten me -- and succeeding.

I’m having a hard time believing that I’m still true to the diet. A donut on the counter at home looks so delicious it’s hard to believe. Even the pretzels in my office at work that I ignored before the diet look like manna from heaven now. But I’m steadfast to 1000 calories a day – at least so far. I’m not eating to live. In 10 days I’m assured it will get easier.

One good sign: I weighed myself this morning and I’ve already lost 21 pounds in the first four days of this program. Not bad. Believe it or not, I’m running out of notches on my “fat belt.” It won’t be long before I have to go into my closet for the next level of clothes. I look at it this way: a midway goal is when I can again fit into my cashmere Zegna overcoat.

Another will be when I get up enough courage to tell you my actual weight. More later.

IT’S NOT EASY

SUNDAY NIGHT -- Eleven days to go.

Well, the weekend’s over and I've made it through 3½ days now without breaking the all-liquid diet. It’s been a lot easier because my darling wife has agreed to join me in this effort simply because she loves me (although she says it’s a matter of solidarity).

I’m allowed 2 cups of low-calorie veggies a day and I’ve discovered that a combination of steamed Brussels sprouts and onions makes a pretty good-tasting meal. Also, I’m allowed high protein drinks like Ensure or Opti-fast. A total of 1000 calories a day – that means 4 bottles of Ensure.

As bad as Ensure tastes by itself, I’ve discovered a combination of chocolate and vanilla mixed with ice in a shake tastes alright. But I really can’t imagine existing on this for another 4 weeks and I’m on the lookout for more recipes.

So far so good. I believe I’ve actually lost some weight and inches already. Tomorrow morning I’ll weigh myself and I’m scheduled for pre-surgery medical tests. Keep tuned, I’ll let you know how it goes.

THE RETURN OF THE BLOG

WE’RE BACK!

Dear friends: It’s been an eventful year, that’s for sure. But Marc’s about the start a new adventure and he thinks it might be worth writing about, even if it’s just for his own sanity. So watch this space for new hilarious misadventures and medical updates. Following the advice of just about all of his doctors, he’s going to try to lose weight. A lot of weight. Except this time he says he’s serious and he has convinced a doctor to operate on him. Here’s his first entry:

I’m going to lose 150 lbs. Really. No gambling please.

Just to get off to a fast start I began with a good lunch yesterday. It’s shown in the picture above. That’s an overstuffed pastrami sandwich from Katz’s Deli on the Lower East Side displayed on my desk before I made a meal of it. A bag of crisp, greasy french fries sits on the right and a big pile of half-sour and sour pickles with a couple of pickled tomatoes thrown in is above left. The sandwich is the classic New York pastrami on rye with mustard and cole slaw on the sandwich with a side of slaw because they NEVER put enough on the bread.

Katz’s (they still have signs that ask you to “Send A Salami To Your Boy In The Army”) has become more of a tourist attraction then a real deli in the past 20 years. Every 15 minutes another tour bus full of Germans or Midwesterners pull up and herd their clueless, grossed out passengers inside, where they order corned beef on white with mayo. Except now, the dazed, non-confrontational waitresses don’t even raise an eyebrow -- they just deliver the sandwich without comment. Every so often, a gaggle of overdressed girls from New Jersey or Long Island arrive and are disappointed that they can’t get waitress service at the table where Rob Reiner’s mother sat in “When Harry Met Sally.” A sign hangs over the table to save everyone’s time. (“I’ll have what she’s having.”)

I was immediately recognized as a knowledgeable food junkie because I ordered “soft pastrami” to insure I got enough fat. Only those who aren’t properly initiated order “extra lean.” A sign above the counterman advises that will cost ya an extra buck. But Myron the sandwich guy quickly sized me up as a real member of the club – especially when I reached up and slid a dollar bill across the glass counter. (The countermen at Katz’s stand above us mortals like pharmacists in an old drug store.) I swear there was a twinkle in his eye as he hand cut the sloppy piece of cow flesh and passed a flaky, moist translucent slice back to me for my approval. He did it with all the pride and professional flair as a tuxedoed waiter pouring a taste of fine wine at Jean George. The meat exploded with the proper firework display of tastes as it quickly melted on my tongue and I gave my approval to him with just a glance.

Back in my office, I stuffed myself until I thought I might become bulimic and solve my problem the hard way. But I didn’t and I will go ahead with the surgery. The sandwich was my last meal before the operation because for the next two weeks I’m on a strict liquid diet. It seems they need to shrink my liver to get it out of the way before they fuck around with my stomach, which for 60 years is used to getting crap like the sandwich from Katz’s and I’m sure it will try and punish me for denying it what it wants. It’s used to getting what it wants.

But in two weeks it’s not going to want it anymore.

I won’t bore you here with the gory details of the operation. It you’re sick enough to want to know more just check out “Adjustable Gastric Lap-Band Surgery” on the doctor’s web site. Just click here. Meanwhile, it’s four 8 ounce bottles a day of Ensure for me. Today was my first full day. Oh my God!

HELP!

Watch this space for more news.

THE HISTORY OF MEDICINE, ACCORDING TO ME

Almost four years ago, on September 9, 2003, I was diagnosed with leukemia. On that moment, my life – and the life of my family – changed forever. I realize now that Marcia and I will never be the same. Our journey through the American medical system has taught me a lot – including just how hard you sometimes have to work to survive. And not just survive, but do so with some measure of dignity, a sense of humor and a continued fascination with life and its many secrets.
Wow, it didn’t take very long to wander into the deep end of the pool, did it?

So come over here in the shallow end kids and I’ll try to let you in on a few things you might need to know if you ever get sick. Stuff you won’t learn on the Discovery Channel.

I had to learn pretty quickly – although, I have to admit, I was treated like a celebrity for the first couple of days. I had a private room. Hospital executives came up to ask me if I was being cared for properly. Pretty young nurses answered my calls. The medical tests were non-stop but fairly benign – none of them hurt very much. Even the one that did hurt, a bone marrow biopsy, at least took place in the safety of my room. (It hurt a lot.)

But that was the first couple of days. After that, Dr. M, my first oncologist, threw me into the deep end. It was sink or swim time.

It began Thursday morning when he sent me down into the basement (dungeon?) for some sort of ultrasound test. Still hooked to my IV lines, they put me on a gurney, wheeled me down to the basement and into the test room. The technician was great and the test went well – but then my war with medicine officially began.

Still on the gurney, they wheeled me out of the test room and told me that someone would arrive shortly to take me back to my room. Dressed in a tattered hospital gown that was open in the back, ripped in the front and all greasy from the ultrasound crap they smear on you during the test, I found myself alone in a deserted, fluorescent-lit basement corridor. My cart was lined up against the wall of a hallway with a half-dozen other gurneys that looked abandoned -- like the rusted hulks of so many ’57 Chevys dumped on the side of a Georgia trailer park.

Thirty minutes passed. I felt stupid for waiting so long already. But I was tethered to my IV lines and felt more naked every minute that went by. I tried to explore but every room was locked, including the one where I had my test. No one answered my knock. The only sound was the annoyingly loud buzz of the fluorescent ballasts. It occurred to me that it might have made a good episode of “The Twilight Zone.” Except it was real.

I started to write the lead of a tabloid story about the mysterious discovery of a skinny human skeleton found inside a huge pajama robe in the bowels of a tony East Side hospital.

NEW YORK (AP) -- Police today were trying to determine if the skeleton found in the sub-basement of a posh midtown hospital is the remains of an overweight newspaper editor missing for over 30 years.

"Apparently, they just forgot about him," a source said. "It appears he was taken from his room for a routine test and left in the basement hallway without any way to call for help."

Judging from the size of the robe found with the remains, the patient might have survived for over a year trapped in a hallway without food, police said.

If only I could find a way to fit the word “blonde” or “co-ed” in the lead, it wouldn’t be a bad story, I thought.

But exasperation slowly gave way to panic. I started to sweat. You know the drill: minutes seemed like hours, hours seemed … Finally, someone with an ID tag hanging from her neck walked by. At first, I was sure she was lost too. But she seemed to understand my predicament. She said she would help and she actually had a key that actually opened the door of a nearby office that actually had a telephone. The telephone actually worked. She called some service that allegedly dispatched drones to various parts of the hospital/factory to deliver patients/bodies to where they were supposed to go. It appeared I was to be rescued!

“Someone will be by in a few minutes,” she said. “They get lost. This happens all the time. Don’t worry, I’ll be in here.” Then she disappeared behind the locked door and I was alone in the hallway again.

But after 10 long minutes, some sad sack actually showed up, grunted and pushed me back to my room. Only a little more than an hour had really passed but it might as well have been a week. And no one ever seemed worried that I, a patient, was missing.

The point is, from that point on, everything that happened in the hospital was fucked up in one way or another. It always seems to happen in hospitals. There comes a point when the building tells you that it’s time to get out. If you haven’t been in a hospital, you’ll just have to believe me. If you have ever been admitted, you know that your stay may be like staying at The Ritz and then one moment everything goes sour -- nurses ignore you, food, medicine and doctors don’t show up and (worst of all) your veins decide to go south for the winter. (Laugh it up rookie, but it actually happens and when it happens to you as they’re about to give you a transfusion, you won’t be laughing.

A veteran hospital patient, I knew the moment had arrived for me to go. My senses sharpened and my thoughts raced. In such a state, I came up with certain universal medical truths.
Pay attention kids, here’s the first punch line / lesson / rule of medicine for today …

NEVER ALLOW YOURSELF TO BE VOLUNTARILY ADMITTED TO A HOSPITAL

because (pay attention, there will be a quiz on this later),

A HOSPITAL IS NOT A GOOD PLACE TO GET BETTER.

Or even visit for that matter. Anyway, the next thing that happened was actually good – Marcia showed up. She was so great to see, I remember today what she wore. But she was exhausted from getting up early to cover the phony-baloney political publicity availabilities that were supposed to mark the solemn second anniversary of 9/11. I can’t remember if the president was in town but she had to leave home at 5 a.m. to be in a location that she wouldn’t be able to leave until after the afternoon broadcast was finished. She was a ray of sunshine, a breath of fresh air and a break in the clouds but she was so beat I was worried about her and I told her to go home and get some sleep. Heaven knows she wouldn’t get any rest once I was sent home.

A half an hour after she left, Dr. M arrived. In just a few minutes, it all crashed in on me once again. Dr. M had a bedside manner like a vulture and he wasted no time getting into it. “The test results arAe back and they confirm the diagnosis. You have b-cell chronic lymphocytic leukemia.”

After two days the very word “leukemia” didn’t hurt as much as it did in the emergency room, but Dr. M wasn’t done. For the next 10 minutes he described that the condition that sent me there in the first place wasn’t leukemia but the better-sounding anemia -- a lack of red blood cells. (Those of you of a certain age will remember the ads for Geritol, a completely useless OTC medicine that was sold as a cure for anemia during the age of black and white TV.)

My anemia was caused because the red blood cells were being destroyed by mutant antibody-crazed white blood cells. Or something like that.

Then Dr. M told me his course of treatment. Out spewed the names of strange chemicals – each followed by a litany of possible reactions and side effects. “You’ll probably have an allergic reaction to this, but only the first time. So when you come back Monday, bring someone to drive you home,” he said. “After that you can drive yourself.”

Then, after the anemia is under control, we’ll talk about treating the leukemia, he said. “Okay?”

My head was spinning. I tried to ask questions but Dr. M wanted to go home and I was in totally unfamiliar territory. This was the moment that I always relied on Marcia for. Man, could she ask questions and get answers. Nobody – nobody – was better than her at that. I tried to think – but all I could think of was getting out of the hospital and away from all this.

He said I could leave tomorrow if my blood levels were better. I clung to that promise like a life preserver as he got up and left without my answer. I was alone. My mind shifted into overdrive again. The thought of all those mutant blood cells spreading cancer throughout my body terrified me. It hit me all at once -- it was going to be tough to wiggle out of this one, Marc. This was the real shit.

I couldn’t sleep. I kept going over the situation. Then, suddenly, as the sun came up over the East River, I figured it out. Almost at that moment, before the sun reached my 17^th floor window, the phone rang. Marcia was awake.

She could immediately tell I was freaked out. I tried to tell her about Dr. M’s visit but I couldn’t help but tell her my brainstorm and have her beautiful -- and capable – hands bring it to life.

“You gotta get me another doctor,” I sobbed. “Dr. M scares me to death. Ya gotta get me someone else and get me outta here.” She calmed me a little and then listened to what I remembered of Dr. M’s cure. It was pretty accurate because like a good reporter I took notes.

I’m still not sure what Marcia did after that. I still really don’t know how she produced the miracle that next took place. I do know that phone calls were made and favors called in. I also know that at 9 a.m., Dr. A, the hospital’s head of hematology and something of a legendary figure there, arrived at my room looking a little like a man called back from vacation by the President and said: “I’ve been told I’m supposed to examine you and take you on as a patient.”

He looked at my charts, and then he looked at me. Then he told me he would be he would be back at five in the afternoon and then I could go home.

When he came back I was prepared – Marcia was there. Basically, he confirmed the diagnosis and laid out his own plan of action – a series of treatments and drugs that was totally different than what Dr. M wanted to do. When he was told what Dr. M proposed, he said something like he thought that was “totally inappropriate.”

Then the conversation went around in circles for a few minutes before I shut it down and laid out MY OWN plan of action. The only logical thing, I said, was to get another opinion. I would try to get an appointment with The Wizard. I left the hospital feeling better. Not only did I have three units of blood transfused into me, but I had a plan. Somehow, I would see The Wizard.

The Wizard is actually Dr. R. If you Google “CLL,” his name comes up all the time. The staging system used to measure the poor schmucks with CLL is named for him. Everyone we know made phone calls to get an appointment but I got one by just calling his office and asking for one.

His secretary said: “Sure. He can see you November 17^th.”

“You do realize he’s a cancer doctor,” I said. Told that she had been so informed, I continued: “Then you can tell Dr. R he can examine my body at the morgue.”

“What did you say your name was?”

Uh oh. I told her my name and she put me on hold.

A few days later I was on my way to Oz. I’ll write more about The Wizard later – the little guy is good for a few stories, believe me. But for our purposes now, all you have to know is that he proposed his own course of treatment. The thing is … it had very, very, little in common with the first two menus already on my plate.

I’m used to this medical bullshit now. But I was a newbie then and it gave me a lot to think about. I came to two new rules of medicine:

MOST MEDICINE IS AN ART, NOT A SCIENCE

and, more importantly,

ALWAYS GET A SECOND OPINION.

Believe me; this last rule has become so important – and so tough to pull off. You have to be part psychiatrist and avoid pissing off your first – or second, or third – doctor. Because, (here’s another rule kids):

THEY TEACH PATIENTS TO GET SECOND OPINIONS BUT THEY NEVER TEACH DOCTORS TO DROP THEIR BIG, FAT EGOS AND ACCEPT THEM.

Don’t get me wrong, doctors today are, as a rule, not overpaid and do not exactly live a life of ease. Most are dedicated healers and I’ve been very lucky and found a good batch. But it’s hard in any occupation to be told you’re wrong. Especially in medicine, where you’re accustomed to be treated like a minor god.

But there are two major secrets of the profession that every doctor relies on:

WITH THE EXCEPTION OF SERIOUS WOUNDS AND BROKEN BONES, THE BODY WILL TAKE CARE ABOUT 95 PERCENT OF AILMENTS BY ITSELF WITHOUT HELP

and …

MOST OF THE TIME, THERE’S NO RIGHT OR WRONG DECISION IN MEDICINE.

You, as a patient, have to remember the latter because you have to make all the decisions affecting your body. Never give up that right. You have to manage your disease. And manage it closely because no one else will.

I hope that as my story develops, I’ll be able to explain these rules more fully and let you in on more of them. Keep your eye on these pages.

In case you’re wondering how this story turned out – I decided to take the one drug that all three doctors agreed on. After the transfusion of two more units of blood, we figured out that it didn’t work. Three months later, Dr. A and I finally decided on the right combination of drugs to get my red blood cell levels back to normal. Or, my body just healed itself.

I’m betting on my body.

Then, we all tackled what to do about my life-threatening cancer. The answer was obvious – nothing.

I’ll explain later.

CAPTAIN'S MEDICAL LOG / addendum

Stardate: 1/060707 ... I finished. I'm done!

Yesterday, the last 180 mg of a total of 2,160 mg of Rituxan, was pumped into my bloodstream at NYU Medical Center on 34th Street. Except for some saline solution, acetaminophen and Benadryl, I can't think of anything else that was in the mix that could make me feel as great as I feel today. The photo above shows me celebrating with two good friends.

I feel confident enough to schedule vacations well into the century. Moe mentioned that he would like to see Sombrero Beach in Marathon. Norma, think "pet-friendly." As for me, I don't understand how Moe knew how to spell Sombrero. He didn't even have to check with Curly. Everyone knows Curly is very good at spelling.

Dana and Sean: The pizza was great! Thanks a billion! Moe, who's terrible at geography but loved the pizza, wants to know if it's possible to drive to Hawaii. He hates to fly.

Incidentally, I've been talking to my dogs for a few years now. It never worried me until they started talking back.

LIVESTRONG!

CAPTAIN’S MEDICAL LOG:

Stardate 1/052307 ... It’s been over a month since our last posting – but the time hasn’t gone to waste. Without ever being admitted, I’ve spent more time in the hospital so far this spring than most doctors. I’ve decided that my journey through the American health-care system has been so Kafkaesque that maybe I can do some good by documenting it somewhere – and I believe the Web is now the best and most immediate place to publish anything. There’s some hope that once it’s online, it will always be there, somewhere. If we’re careful, the Web will be the single greatest tool ever created for the spread of freedom, democracy and truth throughout the planet.

But back here on Earth, my recent reality has been fueled by infusions and pills. Just managing all the drugs that I take – making sure I don’t run out of any, gathering the proper prescriptions and simply sorting them out three times a day – is a full-time job. I carry around single-spaced print outs of the latest list of drugs I take daily just in case a nurse, doctor, druggist or ambulance attendant might ask if I take any drugs. It’s come in handy on more than one occasion.

And back here on Earth, I’m exactly half-way through a series of infusions of mega-doses of Rituxan. Since Rituxan is a monoclonal antibody I’m not getting chemotherapy but they are pumping into me doses of 800 mg/l three times a week for four weeks. Each infusion lasts about four hours. I won’t bore you with details of how Rituxan works (although it is fascinating) or how expensive it is (although at 50 large/dose it is scary) or what the usual dosage is (although at 350/week it is much less) -- but all this is easily available with a Google search.

The present story began just before the New Year with a simple case of diarrhea that just wouldn’t go away. I’ve got three active doctors and none was very interested in my bowel movements. Even a persistent sinus infection failed to peak their interest. They were all fascinated however with the swelling in my legs. My skin there was so dry it cracked and wept the fluid that my lymphatic system was no longer dealing with. I got the problem in my right leg under control but my left leg refused to respond to treatment and wept so much that my sock and shoe were soaked through after a few hours. It was a pain in the ass but I could deal with it with gauze and ace bandages. It was the pain in my ass that bothered me. Finally, on April 10, I convinced my oncologist to take a stool sample, a test that was actually first recommended by Dr. Kramer, who happens to be my wife and an uncanny diagnostician. (She’s good looking too.) I won’t describe here the actual procedures suggested and used to collect this sample because I’m saving that for the plot of a 22-minute situation comedy one day.

Stardate 2/060507 ... My last dose of Rituxan is tomorrow. I’m so full of it that it’s about to come out of my ears. My leg is weeping again but I feel real good and optimistic about the future. Back to our story …

The results of the stool sample came back a week later and revealed that I had a staph infection. Dr. K, my steadfast endocrinologist, exclaimed “That explains everything!” but Dr. A, my oncologist and the Wizard, the world’s foremost authority on my kind of leukemia, were less impressed. Dr. A wanted to start immediate full-blown chemo – something I didn’t want to do – and the Wizard actually said I was too sick for chemo and should have radiation before a dose of it. But a radiation oncologist at NYU refused to participate in it because he didn’t think I was sick enough.

That sent Dr. A and I back to the drawing board and the good doctor, knowing how I felt about chemo, brought up a suggestion I had made a few weeks earlier -- a regimen of Rituxan alone. The Wizard concurred. So here I am. An Independence Day Cat-scan will determine if we guessed right. (Incidentally, a 10-day course of antibiotics cured the nasty staphylococcus aureus bacteria and almost everything that was bothering me.)

I feel pretty good except for incredible fatigue and achy joints. A nurse who has had patients who have gone through mega-dose Rituxan told me last week that those symptoms were exactly what other patients experienced. That news actually made me feel better.

I think I’ll celebrate the end of this round of infusions by having pizza for dinner tomorrow. Not any pizza but a pie from Brickoven Pizza in Kauai, Hawaii, producers of what’s maybe the best pizza in the world. No kidding. It arrived today from cousins Dana and Sean. It’s arrival is one of the nicest things to happen to Marcia and I in a long time. Guys, just the thought of what you did makes my day. It’s what family is all about. I’m proud I’m part of yours. Thanx.

HERE I GO AGAIN!

Man, am I a schmuck! For the third time in the last few years, I've injured myself just days before the Kalech's were to start a vacation.

This time, I tripped and screwed up my ankle walking from a doctor's appointment. X-rays revealed the foot was meerly sprained, not broken.

Now. sitting here tonight, it dosen't look like the trip Marcia, Max and I had planned to visit Richard and Norma in California starting in 40 hours will become reality. Much has happened in the past month. I'll catch up later.

EARTH CAUGHT MOONLIGHTING

It’s a wonderful time to be alive, isn’t it? Think of all the thousands of things that we can see that nobody else has ever even dreamed of. The Hubble Space Telescope and all of its orbiting cousins are great producers of wonder. And almost everything they do is owned by the public and distributed for free and to all. Here’s a few from NASA that have blown me away in the past few days. First is a photo of our home planet Earth eclipsing the Sun that’s taken from the moon. Don’t be seduced by the dark side of Earth. It’s illuminated by the Moon, which is reflecting the light of the Sun – the star that supplying all the light in the photo. The entire photo, with its moonscape, is just as breathtaking -- but for different reasons. And then NASA outdid itself by releasing a slew of new snapshots of Saturn. They’re all spectacular and available here. While you’re there, be sure to play the video from a spacecraft passing through Saturn’s rings. I’ve told you before of one of my all-time favorite web sites, but I’ll gladly tell you again about the Astronomy Picture of the Day.. And check out the site’s amazing archive. Thousands of pictures documenting mans discovery of the universe. It is wonderful to be alive. p.s. Sorry about the long time between posts.

BABBLEFISH: THE TRUE STORY

ATTENTION ALL FISHERMEN! It seems that fish can -- and do -- talk. Scientists at Auburn University have discovered that they make sounds in order to communicate with each other (sound waves are the perfect way to do so if you live underwater). Even the lowly minnow, which was studied by Auburn and is pictured above, has a decent vocabulary. For a wonderful story on this, complete with actual sounds of fish speaking, click here. (If you can't get enough of this story, also try this.) If they speak to each other, it's only a matter of time before they start to speak to us. Something to think about while planning the next catch-and-release program. (PLEASE NOTE: I APOLOGIZE FOR THE ERRONEOUS LINKS PREVIOUSLY PUBLISHED ON THIS POST. THEY HAVE BEEN CORRECTED AS OF JANUARY 25.)

...AND A HOUSE CAT IN A PALM TREE

Marcia and I noticed that in Florida, everyone had a lighted palm tree outside their house. Our next door neighbor had a huge one with blue coconuts (no pun intended) that lit up in a neat light show after dark. It was so cool, we went on the web to buy one but were put off by the price ...$2500. When we returned home, we returned to the web and found one for much less. It arrived yesterday and we had its debut this evening. It actually looks great and it probably is the only lighted palm tree in Westchester. The feline is a pcture of our Morris, who recently complained his picture was absent from the web.

URI DAN, 1935-2006

MY FRIEND Uri Dan died yesterday. He was 71.
Uri touched my life for 25 years. I regret that it was limited to that time. And I regret that I didn’t press him more to stop smoking. Uri died of lung cancer.
He was a world-class journalist, an author of books read around the world, a worldly patriot of Israel, and an unabashed propagandist (in the best sense of the word) for his beloved homeland.
And he was a friend. He was my friend. I’m proud he was my friend and I’m better for it.
When Uri found out that Marcia and I wanted to be married in a Paris synagogue, he insisted on making all the arrangements – which turned out to be so complicated that it took the better part of a month to accomplish and had enough Byzantine twists and turns to fill a book. But he accomplished the task, found a friendly rabbi, rounded up upstanding witnesses and flew to Paris to take part in the ceremony. He was my best man.
I will always be grateful that Uri was in New York those unbelievable weeks of The Post rebellion in 1993 and saw my finest hours first-hand. One of my clearest memories of him was at a party of Post people given by one of our felon/publishers – at the top of the World Trade Center.
Memories of Uri include dozens of memorable dinners with him and his wife Varda all over the globe – from Jerusalem, Tel Aviv, Haifa and Cairo to Paris, Manhattan and White Plains. I remember Uri and Varda at our home in White Plains feasting on Maine lobster for the first time. Good food was as important to Uri as good conversation.
I’ll never forget a dinner with Uri and another man that went into dessert before Uri informed me that our dinner-mate was the Mossad agent who arrested Adolf Eichmann in Argentina.
I have enough Uri stories to last me a livetime. I’ll make sure they do.

Uri was very loyal to his friends. He taught me how to be loyal in friendship. In a sense, I‘ll be keeping his memory alive in that way and I’ll do the best I can to honor him.

Marcia and I send our sympathy to Varda and Oron, their son.

Goodbye Uri. "Next year in Jerusalem!"

A WEEK IN THE KEYS

Marc and Marcia had a great week in the Florida Keys with Norma, Richard and their daughter Dana. Everything and everyone cooperated for an wonderfully unforgetable time. Next year, we'll do it with the dogs!

THE KEYS TO A GREAT VACATION

Here are some of the material reasons why we had a great time in Marathon last week: Great accommodations and great attractions. Next: Great people.