Updated: A Personal Side Note - A Surprise Health Issue Will Delay the Start of My Imaging Projects this Year…
April 7, 2023
Updated April 20, 2023
Image created by DeepAI Cyberpunk Generator when given the phrase “Astrophotographer looks at the night sky while a robotic surgeon operates on him”
Hi Folks,
So far this year, I have not captured any new photons, and I have been frustrated by this. I have shared this in other postings and laid the blame at the feet of clouds and poor weather in this region.
And that this certainly true.
However, I will not be able to capture any photons during the next month either - regardless of the weather situation - and this will put me way behind on the imaging projects I usually post on Cosgrove's Cosmos.
This is because I am recovering from an operation that I just had that will limit my physical activities for the next month.
This has come as a huge surprise and unfolded over the past two months.
I originally had no intention of sharing this. It was -after - extremely personal. But as I thought about it - most of what I share on this website is shared with the idea that this information might be helpful to others. So after some thought, I decided to share my personal story now, as I hope there is something in my experience that will help others.
The rest of this post has nothing to do with astronomy or astrophotography.
Free to skip this if it is not your cup of tea.
Background
First, a little background.
20 Years ago, I was working long hours and not caring for myself. I was overweight and eating poorly.
One night I woke up with what I thought was horrible indigestion. Long story short, I had a heart attack at age 46!
I was hospitalized and had two stents placed in the arteries of my heart.
A doctor at the time suggested the best path forward. A change in diet, exercise, and work level can do wonders - but in his experience, people never really change their ways, and within ten years of a heart attack, they often begin to suffer from heart failure.
Talk about a wake-up call!
I had a wife and two young sons - I had obligations. So I decided to make a change - and when I decide to do something, I can be very disciplined and driven.
I shifted my diet to a low-fat, low-calorie Ornish diet.
I started an aerobic exercise program of speed walking - sometimes up to 2 hours a day
I told my boss that things would have to change at work. I was not going to kill myself for a job
The results were outstanding.
I lost over 100 lbs and kept the weight off. My blood pressure was excellent, and my lipid profiles were as good as possible. My heart performance improved back to almost pre-heart attack levels. My cardiologist called me his poster boy for heart health. And even though I cut back my hours at work - I was working smarter, and my performance reviews reflected that.
A family shot in the Canadian Rockies, Taken in 2002 before my Heart Attack. I had put on a lot of weight - and trouble was brewing.
This image was taken of me in mid 2004 - about a year after the heart attack. My son Brian took this the day we climbed Giant Mountain in the Adirondacks - Lake Placid, NY. Down 100lbs. Hiking the mountains was a whole other ball game without all that weight!
In short, I had a significant wake-up call and changed my life because of it.
Twenty years later, I have had no further heart problems, and my health has been good. I have kept my weight down, continued to eat well, and to this day, I do 3 x 30 minutes on the treadmill every day for exercise. But I am very cautious. If something seems off healthwise, I get it addressed.
Now Back to Current Events…
Typically, I measure my blood pressure about once a week at home. Over the Christmas Holidays, things got very hectic this year, and I stopped doing it for a couple of months. In late January of this year, I started doing this again and got a surprise - they were suddenly VERY high - dangerously high. I had no idea why.
So I went to my doctor's office, and they adjusted my medications - specifically my diuretic - which they doubled to see if we could bring it back down.
One week later, I noticed that I was having chest pain one morning.
It felt like pressure under my diaphragm and a knot under my sternum. With my history, I didn't mess around with this kind of thing, so I called my doctor, and they told me to go right to the ER, where they could run a blood enzyme test to see if this was heart-related.
In The Emergency Room
So I spent a surreal day in the ER.
After the COVID years, the ER experience was very different! I was led to a room filled with a grid of hospital-room recliner chairs and told to sit down.
Occasionally, someone would come and get me for questions, a blood draw, or some test.
And I sat and waited. I used my phone to pass the time.
But this is also now the era of online medical portals.
In my area, the portal is called MyCare.
I would get a blood test, and a few minutes later, I would see a notice on my phone from MyCare telling me that I had new test results. I then went to the app and saw my results.
One of the first tests was the 0-hour Troponin Test. This is a measure of an enzyme exuded by the heart muscle when its cells are dying due to a lack of oxygen - as when you have a heart attack. They take a first measure as a baseline and then take blood later to see how it changes.
I looked at these tests as they came in, and I could see that the data looked good and it was not likely to be a heart issue. Great News!
Then finally, an ER doctor came in to talk with me and shared why they felt this was not a heart issue.
It sounded like something was putting pressure on my diaphragm, causing sensations of chest pain. But what was causing this pressure? The doctor ordered a chest x-ray and a CT scan to see what was happening.
These tests were done quickly, and as I sat there waiting in my chair, the results from the imaging came in on my phone. I could not see the images, but someone had analyzed them and written up their findings.
The chest X-Ray showed no issues. Great!
The CT-Scan showed what the problem was. Apparently, I was seriously constipated and backed up, with my stomach and intestines filled with air - and this was now pushing on my diaphragm.
Now people have told me in the past that I was full of shit and hot air - but I always considered this to be just a matter of personal opinion.
:-)
But now, there was a medical finding of fact to back this up. Hmmm.
Then I kept reading.
Everything else was normal until I saw the following entry:
“Kidneys: There is a 5.3 x 4.9 cm heterogeneous, enhancing mass at the inferior pole of the left kidney concerning for renal cell carcinoma. Mass appears confined to the kidney. No extension into the renal sinus or renal vein. ”
Boom.
And In An Instant, The World Changed…
One moment, I was cancer free. Then the next moment - it was likely that I had kidney cancer.
Remember that I am finding this out through the health app and not from a doctor.
So while sitting there, I do some Google-fu and start learning about Kidney Cancer and likely treatments - and 5-year survival rates. Crap.
Finally, a doctor comes around. They felt that the change in the diuretic caused the backup and pressure on my diaphragm. Simple to fix.
The bad news was the kidney mass, an incidental finding.
The good news was the kidney mass, as an incidental finding.
This was good news, as this would typically only be found by accident - while looking for something else. Thus the “incidental finding” description.
I had no symptoms from this. By the time you have symptoms, you are too far along, and your options are few and far between.
The tumor may be what was causing my Blood Pressure change - but this cannot be known for sure.
But in the end - my constipation caused this tumor to be found.
It appeared to be fully contained within the kidney and well away from the major arteries in the kidney. These were all good signs. Finding it now gives me a good chance.
Finding the Path Forward…
This was followed up with finding a Urologist and determining the next steps.
I got an appointment with the head of the Urology Department at Rochester General Hospital after a recommendation by family members.
After the initial consult, the recommended path forward was a Partial Nephrectomy done via the da Vinci Xi Robotic Laparoscopic Surgery.
The da Vinci Xi Robot Surgery Sytem.
Another view.
This removes a portion of the kidney containing the mass and preserves some redundant Kidney functions.
But they would not know whether this would be possible until they arrived during the surgery.
They might have to remove the entire kidney. They may find something that would cause them to abandon the robotic approach ad open me up completely to remove the kidney. I would not know the outcome until I woke up from the surgery.
At this point, we don’t even know that it is a Renal Carcinoma. We won’t know that until the pathology analysis is back after the surgery. There is a 15% chance that it is non-cancerous. But of course, that also means there is an 85% chance that it is. Either way - it is large enough to cause problems and must be removed.
The other thing we decided to do was to have some additional imaging done. An MRI with and without contrast was ordered. The goal was to have a detailed 3D map of the arteries and veins to better guide the surgery.
I just had my first CT scan, so I figured the MRI would be similar. It was not. The CT Scan took 30 seconds. I soon discovered three things:
In an MRI, your entire body is inserted into a narrow tube for the duration of the scan.
Scans take longer than CT scans - mine took almost 45 minutes!
To my surprise - I found I suffer from claustrophobia!
I am a big guy, and the MRI is a long, narrow tube. Being inserted into this long narrow tube freaked me out! It was all I could do to keep from losing control! I closed my eyes and pretended I was lying in my bed a night. However, that scan was the longest 45 minutes of my life!
The Surgery
So, Monday, April 3, I had the surgery at 11 am. It took about 3 hours, and when I woke up, I discovered that the partial nephrectomy had been done and that there were no surprises or problems. They had good margins, and things looked good. I had five tiny poke holes and about a 2" slit where the kidney portion was removed. I had surprisingly little pain and discomfort.
Ready for surgery!
Amazingly, I was released from the hospital the next day around 4 pm, and I am home now recuperating.
Since the kidney is a very fluid organ, I need to be careful and quiet while it heals. No straining, bending, or twisting. No lifting weights of more than 5 pounds for at least a month. I suggested to my doctor - just in the spirit of being cautious - that I should probably say well away from house cleaning chores for at least a year. He said, “Well - of course.” So I have got that going for me.
However, this means no setting up my telescope equipment for a month! As my local astrophotography friends have mentioned - that time will go by very quickly, and soon I will once again be setting up scopes in the driveway and swearing at the clouds as they move in!
But I am enormously grateful that this tumor was found in time to be safely dealt with.
I am still waiting for the pathology report, but my surgeon says that we will be monitoring for reoccurrence or spread, but that, in his experience, is very unlikely to occur.
I could have had this tumor growing for years. It could have continued growing for a couple more years until it killed me. Most such tumors are found accidentally. No biomarkers can be searched for in a blood test - only imaging can find them.
The problem is that they don't do much imaging unless there is a reason. I am 66 years old, and it would seem to me that at some point in your life, it would make sense to do a CT or MRI scan to look for unseen troubles so that they could be found and dealt with before it was too late.
After all, they do colonoscopies for early detection. They do Mamgrams for early detection. Why not a CT or MRI every so often for the same purpose?
I had no reason to believe that I had a kidney tumor. No family history. No symptoms. But I was carrying around a time bomb waiting to go off. Found early, these things can be dealt with.
I will now get routine CT and MRI screenings as a follow-up. I wished I could have gotten one every so often and found this even earlier.
Being Proactive…
My wife has a physical coming up, and we plan to ask for a CT or MRI scan for her.
CT scans are quick - but they do use ionizing radiation. MRIs are slower and more expensive but can give a more detailed view and do not use ionizing radiation.
I am sure insurance would not cover this without a medical justification. But I would be willing to pay for this out of pocket if it can find things that must be dealt with early. Both scans cost between $800-$1500, depending on where you live. If you can afford it, why not have the choice to elect to have one?
You have to have a medical order to receive a scan, and at this point, I am unsure if our doctor would approve this without a specific medical cause.
But the idea that there may be something lurking in your body that could be dealt with - if we only knew about it - is a powerful motivation.
Now that my wife and I are in our 60s, we have had plenty of time for things to manifest, so why not take a look?
Wrapping Up…
So I plan to be a good patient and wait before I drag my scopes back out again.
I will let my body heal, and in the meantime, I will continue to work on technical videos and how-to articles. The sky will still be there in a month, as will the clouds - and the typical game can continue.
I hope by sharing this, I don’t end up having anyone feeling sorry for me. Please DON’T!
I consider myself lucky as all hell:
I found it in time.
I have a hell of a doctor taking care of me.
Medical technology and skill have evolved to provide efficient surgical treatment.
The Surgery seems to have gone well, and I am on the path to healing.
My family has been super supportive and helpful.
My wife has been my rock through this.
My prognosis looks good, and I am hopeful.
What haunts me is the idea that if I had not found this, I could have been moving on with my life, not knowing what was going on - in stealth - under the hood.
Update 04-20-23:
It’s been two and a half weeks since my surgery, and I wanted to share an update.
I am feeling great and quite surprised at how rapid my progress has been. For the first two weeks, all I needed was Tylenol to manage the pain, and I stopped that at the two-week mark! My energy and stamina have been returning, and I have been walking on the treadmill three times a day to work back on the exercise front slowly.
They say that Robotic surgery is much easier on the body, and I am here to testify to that!
I have been waiting for the pathology report, which was supposed to be available about a week after the surgery. However, this seems to take longer, but we finally got the results yesterday. It took longer as they sent samples to another lab in California for more tests.
It turns out that this is a very rare type of tumor - thus the need for more testing. However, they concluded that despite its size, this was a basically benign tumor. My surgeon suggested that, given this result, it was questionable if there was a need for monitoring over the next few years but that he would support it if it gave us peace of mind. We opted to go ahead with the monitoring process - just to be cautious.
Two months ago, I could not have guessed that I would have this kind of an outcome - the odds were certainly against it. But I do feel so fortunate at this turn of events.
My physical restrictions will be behind me in another week and a half, and I will return to my normal activities.
I do want to thank everyone who has reached out to me. I can’t begin to tell you how much your support has meant as I went through this!
Now back to catching distant photons and making more great images of the universe!!
May your skies be clear and your seeing be great!
Pat
