Monday, July 25, 2022

BPH


"I'm going to go pee. If the universe is bigger and stranger than I can imagine, it's best to meet it with an empty bladder".  - John Scalzi, Old Man's War


Even as a young man I occasionally got up during the night to go pee. If I felt any urge down there I just couldn’t get comfortable.  As I got older, the trips became more frequent.  In fact, the last time I can recall sleeping through the night was 10 years ago down in the Big Bend Country.  We were staying at The Gage Hotel in Marathon and after a full day of activity went over to Alpine for dinner and drinks.  And I had a few more drinks, then more than a few more drinks.  I was very thirsty.  My wife drove us back to Marathon.  I just remember that it was sundown and the mountains were beautiful.  We got back to The Gage, I fell on the bed and slept in my clothes.  Never moved.  And the next morning, other than being incredibly thirsty, I felt great.  I guess that’s what a good night’s sleep will do for you.

 

Since then, every night has been filled with trips to the bathroom.  At first one or two times.  Then three, often four times.  And then during the day I started having what I called “Peeing Encores”.   One goes and pees, then 10-15 minutes later, one goes and pees again.  Certainly not the best way to travel if you’re flying coach on a crowded flight sitting in a window seat. But it can lead to a fellow passenger giving up their aisle seat for you.

 

During my annual physicals the doctor would do the finger wave. (If you don’t know what that means, look it up.  And it has nothing to do with women’s hairstyles).  The doctor noted that I had a slightly enlarged prostate, but not to worry.  I told him about the frequent nighttime trips to the bathroom and he encouraged me to cut back on the antihistamines and limit my fluid intake in the evenings.  Of course, I did neither of those.

 

Finally, I decided to go to a urologist.  He put me on Tamsulosin (Flomax).  After 45 days, there was no improvement.  Then he said let’s add Oxybutynin a drug that calms the bladder.  The only effect was that it relaxed my upper stomach and gave me severe acid reflux which I had never had before and never want again.  So we stopped that.  A few weeks later, I decided to have the exam.  The exam being a cystoscopy procedure where the urologist inserts a device in the penis, runs it up the channel a ways, takes a look, a few images, pumps you full of fluid and then has you pee into a vial hooked up to machine that measures your “flow”.

 

Turns out that my flow was really bad.  And the images showed that I also was starting to develop bladder stones.  No trouble today but would only get larger and become big trouble tomorrow.  Indeed, I had the classic old man’s problem, an enlarged prostate, aka Benign Prostatic Hyperplasia (BPH).  Benign sounded good, Hyperplasia not so much.

 

So the urologist gave me several options including continuing medication.  But the reality was that surgery was the best option and the best surgical option was the tried and true “gold-standard” of BPH surgeries: TURP (Transurethral Resection of the Prostate.)   TURP is just medical shorthand and a fair bit of marketing genius if you ask me.  It sounds a whole lot better than saying we’re going to stick a cable in your penis and run it up through the urethra and use a little roto-rooter like instrument to carve out enough tissue so you can pee better and less often.  Now Mr. Click we just need a few signatures.

 

So I signed up.  It would require a night, maybe two, in the hospital.  Post-surgery I would have a catheter in for as long as necessary and might even get to wear it home.  I had a catheter several years ago with a left knee replacement.  I spent two nights in the hospital, even got up and moved around with it.  The nurse took it out before they sent me home and it wasn’t that bad.  But with another bit of good salesmanship, what the urologists don’t tell you is that the catheter they use after TURP surgery is the size of a small garden hose which in necessary to handle the volume of water and blood that comes out.  And just for fun it has an inflatable balloon that keeps everything open while your wounded and angry prostate responds to the invasion. Fortunately, they deflate the balloon before they take the catheter out, but it’s just one more thing.  What goes in, must come out.  

 

The good news is that I only had one night, one long sleepless night in the hospital with noisy equipment running to monitor blood pressure and keep the fluids pumping through the IV in my arm and out the catheter in my little friend.  I was also drinking water non-stop.  Anything to speed up the process and get me out of this cage.  But I did have my I-pad and my noise-cancelling Bose headphones.  So I watched “The Terminal List” or listened to classical music.  Every couple of hours the nurse came in to empty the catheter bag (which was at least gallon size) and muse about the color of liquid that had come out of my body.  The good news if there really wasn’t much pain, just a lot of discomfort and inconvenience.

 

“Take a deep breath Mr. Click and when I tell you to breathe out, I’ll remove the catheter.  There may a be a little bleeding.  Okay?”  As if I was going to say, “Nah, I think I’ll just wear this home and wait for it to slip out on its own someday”.   So I took a deep breath and she said breathe out.  As I did, in one smooth, quick motion she pulled the garden hose out.  And it did hurt.  How could it not?  And it was a bloody mess.  But it was out, thank God.

 

But before they would let me go home I had to conquer the pee challenge.  I’m chugging down water like crazy and peeing as best I can into one of three numbered quart sized pitchers. The goal is to see if the urine has an ever-decreasing amount of blood in it.  If not, the nurse suggested that they might have to put the catheter back in and send me home with it.  That was at once more than enough motivation to keep me chugging water to clear up the stream.   The nurse was taking pics of my output and mailing them to the urologist who would make the final decision about the release with or without the garden hose.

 

I do believe in prayer.  But, in the grand scheme of things, I wasn’t sure if God cared all that much if I had to go home with a catheter or not.  I concluded that if I did, there must be a reason and it must be for the best.  So I alternated between praying that my pee would clear up enough to pass inspection;  but if not, praying that I would deal with all of it graciously, being thankful that I lived in a time when such medical solutions are available.  Thank God for doctors and nurses.  Thank God for those who invent, design and manufacture the technology and equipment used in modern medicine, including catheters. Thank God that I live in this time and this place and have access to medical care.  And thank God for anesthetic.

 

Now almost two weeks post-surgery, things are getting back to normal.  It will take 4-6 weeks to determine how effective the procedure is in correcting my “pee problem”.  At this point, I am optimistic. But, also realistic enough to know that time takes its toll and something else in this old body will start to fail one of these days. 


“For dust you are and to dust you shall return.” Genesis 3:19



Sunday, July 3, 2022

Alter or Abolish

 

These days it’s a real challenge to write about serious matters.  Somewhat like walking on broken glass. Therefore, one is left to write about dogs and butterflies, or what they had for breakfast.  Even those innocent topics can draw fire from those who are ever ready to be offended.  And just try saying something about abortion, guns, critical race theory, climate change, crime, vaccinations, immigration, inflation or education.  Good luck with that.

 

Now it would appear that July 4th has been added to the list of “hot topics”.  With the recent Supreme Court ruling that returned the abortion issue back to the states, the whole idea of American Independence has once again gone under the microscope of public opinion.  

 

This is not the first time American Independence has been questioned.  Slaves were, by definition, not independent.  Even after slavery was abolished, black citizens were only as independent as white citizens would allow.  Not that long ago, women by tradition, law and holy scripture had very little independence.  Native Americans became dispossessed prisoners, forced on to land not of their choosing. Living in ways they did not know or understand.  Independence lost.  Those Americans who labored on farms and in factories were only as independent as the next harvest or paycheck.  And while new immigrants found America to be a better place than the one they left behind, economic freedom and independence would be hard to come by.

 

“We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the Pursuit of Happiness…”  The Declaration of Independence goes on to insist that Governments exist to secure these “Rights” and when such Governments fail to do so; the people who are governed have the Right to alter or abolish such Governments and institute new ones.  

 

In July 2022 we find ourselves, those who are governed, somewhere between “alter” and “abolish”.  The genius of our Founding Fathers was the creation of a Constitutional Republic of States, a Federation, that gave us the best system yet devised by which people might secure those Rights of Life, Liberty and the Pursuit of Happiness.  A system of checks and balances, alteration and amendment.  But it’s not perfect.  Not long after the ink was dry we fought a Civil War where over 600,000 Americans lost their lives in the name of freedom and independence because they could not agree on what those words meant. 

 

On this July 4th, take care America.  We must come together peacefully and resume this Life, Liberty and Pursuit of Happiness adventure even if we cannot agree on exactly what those words mean. Perhaps we start by listening more and talking less.  Seek to understand, not just to be understood. And we could certainly use fewer fireworks and more forgiveness.  Let's try a little tenderness for a change, America. 

 

“Parents wonder why the streams are bitter, when they themselves have poisoned the fountain”

- John Locke





Saturday, June 4, 2022

On Our Own

 

Ask most any law enforcement officer, off the record of course, about the need for law-abiding citizens to have guns for self-defense and protection and they will nod and say, absolutely.  They will likely qualify that response by saying that gun owners need to know how to handle guns safely and responsibly.  But they know how dangerous it is out there and they know that law enforcement just cannot be there to stop an assault before it happens or while it’s happening.  In that moment, it’s between the attacker and the attacked.  That’s reality.

 

But there are some fundamental questions Americans must answer.

 

_1 Do we have the right to possess and use firearms?

_2 What sort of firearms should we be allowed to possess and use?

_3 Who should be allowed to possess and use firearms?

_4 How should we control and regulate the possession and use of firearms?

_5 What should the penalties be for illegally possessing or using firearms?

 

We know there is very little agreement between Progressives and Conservatives when it comes to answering these questions.  We also know that guns are used to kill a lot of people in this country and that certain types of guns are often used by the crazies who decide to commit mass murder.  Note that I said “guns are used”; not that guns kill.  Big difference.

 

So where does this leave us?  I don’t know about the nation as a whole; but I do know about my own circumstances.  We live outside the city limits.  If bad guys show up, my wife and I are on our own.  This would still be true if we lived in the city, even if it was in an apartment with neighbors all around.  But it’s especially true out where we live now.  I have a shotgun in my office.  I am prepared for varmints, two or four-legged.  We have handguns in the house, one in the family room, a 9MM semi-auto; and one in our bedroom, a .357 revolver.  We have several other handguns, rifles and shotguns.  We lock them all up when we have visitors or kids around.   

 

My wife is also a realtor and handles property from the northern suburbs of DFW all the way into Southern Oklahoma.  She has her concealed carry license.  I’m glad that she is armed.  Realtors, especially female realtors are targets and more than a few have been attacked, raped, and murdered.

 

I also have a concealed carry license.  When I was a younger man, I didn’t worry too much about defending myself. I was big, strong, tough, and athletic. I had a false sense of security and didn’t see the need for a gun.  Now I am older, slower, and weaker.   And more of the bad guys are well-armed.  So, I keep a pistol in my truck just in case.

 

I don’t own an AR-15 type rifle, but some of my neighbors do.  Most everyone out here is armed to some degree and most folks have a dog or two or three hanging around.  Some of us have security systems and cameras.  Are we being paranoid, overly cautious?  Perhaps.  But the bad guys know that folks around here are well-armed and prepared.  I will acknowledge that having guns around makes it more likely that some one will be shot accidently or commit suicide with a gun or in the heat of the moment shoot another family member or neighbor.  But on balance, we’ll take our chances with those unlikely outcomes versus being unarmed and unprepared.  And that’s our choice to make.  Because for the most part, we are on our own out here.


Am I ignoring recent events?  Not at all.  What happened in Buffalo and Uvalde and Tulsa and Ames and on and on; are tragic and must be addressed.  Tighter regulations on who can own what sort of guns makes sense.  It might help some.  But those bent on killing will find other ways to kill.  We must do better when it comes to recognizing those who are mentally unstable and on the brink.   We must improve security around soft targets.  And sadly, we must accept that we are on our own. Taking guns away is not the solution, it’s just surrender.


“Laws that forbid the carrying of arms…disarm only those who are neither inclined nor determined to commit crimes…Such laws make things worse for the assaulted and better for the assailants; they serve rather to encourage than to prevent homicides, for an unarmed man may be attacked with greater confidence than an armed man.” – Thomas Jefferson


Friday, May 6, 2022

Just a Conversation

 

“I know you from somewhere”, I heard him say.  I looked up but the white man wasn’t talking to me.  He was looking across the small waiting room at the black couple who had just sat down.

The black man replied, “I thought you looked familiar.  You bought your pick-up from __________.”

“That’s right, you’re one of the service managers over there, aren’t you?”/

“Yeah, how are you doing? Everything ok?”

“Yep, just here for a follow up with Dr._____.  You?”

“I’m having some problems with my right eye”.  Then nudging his wife who was sitting beside him, “She said I needed to see Dr._____ or quit complaining about it”.

The white man was with his wife as well and the two couples just started talking.  They talked about their work.  The white man was already retired and the black man was looking forward to it. They talked about where they were from originally and the places they had lived and worked.  The wives told stories about their husbands getting lost and refusing to ask for directions.  They laughed about their husbands telling them how to drive when these women knew perfectly well how to drive.  The women told how their husbands were always teasing the grandchildren and making them mad.  But when they stopped teasing them, the grandkids always asked if Papaw was ok.  

They told stories about when they were younger and their own kids were small.  And how their parents, now passed on, used to prod them to come see them more often.  They talked about the weather and going to church.  The white couple talked about living in West Texas for a few years and not liking it much.  The black couple talked about going back to Mississippi and Alabama to see family when they were younger.  But they had now been in Texas so long, this was home.

They talked about waiting to see doctors and why it always seemed to take so long.  And about getting old and then more about their grandkids.

Then the nurse came out and called a name.  The white man got up with a hand raised saying, “That’s me.”  He told the black man it was good to see him and wished him well with his eye problem.  The wives exchanged goodbyes saying how much they enjoyed visiting with each other.

Just a conversation between members of the human race.


Monday, May 2, 2022

A Five Pound Sack of Sugar

 

It was a hot day in the summer of 2009 when Kayla and I drove down to Tolar.  We were going there to pick up a little Bichon puppy.  We already had one Bichon, Dillon, who was getting up in years and needed a buddy.  Or at least we thought he did.  Or maybe we just wanted a puppy.  After a rough patch in our marriage, things were settling down.  We had moved back to Texas and this was where we would stay.  Time for a new dog to share our new life.

 

We had already picked out the name, Boudreaux.  The breeder had sent us his photo and he just looked like his name should be Boudreaux.  Over time we added more names.  He was Boo, or Boo-Boo or Boody Man.  He answered to them all with a tail wag and a happy face that seemed to say I am so glad you spoke to me.

 

That day in Tolar, when we first met Boudreaux in person, it was love at first sight; for him and for us.  I remember picking him up and saying, “You’re just a five-pound sack of sugar aren’t you?”.   He answered me with dog kisses and panting puppy affection.  He would eventually grow up to weigh twenty pounds, but he never stopped giving kisses or being affectionate.  He was always the same sweet puppy we met that first day.

 

Boudreaux was the complete opposite of Dillon who tended to be moody and neurotic.  Sometimes Dillon wanted to be petted and sometimes just to be left alone. But Boudreaux and Dillon got along well.  And I have no doubt that Boudreaux’s attitude and positive energy added years to Dillon’s life and, in the end, made Dillon a better dog.

 

Not long after Dillon passed away, we got Brodie, a Bichon-Havanese mix.  Brodie was a two-and-a half pound sack of sugar with lots of spice.  But he and Boudreaux got along great and became fast friends and allies.  We got a larger kennel so they could stay together and they truly became inseparable.  As Boudreaux aged, Brodie became his little protector.  When we brought Barney, an English Springer, into the family; it was Brodie who would jump on Barney and straighten him out when he played too rough.  Boudreaux, as always, just went with the flow, allowing Barney to chew on his tail and paw at his ears until Brodie came to the rescue.

 

But in this world, nothing last forever.  This week, Boudreaux took his last ride.  It’s only five miles to the veterinarian, but I wish it had been five hundred.  Just a little more time.  Some months ago the bloodwork from Boudreaux’s annual physical indicated liver problems.  We were concerned and he was given some medication.  Not long ago his bloodwork had shown improvement.  We were encouraged.  But then last week Boudreaux stopped eating.  He had been a bit “off his feed” for a week or two.  Nothing to worry about, or so we thought.  But, he quickly went downhill.  After two days at the vet’s, the outlook was grim.  We brought him back home, praying that he might rally.  He was glad to be home and tried to soldier on.  But he would not or could not eat.  When he drank water he threw up and it was not just water coming out of him.  He was dying.  The vet assured us that other than nausea, he was not in pain, but the end was inevitable and would come soon.

 

His last few days with us were spent sitting in Kayla’s lap or lying in his kennel next to Brodie.  When he went outside he would perk up for a moment or two and then lay down.  Once he saw me walking Barney in the field next to our house and somehow mustered the energy to wobble out to the fence, but he could not manage to bark.  Seeing Boudreaux trying to run, attempting to be his old self, broke me.  I somehow stumbled through the rest of that walk, tears running down my cheeks and Barney looking up, wondering if he had done something wrong.   I do not cry easily, but during the last days with Boudreaux, I cried often and I cried hard.

 

In the end, Boudreaux was at peace, ready to go.  And even though we were not ready, one does what one must do.  His ashes will take their place on the shelf alongside those of our first Springer, the original Barney; and Dillon, the cranky old Bichon uncle who showed Boudreaux the ropes when he was just a pup.  We will desperately miss him and today our hearts are broken.  But I take comfort knowing that little sack of sugar is in a better place and heaven just got a whole lot sweeter.


                                  The Five Pound Sack of Sugar - 2009

Saturday, April 23, 2022

Matters of Opinion

 

“Everyone has the right to freedom of opinion and expression; this right includes freedom to hold opinions without interference and to seek, receive and impart information and ideas through any media regardless of frontiers.” – United Nations, Universal Declaration of Human Rights


The United Nations ratified the “Universal Declaration of Human Rights” in 1948.  No doubt they anticipated that advancements in technology would provide greater access to information and ideas.  More information and more ideas delivered to more people in less time and at lower costs.  But could they have imagined instant messaging on a global scale?  Millions of smart phones capturing images, recording events and transmitting them to the masses in real time?  Information and ideas, good and bad, truth and fiction going viral?  And to what consequence?

 

Certainly they understood the risks of “fake news” and propaganda.  A war had just been won against Fascism and the Cold War with Communism was on going.  In a world of print media, radio, movies and coming soon, television; there would be a battle for hearts and minds.  But it was manageable.  It had to be manageable.

 

The generation making that Universal Declaration of Human Rights, is mostly gone now.  Their children are old and fading away.  And their childrens’ children and grandchildren are mostly divided and disillusioned.  The battle for hearts and minds rages 24/7 and there is no escape.  The search for truth has given way to demands for tolerance of whatever ideology the loudest voices declare to be worthy.  

 

For all practical purposes human rights no longer include the right “to hold opinions without interference and to seek, receive and impart information and ideas through any media”.   As it turns out, receiving and imparting information in a world without shared values is only manageable by censorship and control.  And so the question becomes who gets to censor and who has control?  Welcome to the 21st Century.

 

“Why sometimes I’ve believed as many as six impossible things before breakfast”-The White Queen from Alice in Wonderland (Lewis Carroll)



Monday, March 28, 2022

Texas 6

 

There is a documentary series available on Paramount Plus that follows a small-town Texas football program over the course of two seasons.   The town of Strawn, Texas is so small that it can only field a Six-Man team.  But, make no mistake, Six-Man football is still a big deal in the state of Texas because….well…because it’s football.   Texas is a huge state with a lot of small towns.  More than 150 of them have Six-Man football teams.  Most are not very good, but a handful have developed exceptional programs that consistently win and compete for the coveted state title. 'Texas 6' is about one such program.

 

Strawn is half-way between Fort Worth and Abilene, almost metropolitan compared to some Six-Man teams in Texas.  As an example, Sanderson in far Southwest Texas is 150 miles from Odessa, 200 miles from San Angelo and almost 300 miles from San Antonio.  Strawn is in Palo Pinto county, a place rich in western heritage.  A place where Comanche Indians once ruled, where Oliver Loving and Charles Goodnight ranched, a place of oil booms and busts.  Now it’s mostly just a place where State Highway 16 crosses Interstate 20.   A forgettable place passed over by truckers, trains and travelers.  A few stop at Mary’s CafĂ© for one of the best chicken fried steaks in Texas.  And there is dove hunting and deer hunting that still draw people out from the city.  But mostly no one stops and no one cares much about Strawn, Texas.

 

Being a Texan and a fan of high school football,  I thought the series was great.  But what really struck me was how much it reflected the America that is overlooked, discounted, disparaged and even despised by our “Wealthy Elites”.   Strawn Texas is uniquely Texan, but it has a lot in common with other rural communities and small towns all across America.  I would venture to say that any small town which  is more than an hour’s drive from a major metro area has more in common with the citizens of Strawn Texas than they do with those of major metros within their own state.  Even more so if that small town happens to be located in the South or Midwest.

 

Palo Pinto County Texas was once solidly Democratic; known back in the day as Texas “Blue Dog” Democrat.  No more.  Over 80% of the votes are now Republican Red.  It’s a poor, hard-scrabble, working class county that votes totally opposite of the way poor, hard-scrabble, working class counties in Texas voted 50 years ago.  This shift is not unique to small town Texas.  It’s happened all over this nation and it’s foundational to the extreme partisanship and division we now experience.

 

Too many on The Left, including the mainstream media, want to chalk it all up to a toxic mixture of racism, misogyny, Christian fundamentalism, homophobia, right-wing conspiracy peddlers and just plain old stupidity.  Deplorables clinging to their guns and religion.  Unfortunately, the real life of people like those in Strawn, Texas is not well-known and seldom portrayed accurately.  We are more likely to see movies and television shows about people and events which are familiar to those living in big cities or the surrounding urban sprawl.  When life in small town America is shown, it tends to be either idealized or demonized.  The truth, as is most often the case, is somewhere in between.

 

Texas 6 shows us life in a place where many families live below the poverty line.  Kids are being raised by single moms and grandparents. There are problems with alcohol and drugs.  Teachers and coaches do their best, but too often it's not enough.  Old men hold court over cups of coffee in the convenience store that serves as the local gathering spot.  Mostly they talk about football, the weather, livestock prices and the past.  When politics are discussed it’s with disdain for both parties and politicians in general.  There is a tone of resignation, mixed with patriotism and sadness. Whatever white privilege that may have existed left this town long ago.

 

So they vote for the lesser of evils, for the charlatans who are not as likely to disrupt what’s left of their way of life.  They cling to the hope reflected in their little high school football team, as well as their guns and their fading faith.  The kids and coaches kneel and say the Lord’s Prayer before each game and then rise to shouts of “Now let’s go kick the shit out of these guys”.  Those who have graduated, lean on the cyclone fence around the football field and remember their best days as they cheer for today’s heroes. Kids who would likely be faceless and nameless in big city high schools are stars in Strawn.  The players, the cheerleaders, even the water boy; everybody know who they are and that matters.  Most of them will move away and live out their lives in the suburbs, barely knowing their neighbors and watching their own kids disappear into the crowd. But they will remember what it was like once upon a time growing up in a small town.