Monday Update, 29 May, 2017

I continue doing well following treatment last Monday. Had very little symptoms of nausea. GI symptoms include altered tastes though not too bad for I continue to eat trying to gain weight. Fingers touching freezer food do cause tingling and lasts a while. Also eating cold food causes the lips to quiver and tingle. I also discovered that avoiding lactose helps the frequency of having to go. Energy level comes and goes, but I was able to play a round at Pt Ludlow with very tolerant friends and shot a 99 without delaying others behind us. Presently scheduled to play the last round of cheap golf at our local course Meadowmeer through GolfNow Tuesday 5/30 for they are going off the GolfNow contract as of June 1. Wish me well.

My next Chemo treatment is Wednesday 7 June. I will report my medical progress while receiving the IV cocktail. The next CT scan is scheduled for 21 June, until then we just hope that the Chemo is doing its job. Clinically and physically I am certainly on the road to recovery, but then I was doing as well as can be from August 2016 until the surprised finding of metastasis in the liver this past February, 2017.

Heartily appreciate your continued good thoughts and fervent prayers. Update in 10 days due to slight change in Chemo schedule.

Thanks for visiting. 💜💜💜❤️❤️❤️😍😍😍

USPHS Hospital Responsibilities

My official title with the USPHS Hospital in Seattle was Deputy Chief of the Department of Ophthalmology and was assigned as an assistant clinical professor in ophthalmology of the University of Washington, School of Medicine. My chief at the PHS was a civilian GS physician named Piro Kramar, a renowned ocular-plastic specialist who often was requested to give lectures around the country and was away from the hospital frequently. She was also a premiere mountain climber who was among the first group of women to summit Annapurna in 1990’s. Did I mention she was also a concert violinist? While she was away, I acted as chief of our department. Our staff consisted of Dr. Kramar and myself, a contract ophthalmologist, who substituted when Dr. Kramar and I were both away from the office, a Sr. Surgeon ranked optometrist and a second year resident from the UW. We ran a very busy daily clinic with at least two of us on site; Dr. Kramar and I each had one half-day a week blocked for surgery. We could always add on surgical time for urgent or emergent cases.

Our patient clientele consisted of the following:

1. Merchant Mariners, domestic and international
2. US Coast Guard members – we were their primary medical service providers whereas other services have their own medical corps.
3. Indian Health qualified patients
4. Reciprocity with other military retirees – lots of Navy folks in this area
5. Indigent poor and Seattle homeless street populace

Every 3 months, a new second year resident rotates through me. My job was to expose and teach the second year residents their first adventure in doing Intra-Ocular surgery, mainly cataracts and glaucoma. We started over with the basics each three months. I was very excited and enthusiastic with this new assignment challenge. Needless to say, most residents were very teachable and later became excellent ophthalmologists. UW had 4 residents each year in the 3-year residency program. While the residents performed surgery under supervision, my only opportunity for surgery was when presented with ONE-EYED patients, both for not taking unnecessary chances of complications and also as a teaching opportunity. After their three month stints, they rotated on, and the next resident arrived. Needless to say, I was privileged to care for the accumulative complications and poorer than expected results of their patients’ mishaps. After three years and 12 residents, this became thankless and somewhat frustrating. If I had to follow poor results, I would rather follow my own!

We participated in Thursday Rounds and teaching sessions at the UW, Childrens’ and Harborview hospitals, followed by free lunch at the Westin Hotel sponsored by Western Optical. Finding free parking was the main problem. But Thursday mornings were mostly a pleasant and relaxing time to which I looked forward. Additional, I truly and thoroughly enjoyed and benefitted from these three years of teaching experience. But in 1979, Federal budget was tight, (when not?) and there were negotiations that foretold the closing the Seattle hospital. I was offered the position of Chief of the department of ophthalmology in New Orleans with affiliation at Tulane U, similar to my position here at UW. I would aluso be temporarily promoted to Sr. Surgeon rank, 4 stripes, equivalent to the Navy Captain. But there was no guarantee that they might also close that hospital in the near future! I loved living on Bainbridge; my family had settled in with the kids liking their school and we’d made wonderful friends in church and the community. I decided to resign my commission and left the USPHS after nine years of active service, 1970-1979.

Before I decided to come to Bainbridge and buy the house impetuously in 1976, I had checked the yellow pages and found that there was an optometrist on the island but no eye surgeons listed. In the back of my mind, I was thinking that if PHS didn’t work out, I could set up a practice here. Once on the island, I discovered that Dr. Thomas Case had opened an eye clinic at the North Kitsap Medical Center in Poulsbo. I had introduced myself to him and informed him that perhaps in a few years I might be interested in joining him.

Well, now, 1979, it was getting real. I negotiated with Dr. Case to share the equipment usage, and take his overflow patients, and I presented a cost sharing formula based on patient count and 50% of the lease of office space. Eventually we came to a mutually acceptable agreement. In reality we shared office space but maintained our separate individual private practices; we agreed to split on call duties to cover our patients for each other.

Tom Case and I were together from 1979-1995, expanding our clinics to include physical space from Poulsbo to Pt. Townsend, to Silverdale. Finally I separated myself and built my own clinic, the Bainbridge Eyeland, next to the Bainbridge Library in 1995.

I retired in September 2003 due to changes in medical reimbursement and other regulations. I practiced ophthalmology from 1972-2003, a career of 33 years. During and subsequent to retirement, I had made 7 mission trips to China, teaching the rural country doctors cataract surgery techniques enabling them to care for their patients more safely.

Monday Update, 21 May, 2017

Today’s appointment is much like my last treatment. We were scheduled and arrive on site at 1:00 pm. Dr. Picozzi was scheduled for 29 patients, I happened to be #29.  He checked me out at 3:30 and proceeded to order my Chemo cocktails. But we await for the VM pharmacy to ‘create’ them.  It is now 5:25 pm, I am still waiting for the Chemo to arrive.  Once started, the infusion process takes a little over 2 hours.  I hope to leave this room by 7:00 pm.

My blood works continued reverting back towards normal.  I am still minimally anemic with a Hematocrit of 37%, slightly low on Ca, blood protein, and albumin; otherwise all liver and kidney functions are back to within normal.  The cancer marker, CA 19-9 also has come down from 148 two weeks ago to 118 today (though normal is deemed less than 37).  However, the trend when shown in graph form looked good.  Dr. Picozzi said that he was not concerned.

Because it is getting late, I am going ahead to post this entry even though they have yet to start my treatment. If I experience any changes during the infusion, I will enter an addendum early tomorrow.

Thanks again for your care, concern and continual prayers. 💜💜💜💜💜

p.s. The infusion procedure was absolutely uneventful; they premeditated me and I slept mostly. But finally we were discharged at 7:40 pm PDT, to catch the 8:10 ferry home, ETA a little after 9 pm. A long but hopefully a successful day.

Keep in touch. 😍😍

Monday Update, 15 May, 2017

Today is an off day for treatment, resumes again next Monday.  I continue to do well.  The symptoms this round have mainly been fatigue and sleepiness, with minimal nausea and much GI activities.  Reasonably tolerable.  I went to VM Bainbridge on Wednesday to be disconnected from the 5-FU pump and then attended the choir rehearsal/party that evening.  I got up early enough to go to the Men’s Oatmeal club Thursday at 7 am.  Friday, we left for Mother’s Day celebration with Linnea’s Mom in Portland and returned to commemorate with my Mother in Tacoma last night.

Tomorrow morning I intend to participate in the Bethany’s Men’s Bible study and then attend the Compass Housing Alliance Board Meeting in Seattle tomorrow evening.  On Friday, Linnea will be accompanying me to our NW ELCA WA Synod Council Meeting in Mt. Vernon.  We will be staying overnight to be there for the General Assembly at Salem Lutheran Church all day Saturday.

I am recounting coverage of my schedule to indicate that I am determined to resume my life as before.  This illness will not define me nor limit my activities.  Linnea has been invaluable in helping me manage.

Next Chemo cocktail is scheduled for 22 May.

Thanks again for checking in, continued prayers and good thoughts are much appreciated.

Trip to Bainbridge

On Memorial Day week-end, 1976, after having been accepted by The University of WA to be on staff, and approved by Dr. James Erickson of the USPHS Hospital to be transferred, I flew over to Seattle and visited Bainbridge Island for the first time.  It happened because we had met a friend while in San Francisco at Shepherd of the Hills Lutheran Church named Dolph Jaeger.  He and his wife Fran had moved to the Seattle area in early 1975.  Since he was the only person I knew, I called him.  He was excited that we were coming to the Pacific NW and insisted  convincingly that if I was stationed at the USPHS Hospital, the only place to live and raise my family was Bainbridge Island.  They’ve been here for a year and just love the island.  And the ferry commute was very relaxing and convenient.  Furthermore, he was a realtor and has in mind just the house for us.
After finding my way to the island, Dolph picked me up at the terminal, housed me overnight and discussed the advantages of Bainbridge.  Of particular interest to me was that the school system was stellar and the ferry commute seemed very feasible.  The next day we toured a few homes and finally Dolph showed me the house he had selected for us.  The owners were Mr. and Mrs. White; he was a supervisor of the WA ferry system, nice, honest and friendly, grandparent variety.  They had to urgently downsize and were willing to negotiate.  The six bedroom house was listed for $65,500.  It was in very livable condition with three bedrooms and two baths at one end of the ranch style layout and kitchen and family room on the other side.  There was also a large living room with windows facing a well kept garden on the other side of the kitchen.  Additional, there were three bedrooms on the upper floor with one full bathroom.  The whole family could live on the first floor and house and entertain relatives and friend upstairs.  I still had not listed/sold the Norfolk residence and qualified only for an additional $60,000 loan.  The Whites agreed that if I’d take the house as is, no further inspections, roof certifications and septic checks.  We completed the transaction right then and there on the spot!  Subsequently, I built a large 24′ by 36′ great hall attached to the house.  (Now the home has been converted and serves to house six clients as an adult care facility.)

Next day, I attended Bethany Lutheran Church and found the congregation friendly and welcoming.  Confidently, I knew I had made the right decision for my family.  All these plans were made without the knowledge of Dr. Nelson.  Already having this plan in place was one reason I was bold enough to go AWOL when attending to my twin brother’s tragic demise.  But, unexpectedly, I became a pawn in the struggle for staffing between Dr. Erickson here and Dr. Nelson in Norfolk as related in the immediate previous post.  Instead of moving at the end of June, the final transfer order for leaving Norfolk was not in play until 1 September, 1976.  I was granted 5 days travel time in order to report to USPHS Hospital, Seattle, 6 September.

Propitiously, we were able to sell our house without much of a loss, bought in 1975 for $62,500 and sold for $58,000.  We felt fortunate that everything worked out.  The moving van packed us and had a destination to deliver the goods.  We also packed up odds and ends, and loaded up in our 1975 Chevrolet van that Brother William transferred to us while we were still in San Francisco, the last car he got us through working at GM in Saginaw before his sudden death.  Along the drive westward, we stopped very briefly in OH and MI paying respect to relatives.  Then Catherine, our 1 ½ year old became very fuzzy and was inconsolable and unable to be satisfied.  Feeding her was not comforting and food was spit out; she cried persistently.  We had to stop unexpectantly earlier than planned and checked in at a motel in Sioux Falls, SD.  The next day, Catherine doing better, we felt it best to head straight towards our home on Bainbridge since we lost some time; I drove the entire way (>1500 miles) in 30 hours, arriving at our new home in the mid afternoon, Saturday, September 4th, 1976.  We settled down and slept on the living room carpet until mid morning Sunday.  Monday was Labor Day.

I reported for duty at USPHS Hospital on 7 September, 1976, my birthday, 33 years old.  I felt very comfortable and welcomed with the entire staff and Dr. James Erickson, the Director of the hospital.  A brand new chapter began, now I have been living in the Pacific NW for 40+ years and I don’t really mind the weather that I disparaged formerly.

Monday Update, 8 May, 2017

Linnea and I are on the 9:00 pm ferry returning to Bainbridge.  Our oncology appointment was for 1 pm but they were backed up nearly two hours… First time that happened to me.  Treatment infusion of Leucovorin and Oxaliplatin were finally completed at 6:45 pm. Then I was hooked up to an Infusion pump with the 5 – FU for the next 46 hours.

We had made plans to gather at my son David/Ana’s house ~ 6:00 pm (granddaughters Fiona and Juliana) and daughter Jennifer/Michael and sister Elizabeth who brought Mom/Gma Shirley over for all to celebrate Gma’s 92nd BD totomorrow, 5/9.  Needless to say we arrived late at 7:15!

Prior to treatment, the blood works all indicated continuing improvement in hematology, liver functions, electrolytes and renal functions.  One slight disappointment was that the CA 19-9 went to 140’s, (last visit 80’s) but this number can vary and we need/should continue to monitor this number for any trend development.

Clinically, I am well, gaining strength daily.  Appetite is great and my weight has stabilized.  I joined the Bethany men’s retreat Fri – Sun last weekend at Leavenworth, WA. Phenomenal food and Fellowship.  Linnea served as my Uber driver to and from our motel room in town.  Had a great time!  Thanks Guys!!!

Truly Appreciate and Heartily Welcome your continued prayers and good vibes.  Have a great time this coming week.

Up date  next Monday.  Hope for least side effects.

 

 

September, 1976, Transfer to Seattle

I was told by the hospital director Dr. Frank Nelson in early August, 1975, that the USPHS was having a medical recruitment gathering over the Labor Day weekend at a hotel in Virginia Beach.  This was to be a welcome meeting on Saturday that the USPHS Norfolk Hospital would act as ‘host.’  They were expecting about 25-30 medical graduates with their partners and/or families.  Nelson’s intention was to have the four new physicians be ‘hosts’ to ‘sell’ these participants about the significance and importance of serving the country as officers through the USPHS via the hospital division, the Indian Health division or the National Health Service Corps.  We were to share our personal experiences.  He implied that this was a non negotiable assignment and that I could show off my family if I’d wished, Jennifer was 3 and Catherine was 1 ½.  I said that he could count on me, but the family probably will not be participating.  Assuming that we’d be getting together in advance to discuss the program format, I simply forgot about this commitment, being too busy taking care of patients in the eye clinic.

Then Friday afternoon just before the Saturday conference, I got a message that Dr. Nelson wanted me to show up in my full ‘dress blues’ tomorrow.  After work, I dug out my uniform and rushed it to the cleaner.  Labor Day Saturday in Virginia was not a pleasant day.  The temperature was already in the 70’s and the humidity in the 80’s when I left home at 7 am.  I had my air conditioner on full blast, still, I was already sweating.

When I arrived at the meeting room, I looked for the organizer and introduced myself to her.  When I asked to see the program agenda, she simply replied that this was to be a fun-filled meet-and-greet jamboree and nothing formal was planned.  ‘Oh, by the way, you are our only speaker for no one else responded.  The agenda was yours to be determined.  Shall we get going?’

She gathered the attention of the group and thanked Dr. Nelson for his hospitalities and verified me as representative of the ‘host’ USPHS Hospital.  ‘Here is Dr. Franklin Chu; I’ll let him introduce himself to you.’

I hardly had poured a cup of coffee and was trying to get a grip of the situation but now I was on center stage.  I stood in front of the group, looked around and noted that the audience were all wearing cut-offs and tank-tops, ready for the beach.  So I acknowledged that I knew that their goal was to get done with this meeting and head for the water.

Thus I started, “Looking at you, here I am, dressed in full attire.  Don’t be concerned or embarrassed.  As a Chinese, I am used to be ‘outstanding.’”  They laughed heartily.  I went through what I knew about the PHS history and proudly explained each aspect of the uniform that I was wearing.  Though similar to the naval uniform, our purple stripe band on our white hats distinguished us as special.  Our emblem on the sleeves of the upper arm had meaning.  Though not all settings throughout PHS required officers to wear uniform, the hospital division did.  We took a 15 minute break.  Afterwards, I noticed a man sitting in the back was now fully dressed in our PHS summer whites.  I approached him and said, “You really didn’t need to do this in support of me.”  He answered, “I heard your prideful explanation of the uniform, and I, too, wanted these ‘kids’ to appreciate and witness the meaning of PHS.”  Then he said, “I like you.  You come across well with people.  I am Dr. James Erickson, the Director of USPHS Seattle.  Have you ever consider a position in Seattle?  We have a good set up there.  Give me a call if ever you are interested.”  My parting words were “Thanks, but no.  Allegedly, it rains all the time there in Seattle, doesn’t it?”

Work was overflowing.  I had no days off because Nelson would not approve any expense for on-call coverage.  Interaction between us were always hostile.  Any request for anything was summarily dismissed.

At reported before in the last entry, after my days of being AWOL, attending my twin William’s funeral, life for me at the hospital under Dr. Nelson became beyond overbearing.  But, earlier, sometime in March, 1976, I had received a call from NY PHS, asking if I’d go back to Staten Island and accept the post of assistant chief of the ophthalmology department.  I answered that I had committed two years in Norfolk and that headquarters would never allow such a move.  The answer was that this was already cleared by Dr. Herington at PHS DC.  I got to thinking, if they were willing to transfer me to NY, what if I requested to be in Seattle.  Perhaps I could have a way out.  I phoned Dr. Erickson sometime in March and asked him.  His reply was indeed, he remembered me and would love to have me.  Presently, he had a civilian as the deputy chief of ophthalmology, but he’d prefer an officer in that position.  If I were interested, I needed first to be approved by the Chair of Ophthalmology at the University of Washington, Dr. Robert Kalina, because the USPHS Seattle was one of the teaching hospitals for UW. Accordingly, I had filed my application and was approved and deemed eligible to be on the clinical staff of UW, School of Medicine.  This process was started before my brother William’s sudden death.

By June, 1976, I mustered up sufficient courage and pleaded personally to Dr. Herington and begged to be transferred to Seattle.  He asked for assurance that I’d be a career PHS officer.  I promised that as long as I was happy and contributing, I was very committed.  However, if dissatisfied as I was in Norfolk, I’d be leaving after my required time was fulfilled.  Once again, he kindly granted my request, but the final resolution was to be between the two hospitals.

Dr. Nelson was of equal rank with Dr. Erickson, but was senior to Erickson in years.  Thus Nelson pulled rank that unless Dr. Erickson found an acceptable replacement to him, I would not be leaving Norfolk PHS.  I was caught and stymied.  Dr. Kalina needed someone at the UW 1 July.  I was already approved and accepted, but I couldn’t move!  Dr. Kalina said he was willing to give me a little slack, but needed the situation resolved asap.  All Dr. Erickson could say was that he was doing his best but had no real power to make the change at that time, but requested me to remain patient.

In the middle of August, 1976, I was called at home, 5 am EDT from Hawaii.  It was Dr. Erickson; he had been tapped to work with C. Everett Koop, (at that time) the assistant Surgeon General.  Dr. Erickson was in HI, being commissioned to be a 1-star admiral.  He now out ranked Dr. Frank Nelson, Erickson pulled rank, and told me that my transfer orders would be cut that very day.  Nelson was totally out trumped.  Was Dr. Frank Nelson ever livid and furious!!!  Sight to behold.

September, 1976, we moved here to Seattle and bought a house on Bainbridge Island.  I commuted from the island to PHS, UW, Children’s, VA and Harborview hospitals and joined membership at Bethany Lutheran Church.

Monday Update, 1 May, 2017

My last Chemo session was last Monday.  Subsequently, I’ve had very limited side effects after treatment, mainly gut related and fatigue issues.  I’m eating well and gaining weight and strength.  I feel good enough and planning on attending our Bethany Men’s retreat this coming weekend at Leavenworth, WA.

Since most of you visit this site to follow my health progress, I decided to attempt to write a weekly Monday report.  Next Chemo session is scheduled for Monday, 8 May.

Keep the positive vibes alive.  Thanks for reading.