The Stitches

As promised, once the bandage could be removed, I took a couple of photos of the stitches on RaderBob's schnoz.

The first one is the one that took two passes to get clean margins.

The second one is the one that only took one pass to get clean margins.

Just as a reminder, this is what RaderBob's schnoz looked like after the biopsies had healed, but before the surgery. I expect that, by the time he finishes healing, he'll look pretty much like this again.

RaderBob and Jack Nicholson

Have you ever seen the movie Chinatown starring Jack Nicholson? What do RaderBob and Nicholson's character, J. J. Gittes have in common? (There's a hint in the link above.)

Recalling the last post, RaderBob needed to go in and have a specialist shave off the cancerous bits on his nose till the pathologist said that they had "clean margins" (cut away enough good tissue that they can be *sure* that all the cancer is gone). At the time of the last post they didn't yet have an appointment.

Wednesday was the day! He was warned that the procedure could take the whole day, so his missus packed the two of them sandwiches, snacking grapes, chilled water, reading material, etc so they could camp at the doc's office for the day. And off they went.

Oh yeah. This is what RaderBob looked like on Monday while beating on his computer.

As it turns out, they were done by noon! The first spot on the top of his nose only took one pass at trimming. The second pass on the side of his nose got the last of the cancer there. So, they packed up their lunches, snacks, water, etc and headed for home.

This is what he looked like on Thursday afternoon.

The bandage above is supposed to stay on for 48 hours. He's finding that it's not particularly painful so much as it is uncomfortable and annoying... so far. Once he changes bandages or gets to go bandage-free, I'll see about posting a new photo. Also, as we get more news, I'll post again.

RaderBob's Latest Check-Up

Ever since RaderBob went to see Dr. Cho back in March 2009 and found that he had a bunch of patches of two different kinds of skin cancer (Basal Cell Carcinoma and Squamous Cell Carcinoma) and went through all that surgery and chemo cream, he's been going back for 6-month check-ups.

Well, back on November 8th he had another 6-month check-up and the doc found two spots that looked like trouble and a bunch of spots that looked like pre-trouble. The doc used the nitrogen freeze-spray on all the pre-cancerous spots and took biopsies on the two spots that looked like cancer.

This is a photo of a frozen spot on his right cheek (a week after the fact). The slightly scabrous spot in the middle of the photo is the frozen spot.

This is a photo of the two biopsied spots on RaderBob's schnoz.


There was minimal bleeding on the biopsy spots and he mostly got by with two little round spot BandAids. The spots should be healed by his birthday, but will likely be pinker than the surrounding skin.

This morning Dr. Cho called with the biopsy results. The spot on the top of his nose is Squamous Cell Carcinoma and the spot on the side of his nose is Basal Cell Carcinoma. Like before, he's got a mixed bag. Unlike before, they are not going to treat him with chemo cream. (For those following along, between the antibiotic to kill the MRSA on top of his head and the two different chemo creams over a protracted period, they made him feel icky enough that he wasn't inclined to eat and that's what got his weight down to the current level.)

So, the plan going forward is that they need to call the recommended doc who specializes in surgery of the nose and set up a plan for him to go in to have the rest of the two spots removed. The thing is that, since the skin there is so thin, they don't want to cut off his nose to spite his face. They'll cut around the spot, little by little, having the tissue checked by a pathologist immediately, until they get "clean margins." (A margin is the zone between the cancer and the healthy tissue. A "clean margin" is a certain specified distance from the known cancerous tissue and the healthy tissue. They want to get enough healthy tissue so they KNOW they got all the cancer without actually taking half his nose off.)

No appointment set up as yet, but they're working on it.

How Did You Two Meet?

The other day, while trying to get some genealogically useful information out of Bob, I got him to talking about how he met Betty. He told me about how his boss had been going on for some months about knowing the perfect girl for him. That eventually led to her being invited to the party where they actually met. He saw her home after the party and they exchanged contact info.

Later, he called and set up a date to meet her for an actual date. In those days, very few people had cars -- and neither did he -- so he borrowed a car from a friend and a pair of roller skates from another friend because they were going to go roller skating. He went to pick her up at an ice rink where she was taking ice skating lessons (you know, like figure skating... not just the skate-in-circles stuff).


Well, the date didn't go as planned. When they got back out to the car where he had parked it near the ice rink, his borrowed car had been broken into (along with ALL the other cars parked in that whole block) and the borrowed skates were stolen. They spent the first hour of their date standing in line at the police station waiting to report the crime (along with all the other drivers). Then they went off to the roller rink. She went in to change and reappeared in a well-filled sweater, skirt, and tights. Woo-woo! 


Betty was in good physical condition. She wasn't just a skater, she was also a good swimmer and diver. She was good enough that Betty got a job working for Billy Rose's Aquacade in the 1939 World's Fair. She got to keep her job for a week before her father found out, came apart at the seams and made her quit. 


After the roller skating first date, Rader Bob saw her home and they agreed to continued to date. The problem was that, without a car, the commute to see her was l-o-n-g. He lived out near the end of one line and she lived out on a completely different line (he living in Queens, she living in Brooklyn, and no direct subway route between Brooklyn & Queens at that time), so he had to go all the way to Manhattan, change trains, and all the way out the other line... and back again at the end of their date when the trains were less frequent. This led to a foreshortened courtship and an early marriage.

Rader Bob Has a Past

To date, "Life with Rader Bob" has been mostly about the great health upheavals in Rader Bob's current life and his progress through those upheavals. And the occasional new BBQ grill.  :-)

Lately, however, we've been working on aspects of Rader Bob's genealogy. In the process of trying to get him to remember certain facts, dates, timeframes, locations, names, and on and on, we've been bringing up some memories that have probably never been shared with his kids... or grandkids.  We thought it might be nice to share those memories with the rest of the family. And what better place to share them than in a blog about Rader Bob's life!?

As we hear his stories, we'll try to capture them as best we can -- giving him an opportunity to correct or augment -- and post them.

We'd also like to invite Rader Bob's family to share their stories of Rader Bob. Did he tell you a story? Did Betty share something about him? What about character tales of other family members out of the past. (Stories about currently living family members are right out unless contributed by said living family member.) Contact us and we're post your stories as a Guest Author.

Bob and his New Grill

Bob's new Char-Broil grill was delivered a few weeks ago. So today was the big TEST day. After much reading and re-reading of the booklet on how to assemble (OSH did the assembly and provided for the delivery) and operate the grill it was time to install the propane tank and check it out.

The grill had a lot of dust on it in spite of the fact that the cover for the old Weber grill had been protecting it from the elements. So Magie dusted the grill and helped install the propane tank. There were some instructions on the face of the grill by some of the knobs. Magie read these instructions to Bob. So Bob turned on the propane and turned on the starting burner and Magie pushed on the ignition button. Voila! fire. So the other burners were turned on per the instructions.

Magie decided that it was time to get the camera and take photos. The better photo of the two taken is below. The other photo has a plant obscuring some of the front of the unit.




Bob let the grill get up to "grill" temperature and then turned off each burner. Magie turned off the propane. Bob wll restart the grill when it is time to cook the steak for dinner.

The original intent was to have this blog be about the oxygen equipment and a photo of Bob with the equipment. However, Bob is taking a nap so the oxygen equipment will be in a later blog.

Exercising at the Senior Center

Bob has been going to the Sunnyvale Senior Center (SSC) 2 or 3 times a week since he finished the Pulmonary Rehab class at El Camino Hospital. The Rehab people were encouraging the class members to exercise at least 3 times a week after the class was finished. For Bob this seems to be primarily using the facilites at the SSC or taking a walk over to the middle school.

Bob uses the oxygen setup when he exercises. At the hospital all but one of the class members was on continuous flow liquid oxygen during the exercise period. The flow was set at 2 liters per minute during the exercise and cool down. The students had all gradually worked up to 40 minutes on the exercise machines during the 8 weeks (Tues. & Thurs.) of class. Bob's current oxygen setup is "pulsed" rather than continuous flow. He had started out at SSC with the metering dial set to 2 lpm. However, when he had his next appointment with Dr. Beck, the pulmonologist, Dr. Beck said that he should set the flow to 4 for the pulsed equipment.

The machine Bob is on in the photo is just like the one he had been using in the class in the pulmonary lab. The other photo was taken from just inside the door of the exercise room at the SSC and also shows Bob on the machine. His oxygen bottle is sitting on the floor on the far side of the machine so it is not visible. The bottle is only 9.5 inches tall inside a slightly taller carry pack. For walking, the pack can be carried over one shoulder. I guess we need to take some more photos for a future post.

Bob on Exercise Machine 8 April 2010

Hit a Rough Patch

On the first of March when returning from a trip to the bathroom about 3:30 am, Bob had a problem getting onto the bed and fell onto the floor with his head taking the brunt of the fall. So he skinned his head on the carpet. After getting to a sitting position on the bed, Magie bandaged the area to keep the blood off the pillow. After being less than successful getting the blood out of the carpet, Magie covered the area with wet wash cloths and joined Bob in bed.

The next morning we discovered that the wound had bled in the night and had soaked through the pillow case and the 3 zip covers on the pillow. The fact that Bob is on coumadin/warfarin aggravates the situation. Fresh bandages were applied. Magie went over to Steph's and borrowed the Hoover carpet cleaner.

Tuesday morning we found that the wound had bled through the bandages , the towel covering the pillow, the pillow case and the 3 zip covers. Wednesday morning Magie only needed to replace the bandage. Hooray!!

Wednesday afternoon Bob had an appointment at Dr. Galli's office to have his INR checked. Dr. Curatola asked about the bandage. After hearing what had happened, he recommended that Bob quit wearing his cap and to leave the bandage off because it would heal faster. The photo was taken after removal of the bandage.

Thursday morning (March 4) was the next to last rehab class. That afternoon the AdvantaCare oxygen people delivered an Invacare Homefill II oxygen concentrator, 2 small portable oxygen tanks with a pack to carry one tank over the shoulder, and 2 larger tanks with a wheeled cart to transport one of the larger tanks. Dr. Beck had gone ahead and ordered the oxygen since Bob had not gotten back to him Tues. afternoon after Bob had had a chance to talk to Pete about his supplier.

On Friday, 5 March, we went down to the exercise room at Sunnyvale Senior Center with a small oxygen bottle in the carrier and Bob was able to use a machine just like the one he has been using at the rehab class at El Camino Hospital. If there are people waiting to use a machine, the current user is restricted to 20 minutes on a machine. Bob was able to use the machine for 25 minutes. Part way through, Bob had Magie turn the oxygen level up to 3 (he had started with it set on 2). Magie had attached the oxygen carrier to the back of the arm rest on the machine since it would be inconvenient for Bob to have the carrier hanging from his shoulder while using the machine.

On Saturday, 6 March, Bob took a walk down to the corner of The Dalles and Wright Ave., with the oxygen attached, to put a couple of items into the mail box. That worked out just fine so he walked over to the school with the oxygen on Sunday.

Tuesday, March 9, was the last rehab class and Bob did the warm up exercises, 40 min. on the machine (with hospital oxygen), followed by the cooling down exercises. He does not use the oxygen around the house or when he goes grocery shopping. He also did not use it yesterday when he met his friend Sal for brunch at the Country Gourmet.

Progress has been made.

ICD checked & other info

Bob went to his regular pulmonary rehab class today and did 40 minutes on the machine. They hook him up to a tank of oxygen when he gets on the machine. He has three more classes to go.

After lunch we went to the cardiologist's office for the ICD check. The tech confirmed that Bob had had an episode of atrial fibrillation the day we went to Costco. After the ICD check we went to the car (which we had parked near Dr. Beck's office because there was no space in front of the bldg. where the ICD check was done) and I read a magazine while Bob took a nap. He was pretty tired from the 40 min. on the machine in addition to the warm up and cool down exercises.

Later we got out of the car and walked the short distance to Dr. Beck's office. Dr. Beck had a written message about Bob's oxygen need from one of the staff at the rehab class. After some questioning by Dr. Beck, it turns out that Bob (and I) had misinterpreted some information given out about inhaler use. Further questioning of Bob by Dr. B revealed that, after the class about maintenance and rescue use of inhalers, Bob quit using his inhaler as a maintenance device and only used it as a rescue device.

So Dr. Beck gave Bob a different inhaler (Symbicort) to use as a maintenance device and he will continue to use the Combivent inhaler as a rescue device. Bob is to go back in a month to discuss the results of using the Symbicort which is to be used 1 puff twice a day (every 12 hours). Dr. Beck also wants Bob to be on oxygen whenever he exercises at/from home. Since one of the guys in Bob's class, Pete, is on oxygen full time and comes to class with a small tank in a back pack Dr. Beck wants Bob to talk to Pete about the supplier of his oxygen to see if Bob would like to use the same supplier. So Bob will talk to Pete and then get back to Dr. Beck so that Dr. Beck can call A supplier and make arrangements for Bob to have oxygen here at home. He can use the oxygen when he takes out the garbage cans and brings them back in or goes for a walk or uses the machines at the senior center for exercise.

Ever since the episode at Costco, Bob has been wearing a waist pack in which he carries the Combivent inhaler and a few other items.

About 6:30 tonight Dr. Galli called to tell us the results of the ICD check. He confirmed the episode of atrial fibrillation and indicated that it was at a lower level than other episodes. He said that nothing can be done about it and it will happen again. This was a minor/shorter episode compared with some of his previous incidents where he went to the emergency room.

Bob has an oximeter that he uses frequently to check his oxygen level. Recently, after he had made sure all the doors were locked before we went to bed, he took a reading with the meter. His oxygen level was 88. It needs to be 90 or above. So it doesn't take much moving around for him to get too low on oxygen.

The 6 Minute Walk

As you all know, Bob is enrolled in the 8 week Pulmonary Rehab class at El Camino Hospital. The class started on Tues. Jan. 12 and is held on Tuesday and Thursday each week. However, Tues. this week was the annual Cardio Pulmonary lunch at Michael's Restaurant at Shorline so the class will be extended to the 9th Tuesday so that they have a total of 16 classes.

A couple of weeks ago when Bob and I went to Costco, he got extremely winded pushing a grocery cart from the parking lot into the store. When he got into the store he pushed the cart to one side and leaned over the cart catching his breath. One of the staff wanted to help and said he could sit on one of the motorized carts. Bob declined and said he would be OK and continued to lean on the cart. In retrospect, he should have had his Combivent Inhaler with him and used it. After he caught his breath I led him to a place where he could sit down while I picked up the items we had gone there for. When we got home he tried taking his blood pressure and, at first, neither of the 2 devices would give him a BP reading. The 1st one just kept giving him the "Error" message. The other one finally gave a reading of 148/143 which is not reasonable. So he waited a while and finally got a reading in his normal range.

Since he keeps a log of his exercise activities for the class, he noted on the log that he had had a problem with his breathing and had therefore not done as much exercise as recommended. When he took the log to class apparently the staff wanted to know all about it and subsequently notified his pulmonologist, Dr. Beck, and his cardioologist, Dr. Galli because both offices called Bob here at home. So we set up an appointment with the Pulmonology Lab at El Camino hospital for him to have this "6 minute walk test" at 11 this morning. When I set up the appt. they indicated that the whole thing would take about 20 min. Since Dr. Galli's office did not call until about 5:30 Friday evening, the woman who called asked us to call on Tuesday to set up an appt. for an ICD check.

So Bob had me take him in for the 6 min. walk test. Since we were early they started the test about 5 min. early. The staff lady put an oximeter on Bob's finger. The meter was attached to a pack that she then put around his neck and resting on his chest and off they went. When 20 minutes had passed and they had not returned, I figured that they had probably had to put him on oxygen. Sure enough, when they showed up he was pulling an oxygen tank behind him and had the tubing attached to his nose. He sat down next to me in the lobby and the staff lady went in the back and had a male staff member (Thomas) come out to talk to Bob.

In the course of the conversation Bob revealed that in bed at night his fingers frequently get all tingly. Thomas indicated that tingling in the fingers is one sign of insufficient oxygen in the blood. Then Bob told him about the leg cramps that he had been getting at night but that he had been having less of a problem with them since he had been taking the rehab class. Thomas told him that a build up of lactic acid in the legs, caused by less circulation, was probably the cause of the cramps. He explained that, if the level of oxygen in the body gets too low, the system pumps less blood to the extremities and more blood to the vital organs so that the vital organs get the oxygen that they need. So lactic acid builds up in the extremities because the blood is not moving adequately. Thomas will inform Dr. Beck's partner of the results of the test since Dr. Beck is out of town until next Monday.

Next Thursday Bob has an appt. in the afternoon to see Dr. Beck and an appt. at Dr. Galli's office for an ICD check. It is highly likely that the episode at Costco involved some atrial fibrillation since neither blood pressure cuff wanted to give a BP reading until after Bob had been sitting in the chair for an extended period of time. The ICD check will tell them if there was atrial fibrillation involved.

Before we headed to the hospital for the 6 min. walk test, Bob had commented that he was feeling better today than he usually feels.

Prior to the Costco episode Bob had ordered an oximeter for home use and he has been checking his blood oxygen level a lot.

After Bob sees the doctors next Thursday I will do another post.