Since early June, I’ve had blood in my urine. At first it was plainly visible. My PC ordered urine tests. Each time they came back positive for blood. On my last test, July 5, the it was positive for blood, but it wasn’t visible. The PC sent a referral to the Seattle VA Medical Center.

When I went to my appointment in Urology, I was expecting to see an MD. As luck would have it, I saw an ARNP. (My experience with ARNPs in the VA has been less than notable.) The appointment was remarkably short. Basically, the ARNP’s job was to introduce me to cystoscopy. If you don’t know, a cystoscope is a small fiber optic tube that is inserted in the urethra to examine the urinary bladder. It wasn’t surprising the ARNP hadn’t looked at my cystoscopy record as I had those in 2013 and 2019. Those were administered because I had blood in my urine, but they occurred after the bleeding stopped and there wasn’t any blood detected during the exam.

Today, I had my third cystoscopy. Unfortunately, a relatively large tumor and a smaller one were discovered. The urologist administering the exam said the tumors do not look benign. Since she’s in the business of looking for tumors in the bladder, I’ll have to take her word for it.

Bladder cancer is common in older adults. The key to survival is early discovery. Hopefully, my tumors are in their early stages. But that large tumor was too blaring because it was outside the wall of the bladder. If it had grown inward to the muscle wall of the bladder as much as it had grown outward, the chances of a totally happy ending are close to zero.

Next step is a biopsy under anesthesia to definitively discover if the tumors are benign or malignant.

My birthday was celebrated when I came out of bedroom Sunday morning and sang “Happy Birthday” to myself. My son might have said something, but, since I’m hard of hearing (my brain doesn’t process some sounds), I didn’t hear what or if he had said something. That pretty much says a lot about our relationship. He lived with his grandmother until she went into nursing homes to die. He’s under the assumption that’s why I moved back from Texas to live with him until I go into a nursing home to die. I moved back because I had been given the opportunity to get new knees. I felt the hassle of doing all of the going into a rehab facility for a month and being restricted to my apartment for six weeks didn’t make sense if I could get new knees here.

Unfortunately, the opportunity to get new knees has been put on hold because I had an atrial fibrillation episode three weeks before the schedule surgery on my left knee. The anesthesiologist definitely wasn’t going to put me under if I have a bad heart. So, my arthritic knees are going to have to suffer until my cardiologist gives the green light.

I had a visit at the Cardiology Clinic at the Seattle VA Medical Center on 8/9. Unfortunately, I was a little overwhelmed with everything that was going on to ask the Resident or the Attending about getting knee surgery. I sent a message to them, and, hopefully, they’ll respond with the authorization. Well, the Cardiology Nurse Coordinator responded to my message and said Ortho Surgery will coordinate with Cardiology whether my heart situation will complicate knee surgery. That’s a plus.

Yesterday, I saw an ARNP in the VA Urology Clinic about my bloody urine. He scheduled me for a cystoscopic exam of my urinary track. They’ll be looking for cancer in the bladder. I had a CT scan, but those are only good for looking for cancer in the kidneys or ureters. Other methods for looking for cancer in the bladder include MRU and PET scans. The VA always operates on the lets due the cheapest tests first in the hope we don’t have to expensive tests. After all, the VA is just another federal agency that has a budget that sometimes precludes the best care Vets can expect.

I’m fairly certain the bloody urine is going to stop knee surgery until the cause can be found. The CT scan didn’t find anything. Hopefully, the cystoscopy won’t find anything. That will probably indicate the blood thinner I’m taking is probably the culprit. I’ve been taking blood thinners for a long time due to blood clots I’ve had in my left leg. I’ve also taken mega doses of aspirin to help with the arthritis in my knees. I had episodes on bloody urine in 2013 and 2019, but the follow-up cystoscopies didn’t reveal any specific cause.

So, I’ve got a bunch of medical maladies going on that have made this birthday quite depressing. That is what I’m going to have to discuss with my psychiatrist when we meet next Wednesday. For a person who takes medication for depression, medical maladies can be very stressful. Then having to take care of the dogs while my son is at work throws on stress that I can do without. For me, too much stress drives depression through the ceiling, or is that through the floor?

It would help if my son could be a little more caring as to my situation, but he has his own psychiatric issues, which he refuses to medicate. Just one more stress to have to deal with. If my son wasn’t so conservative in his views, I might be able to get along with him. He claims to be a right-leaning centrist, but he keeps spouting off so much QAnon conspiracy BS I can’t even talk to him. Whenever something comes up in the news, he’s always spouting off it was the Liberals who caused the problem, even if it was a conservative Republican who clearly was a fault. Needless to say, his hero is Trump. The man has and can do no wrong. The way my son talks, he’d be happy if Trump established himself as king of America, if he wins the 2024 election.

Just received the results on my latest urine test. It was the second time in June that my sample came back with elevated red and white blood cells. When I was in the ER on June 7th for atrial fibrillation, I was also passing blood in my urine. I have to assume that was the reason for the first urine test.

This isn’t the first time this has occurred. I think it was back in 2018 when this also occurred. I happened on the weekend, but was still evident on Monday. I went into the clinic and they sent me to the ER at the Seattle VA Medical Center. I had a CT scan that showed an enlarged prostate. That resulted in a prescription for benign prostatic hyperplasia and a referral to the Urology clinic, which resulted in a cystoscopy (urinary tract scope procedure).

That cystoscopy certainly wasn’t fun. It definitely wasn’t like a colonoscopy where they knock you out with Demerol. You’re fully awake during a cystoscopy. You’re lying on your back on a table with a urology resident and the attending. There are two or three nurses to help with the procedure. The scope is similar to the one used in a colonoscopy, except this one is small enough to be threaded up the urinary tract. It has a fiber optic strand that’s connected to a screen to see what’s going on, a means to cause water to irrigate the tract and bladder, the ability to take tissue samples for biopsy, and the ability to treat conditions that could be causing the bleeding. When the scope is removed, all the extra water pushed in during the procedure comes flooding out. The nurses are ready with towels to soak up the water.

I have to assume when I go see my primary care doctor this Wednesday she’ll send in a consult to Urology. Hopefully, they will schedule me for at least a cystoscopy. Maybe, I’ll also get to have a CT scan. Supposedly, there is a CT at the new Everett VA clinic, or that sign on the door is only there in anticipation of installation. You can never be sure what medical care you’re going to get from the VA. Being 100% disabled ensures that whatever medical care I need will be free. I had a previous primary care who kept putting off my deteriorating kidneys until they got bad enough in her view for a referral to the Nephrology clinic at the VA medical center. Strangely, she didn’t have any problem with sending me down to Orthopedics for cortisone injections in my arthritic knees.

I can only hope that whatever is going on down in my urinary tract is something that isn’t too serious.

Last Wednesday (6/7/23) I wasn’t feeling to good, so I took my blood pressure (BP) The cuff is right on the desk beside me. I put it on sufficiently tight and watched the numbers do their magic. Finally, the result showed up. My BP was OK. It was my pulse that was odd. 186 isn’t a number one expects for a pulse. I thought may be there was something wrong with the meter, so I waited for fifteen minutes and took it again. 188 came up. Another fifteen minutes and 190.

I called the consulting nurse at the VA. He said I needed to go to the emergency room. He asked where I lived. Considering I live half way to Leavenworth, he suggested I go to the hospital in Monroe. I asked if I should call 911 for an ambulance. He asked if I felt faint. I said, “no.” He said it was probably OK for me to drive myself, but he did say if I did feel faint on my way, to pull to the side of the road and call 911.

After pulling out on the highway, I saw a fire truck and aid car parked by the taco wagon at The Red Barn (an establishment that sells lots of odd stuff). The men and woman were waiting for their orders. I pulled into a parking stall and walked up to them and asked if they could check my BP. They’re always ready to check the BP for a citizen. Of course the BP was normal, but the pulse was. It wasn’t over 100, but they said I should go in since the VA nurse told me to. They said the VA nurse might have notified the emergency room to expect me.

I made it to the emergency room OK. After getting checked in, my vitals were checked by a nurse and she found me a room. A vein was tapped and the needle was taped to my arm. Then the leads from the heart monitor were taped across my hairy chest. I looked at it when they turned it on. My pulse was 192.

Then the questions began. Had this happened before? Did I have a history of heart disease? Any heart attacks? Strokes or TIAs? When did this begin? Had I noticed anything out of the ordinary before? I had woken up the night before with a heaviness on my chest, but didn’t do anything about it. I told them that when I checked my BP in the morning it and my pulse were OK.

The doctor came in and started asking his own set of questions, which were basically the same one asked by the nurses. He said that I had an atrial fibrillation or Afib. He said check with the on-call cardiologist on whether I should be admitted to the hospital or if it was OK for me to go home.

They gave me a med to lower my pulse. Then they hooked up an IV, which only turned on my kidneys. I lay there waiting for something to occur. They took me to the radiology section of the ER. I was given a CT scan on that came back clear. Some of my blood tests came back with questionable results, but the nurse that checked me out said the cardiologist would discuss those on my visit on the 16th.

So, now I have to be on the look out for symptoms of a stroke or another Afib. The only thing really bad about this was the knee replacement surgery I was supposed to have on the 21st. At our meeting on Friday, the Anesthesiologist said I would have to get clearance from a cardiologist before I can have surgery as serious as that. Oh, well, life goes on.

My primary care doctor has taken me off Amlodipine to reduce its impact on my kidneys, which aren’t healthy and getting worse. I’ve had a long relationship with Amlodipine. I was taking it back during the time I was being seen by a primary care at the North Seattle VA CBOC. Other than my kidneys everything was running rather steady.

Then I moved to Plano, Texas, and was assigned to a new primary care. I’ve never in my life had a worse doctor of any specialty. The only positive thing he did for me was to take me off Gemfibrozil and put me on fish oil tablets, which control my triglyceride far better. Like I said, that was the only positive thing. He took me off of Amlodipine for no other reason than he didn’t like the medication. He never explained why, and who was I to complain. Luckily, when I went to my new primary care, he put me back on it. Then he sent me on the wild goose chase 53 miles up the road to the VA medical center in Bonham, Texas, for cortisone injections in my knees. The doctor there told me I could’ve gone to the medical center in Dallas, only 27 miles from my apartment.

There were other screwy things that he did that only increased my aggravation with him. He had a total fear of the pharmacy staff. Someone once, told him that all prescriptions in tablet form had to be cut in half. That required him to order a large medication, which would be cut in half by the patient. I had prescriptions when I moved to Texas that didn’t have to be cut in half, so I questioned him when he wouldn’t order the smaller size. He said the pharmacy told him that prescriptions had to be cut in half. Then there was the blood thinner I’m supposed to take because I’m prone to get blood clots. He would not prescribe that, period.

I think it had a lot to do with where he got his university and medical school education. It was in a foreign country that has a very militaristic society. Questioning higher authority was something that just wasn’t done. Instructions were instructions, never to be doubted.

Now, that I’ve moved back to Gold Bar, Washington, my primary care is at the Everett VA clinic. She’s a nice doctor who seems to have her act together. She contacted the Coumadin Clinic at the Seattle VA medical center to get me back on either Xarelto, Warfarin, or whatever they want. She’s also taken me off Amlodipine in an attempt to control my deteriorating kidneys. Little does she know that doing so will raise my blood pressure.

All I can say is that I hope my scheduled left knee replacement surgery doesn’t get cancelled.

So, where to begin?

I’m on the schedule to get a new left knee in the May/June surgeries. Once that’s taken care of, I’ll go for a new right knee. I’m delaying the right knee because I’ll lose driving privileges for over eight weeks. That will put more of a strain on Nathan because I won’t be able to run my normal errands. New knees are contingent on passing a few medical tests like EKG, chest x-ray, and possibly kidney exams.

There’s a new family member lurking around the house. Nathan’s friend Bryce has two dogs: a female Pit Bull mix and a male Australian Shepherd/Jack Russell Terrier/Pit Bull mix, neither of which has been neutered. Sometime last November they got together for some unsupervised play. Unfortunately, this wasn’t a time for them to be together anywhere on the property. Of course, pregnancy was the result.

Herbie is smaller than most of the other puppies. Actually, he’s only bigger than the runt of the litter. He’s brown merle with white feet, white tip of his tail, and Pit Bull ears. He’ll be having a little operation the 5th of May, because Sara couldn’t have an operation due to her heart murmur. The cardiologist couldn’t give her good odds of surviving a spay operation.

The schizo thingy has been acting up making it a bit harder to write. Actually, I haven’t been writing at all and it’s easy to blame the schizo thingy. At least I’m reading, doing mathematics with Brilliant, and taking courses at MasterClass (I just started the one for making bread.) So, I suppose that’s helping my brain combat the schizo thingy. Maybe, I should look into that. It’ll give me something more to do rather than writing.

Well, ladies and gentlemen, girls and boys, dogs and cats, horses and cattle, rats and mice, crows and ravens, Chinook salmon and great white sharks, sanity and insanity, 2022 has come to an end, so it’s time to look back and see what the year has given me. Pope Benedict XVI and Barbara Walters lived to the very end, but missed a chance to see the sunrise of 2023. Such is life.

2022 for me was moving from Texas back to Washington to reclaim that bedroom in my son’s old manufactured home. Technically, a mobile home because it was manufactured a year before the designation changed. My bedroom was full of stuff my son put there and I brought stuff with me. I have a whole box of DVDs and no means of playing them because my son stopped watching TV, so he put it in the closet. I’m thinking of getting a bookshelf for the corner where the desk currently resides. I could probably get a small TV to sit on top of the bookshelf with my DVD player. I know my son wants the desk so he can restart his hobby of building model airplanes.

My reason for moving back was the possibility of getting new knees. I joined a gym when I arrived here, but stopped going after two weeks because I overexerted and blew out my right knee. By the time the right knee was sufficiently better, the left knee decided to start slipping. My biggest problem is losing weight. It’s the Seroquel that caused the weight gain, but pretty much all anti-psychotics cause weight gain. A good way for me to lose weight for knee surgery would be to stop taking the Seroquel, start using nicotine, start exercising more. Maybe doing that I’ll lose enough weight to get knee surgery before I flip out from not taking the psych med. Of course, that’s crazy thinking. My new psychiatrist likes me because I’m able to recognize when my thinking goes askew.

Wednesday evening (12/28), I went down to Speedway Chevrolet in Monroe and traded my 2014 Chev Impala LTZ in on a 2015 Toyota Tundra SR5 4X4 Double Cab. It’s one of the Tundra years recommended by YouTube automotive presenter Scotty Kilmer. It was well taken care of by its previous owners, so I think I made a good deal. My plan is to take road trips in the summer when my son takes his vacation. Depending on the weather, I might even try a short road trip during his Christmas vacation.

OK, time for the nitty-gritty. It’s time to discuss how Schizoaffective Disorder Bipolar Type has affected me. First, I moved back to Gold Bar when that was probably not the correct decision in my life right now. The way the orthopedics PA explained it, being sent to a nursing home for a period of recovery after surgery wasn’t something I wanted, but if I would’ve gone to the apartment manager or possibly a local DAV rep, they probably would’ve helped me during my period of recovery. I was afraid of the what might occur if I couldn’t get my daily mail and ordering groceries. If I would’ve thought it out, I probably could get my mail and, of course, online ordering of groceries was doable. I had done it during the time I dislocated my little toe and was stuck at home. It all goes back to my biggest problem with being schizo. I just don’t think like regular people and that gets me in trouble sometimes. Not big trouble like going to jail, though I do remember in my youth contriving acts of violence that could’ve put me in prison for a long, long time. I suppose I’m lucky not being full-blown schizo.

I’ve been working on the rewrite of The Companion since I received the manuscript analysis back in February. It’s been a real slog trying to change it from third person past tense to first person present tense. On October 4, I received an email from the people over at Save The Cat! to participate in a Beat Sheet workshop.

I became involved with the Save The Cat! people back in 2020 when I purchased the book Save The Cat! Writes a Novel by Jessica Brody. Jessica is a successful writer of over 20 novels. My involvement was limited to reading the book. Unfortunately, I didn’t apply any of the instructions to my story-writing process.

So, why should I see if Save The Cat! can help me with The Companion? I suppose it’s because of a change that occurred in narrative of The Companion last week. Having the planet Orcol struck by a sizable interstellar asteroid similar to 1I/2017 ‘Oumuamua that visited our solar system back in 2017.

The other reason is simple. I’ve been a pantser in my story writing for as long as I’ve been doing this. I’ve fought being a plotter, but maybe now is a good time to see if I can get this rewrite going with the Save The Cat! process.

Went to the Seattle VA Emergency Room this morning on the advice of the VA consulting nurse who I spoke to last night. Complaint this time is diminishing vision in my right eye. I don’t know what it is to go blind, so, maybe, I don’t have a serious problem. I definitely can’t see the laptop screen with only my right eye.

The ER doctor said that it was obvious I wasn’t having a stroke, so, maybe, it would be a good idea to send me home and let me try to get an appointment in the Eye Clinic to see an ophthalmologist. Going in today I was under the assumption I’d see the on call ophthalmologist. Since I didn’t have any of the signs of a stroke, they thought it best I go home. I don’t know what it is with ERs that prospective patients have to be near death before someone takes notice.

So, I have my left eye doing all the work. Hopefully, it will continue doing double duty until I can get an appointment at the Eye Clinic.

I made it to 73 last Saturday night at 11:30, which I believe is quite remarkable considering my physical and mental states. I’m beyond overweight, but very short of grossly obese. Basically, I love to eat all the things I shouldn’t and don’t eat enough of the things I should. Also, I don’t get enough exercise. I’ve joined a gym here and hope to get back into a steady pattern of exercise. Mentally, well, if you’ve come here often enough you know I’m basically nuts. Schizoaffective disorder, bipolar type, is about as crazy as you can get without actually going insane. Lately, though, I’ve been having feelings that maybe something else might be affecting my psyche. Dementia or Alzheimer’s? I’m certainly at the age.

My father died at 52 from prostate cancer, though he wouldn’t admit that. He told my mother and everyone else he had hip cancer. His death was fairly easy being that he was able to die at home. Even though my mother knew he was dying, she was devastated that he should leave her so unexpectedly. I was in the Air Force at the time and came home on emergency leave. My Uncle Lyle and Dad’s best friend Larry met me at the airport. When I arrived home, Mother was inconsolable in her bedroom with my Aunt Hilly and Larry’s wife Annie at her side. Larry handed me a small glass half full of whiskey to help me get my nerves in order to I could help Mother in the days ahead.

I’ll admit it right now, I did not cry at my father’s funeral. If fact I didn’t cry at all when I was home. The night after I returned to Dyess Air Force Base, where I was stationed, I got drunk and we out with a bottle of whiskey and tried to burn down power poles. The base police picked me up and tossed me in their lockup. The following morning the air wing admin officer got me released. I thought they would give me at least an Article 15 administrative action, but I was sent to the base psychiatrist instead. My days of being considered nuts began.

My mother died at 83 from metastasized breast cancer. She originally got it 15 years earlier and beat it then, but as cancer often does, it hid from view slowly spreading to her abdominal wall, spinal cord, brain, and numerous lymph nodes throughout her body. When the cancer made its status known, Mom went to an oncologist. Since I wasn’t a part of her life because she hated my wife, I wasn’t a part of her final years. The last time we spoke, she said my son, Nate, would handle everything. She also had friends who helped her until she went to the nursing homes. Then they stopped seeing her.

After Mom died, the Neptune Society had her cremated and they gave her ashes to Nate. That was when I was driving long haul, so I couldn’t be there and that’s the reason Mom chose Nate to handle everything. I did my part by keeping my wife away from Mom. Mom’s desire for her ashes was to have them spread over the summit of Stormy Mountain overlooking Manson, Washington, the place of her childhood and early adulthood. Once again, I wasn’t there because if I made the attempt, my wife would desire to go too.

And, so, I’m 73. Will I make it to 74? Who’s to know. My body could give out. Or, just as easily my mind could go by going into psychiatric crisis and having Nate call 911. That would trigger a police response, which would end in a shower of bullets. Or, that feeling I’m having in my head could be Dementia or Alzheimer’s and I’ll enter a downward spiral to oblivion. Maybe, my heart will give out. Or, maybe, cancer will come my way. There’s always the chance COVID could infect me, and, maybe, I’m healthy enough to beat it. Only time will tell.

Plus, I need to get my novel, The Companion, rewritten.