Pizza and Prostatectomy

...not even I can charm away a sore throat..." - Emma

Making low-carb pizza for Peter

I might not ordinarily consider my husband's prostate surgery to be an edifying or entertaining topic for a Light, Bright, and Sparkling blog post, but it is a logical continuation of my posts about how the low-carb diet improved his diabetes, and made the surgery possible.  So, here are the notes I wrote during the experience.  (Pizza recipe follows.)

Thursday, May 13. 

Afternoon

Peter was wheeled into surgery discussing Chinese literature with the all-Asian surgical staff! That's so Peter. I also couldn't believe he actually asked the admitting lady if he could have a visit from his cat.

Peter and Pindar

However, she took it seriously and said only guide dogs could visit patients, and they had to be shampooed first. Who knew. Now Paul and I are in the waiting room, more than halfway through the surgery, which takes 3.5 - 4 hours. We had to be at the hospital at 5 AM, so we haven't slept, except for naps last night. We've got our laptops to try to distract us, and we had scrambled eggs in the hospital cafeteria. It's interesting to watch all the people come and go and wait, it's like a multi-ring theater here at Cedars Sinai, with goodness knows how many operations going on. Everything's pretty reassuringly routine and assembly-line, with kind staff. But there's nothing that can stop the hands shaking. People are just sitting around, chatting, reading, having tea, all very normal - except that everyone is a family member of somebody going through major surgery (most of them hearts), and every now and then a surgeon comes out to talk to somebody, and you're aware that there are $50,000 life or death operations happening all around. There's something electrically tense in the air. We're coping, but having a loved one be operated on for hours by a robot puts you into a strange area of stress where your respond with involuntary coping mechanisms, unexpected if you haven't been through anything similar to this extent before. Yesterday I spent the entire day sorting and alphabetizing and reshelving and dusting all the books in Peter's study (maybe 1500 of them), a job that we always projected would take weeks and weeks: I did it in five hours. To be doing something constructive seemed absolutely essential. I wasn't thinking about the surgery while deciding whether to put a book in the Greek or the Chinese sections. It really helped.

"Ah, my dear, as Perry says, where health is at stake, nothing else should be considered" - Emma

Evening

Peter survived his surgery and is well and strong, and the small, confined cancer is completely OUT in the garbage along with his prostate!

It was quite an ordeal. Peter was taken in for surgery at 7:15, and at 8:30 they called me and Paul in the waiting room to say "the robot" had begun its work. Around noon we were figuring it must be almost done, but they called again to say it would be another hour and a half. At 2 I started to get very nervous. I googled all the complications of robotic laparascopic prostatectomy, and had just finished reading about the morbidity of the perforated rectum, when mercifully they called and said they were DONE! Well I cried and Paul stared at me like I'd grown two heads (I don't think he'd ever seen his brass monkey balled mom cry before!). It was then 2:30, the actual surgery took six hours.  A long time for a diabetic to be under anesthesia and for our fears to get truly lurid.

At about 3 the doctor staggered out, sweaty and shaken and utterly exhausted. I spoke first, "A rough one?" "A nightmare. That was the worst, most difficult one of those procedures I have ever done," said this world's expert in robotics. He explained that Peter was too obese for the machine, he hadn't expected him to be so heavy (he gained weight because of a recent medication, Actos), and he almost abandoned it halfway through because the tubes and things just wouldn't stretch. But he managed, and succeeded at last. "I've never been so exhausted in my life," he said. "Never been through anything like that." "But how is PETER?" I asked. "Oh, he's fine, no problems at all," he replied. "But what an ordeal!"

(Poor Perry is bilious, and he has not time to take care of himself -- he tells me he has not time to take care of himself -- which is very sad -- but he is always wanted all round the country. I suppose there is not a man in such practice any where. But then, there is not so clever a man anywhere." - Emma)

After that, I thought I'd find Peter half dead, but no! He is strong and weathered it very well. His diabetes numbers remained low throughout the surgery, and I found him sitting up, healthily pink-complexioned, anxiously asking the infectious diseases doctor if he thought he'd lost brain function from the anesthesia, all the while telling him about the Chinese legends he was reading. He'll probably have to wear the catheter for an extra week, because of being slow to heal, but he is fine. What a relief! I thought I'd stay at the hospital overnight, but after having no sleep and all that stress, I was crashing, and the nurses finally told me to go home. So here I am. Hallelujah.

"...she had been within half a minute of sending for Mr. Perry." - Emma

Catully Contemplates the Poisonous Peonies

Day after surgery - Friday

Peter is continuing to recover well, and will be going home from the hospital tomorrow! After just the normal routine stay for this procedure, thanks to the low carb diet.

I'm thinking about what Mr. Knightley says about Frank Churchill, in Emma -

"What years of felicity that man, in all human calculation, has before him!"

Of course, Jane Austen was writing ironically, in a way that almost makes you believe in the notorious "secret subtext," because we only know from tradition, not from the novel, that Jane Fairfax dies a few years after her marriage. The phrase "in all human calculation" thus takes on significance, for how reliable ever is human calculation?

So I can only say "in all human calculation," that now Peter at least has the possibility to live to old age. The cancer is gone.  His diabetes will be much better controlled and his body greatly healed, by living on a completely low carb diet in future. Prognosis:  Good! What relief - and after all, who of us ever has anything more than "human calculation"?

Second day after surgery - Saturday

Peter is home!  I was still befuddled and stressed, and mislaid the car in the parking garage, but we made it, catheter and all.  My friend Ellen writes:

"What I'm impressed by for real is the pure love you've shown. You really love this guy -- you really value him. I say nothing about the personal case or your or his characteristics but there has been something so utterly selfless in what you've done -- since on a fundamental economic and social level you are so independent."

So that started me thinking about Love, and I wrote to her:

"Well, yes, it is love - we both of us have it for each other, with Paul included.  Peter may depend on me in some ways (and I on him in others), but that has nothing to do with what we feel, which evolved naturally. We began to feel that feeling 40 years ago, and over the years the original feeling itself has endured and has profoundly flowered and strengthened and come to beautiful fruition. Now that we're Darby and Joan with a catheter bag, it is only stronger than ever. It has recently occurred to us, with naive pleasure, that this is the real meaning of "growing old together." Deep love and unfailing support surrounding, cushioning and enfolding us, as we come to increasingly need it, now more than ever. It's how things are meant to be, and in this, at least, we are - to use a quaint word - very blessed.

  1985

It was hard setting up a boot camp to get Peter ready for surgery, it's not something that came easily to me, or something I would think of myself as being any good at.  And a hospital is an extremely stressful place for even for a healthy person to be. After a single day spent there with Peter I came home utterly beyond whipped. But there was this little matter of getting rid of his cancer, and we as a family had to pull together and launch all our three combined best forces to make it work successfully. It was a case where an "I'm not good at this" would not have been good enough. There's nothing wrong with "I'm not good at this" if all it means is that your tapes won't work or you have a computer muddle. "I'm not good at this" is unacceptable if it's life or death. Whatever one's inhibitions, incapacities, distastes, weaknesses and frustrations, however manifold and incapacitating they are - you have to do it anyway, you have to step up to the plate in these vital situations, even if you feel you're sick with dread and fear and helplessness. There's just no other choice. "I'm not good at this" is something you can say about being unable to operate the VCR. Not about negotiating health care systems when your beloved has a mortal illness. I'm not good at it. It doesn't come naturally. But to save Peter's life I made myself great at it.

Third day after surgery - Sunday

Letter to a friend whose husband had the same surgery a few months before Peter:

No, Peter's not getting stir crazy, because he's already gone out!  Can you believe, he had the surgery Thursday, went home Saturday, and tonight he went out to the coffeehouse to see his friends and have a cappuccino! 

I was going to write to you, though, to desperately ask how on earth you dealt with the catheter. Peter doesn't mind wearing it, it doesn't hurt, but they are SO complicated to use. We stand around the bathroom having conversations like this:

"Loosen the blue toggle."
"No, I think that one's supposed to have a clamp!"
"I never saw any clamp. Did we lose it?"
"No, it's that thing. Murder! How in the hell do I open that?"
"I think those little clips open it - push them up - "
(Urine spills all over floor)
"Yikes! Wipe the nozzle with the alcohol wipe!"
"No, clean up the floor first!"
"No, then my hands will get dirty! You do it!"
"I can't bend down, remember?"
"Oh, Jesus, well don't step in it, here, hold the toggle..."

Etc., etc.  Fortunately we seem to have a better handle on it today. ;-) And we are calling the catheter the Cat Heater because the cats can't keep away from it!  Said Cat-Heater comes out in nine days, three hours and thirty-eight minutes, but who's counting?

Monday, surgery plus four

If I haven't put you off your food completely, I must tell you that I made the most wonderful, low carb pizza ever for dinner tonight.  Recipe was courtesy of Debbie, my low carb guru, and here it is.

"Mr. Perry recommended nourishing food." - Emma

Low Carb Pizza

2 cups cauliflower, grated, then sauteed for a few minutes in a little olive oil.
2 eggs
2 cups mozzarella cheese.  (I used two lumps, and grated them.)
1 tsp. fennel
2 tsps. oregano
4 tsps. parsley
1 8-ounce jar of Trader Joe's pizza sauce

Toppings: A sausage, sliced.
Package of thinly sliced brown mushrooms.
A few cut-up marinated artichoke hearts.
Shredded mozzarella

Pre-heat oven to 450.
Spread a little olive oil lightly on a cookie sheet.
In a bowl, combine grated cauliflower, grated mozzarella, and eggs. Press evenly on the pan. I spread ithe "dough" thinly all over the cookie sheet. Bake for about 15 minutes.
Remove pan from the oven. To the crust, add toppings, with mozzarella sprinkled on top. Broil until the cheese is melted. Serves 3-4.

Crust, baked and ready for toppings

Tomato sauce going on!

With toppings, ready for final broiling

Being eaten too fast to photograph!

"Do not you think, Miss Woodhouse, our saucy little friend here is charmingly recovered? Do not you think her cure does Perry the highest credit? - Emma