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Well, I made it. (I assume if you’re reading this, you’re probably also interested enough to be following along with the Twitter updates, so this isn’t a huge surprise…) I figured I’d re-cap what happened on the day of the surgery, from my first-hand perspective.

Last Wednesday, as scheduled, we got to the hospital around 10:45am. We checked in with registration, and got handed something that looked very much like the buzzer you get when waiting for a table at a chain restaurant. After a ten-minute eternity of sitting around, the intake nurse came and took Laura and I back. I was given a hospital gown and a pair of ‘safety socks’ to change into, and a bag to throw everything else into. I got changed, and pretty quickly after that, we had a succession of different nurses come through the room, each doing their own specialized task. The first one was responsible for a task I had not anticipated: shaving the right side of my body.

Shoulders to hips, they shaved my right side. I didn't think I was all that hairy ... until I saw what was left behind!

The other nurses had more stereotypical responsibilities: asking various questions, placing a couple of IVs in my left hand and lower arm, and so on. Once that was done, we went back to waiting. After a bit, they let my parents come back to the prep room too, and then … there were twice as many people sitting around waiting.

At this point, we had what could have been a total catastrophe: the bus depot called to tell us Ms12’s bus was waiting at our house and where was somebody to get her off the bus? It was her last day of school, and somehow got converted into a half-day without anybody giving us any sort of notification at all. Fortunately, since my parents were there, they were able to rush home to take care of her.

We eventually found out that previous surgeries were taking a little longer than expected, so we were waiting both for an available operating room and for my urologist and anesthesiologist to finish up their first surgeries of the day. Nothing quite makes time slow down like waiting to go under the knife, lemme tell you.

My urologist came by, and marked my right side with a Sharpie. I joked with her that I had thought about marking my left side with a big red ‘NO’ or an ‘X’, but then I started to worry that a big red ‘X’ would be the symbol they would use for the correct site. A little bit after she was on her way, Dr. Chen, the anesthesiologist stopped by and we had a quick chat. And not too long after that, we were off to the races.

I remember being wheeled into the operating room, and I distinctly remember the sense of surprise I had at how the room felt. I was expecting something sterile and vaguely high tech-ish. Instead, it felt more like the very clean woodshop of somebody who is extremely serious about their tools and craft. (I liked the actual room better than the one I expected to be in.) I also remember that I chatted with the people in the room a little. I remember sitting up so that they could place an epidural needle in my spine … and that’s about where things start to get fuzzy.

The next thing I remember is waking up in the recovery room. Sadly, my memory doesn’t include any particularly silly things I said while waking up, and none of the recovery room staff could remember specifics of what I had said. I laid in the recovery bay for a while, mostly out of it, and then the staff began the prep work to move me to my actual hospital room. At that point, I said, “I’m either getting hungry, or I’m nauseous.” - followed, a few minutes later, by, “Nope, I’m for sure nauseous.” That slowed the move down a bit, as they pumped me full of some anti-nausea drugs and figured out that my blood pressure was super low. Eventually that recovered, and I got wheeled over to my room.

Surprisingly, I got a private room - I hadn’t really thought about this at all in advance, but I’d been assuming I’d be sharing a room with somebody. It wasn’t anything I was going to complain about, that’s for sure. I was happy to be able to see Laura again. I think I slept a little more at that point. I was pretty determined to get out of bed the same day, so after Dr. Ganeshappa came by and okayed it, I gave it a shot. I got as far as sitting up, but then had another wave of light-headedness and nausea, and decided that maybe the next day was good enough for getting up. Sleep happened soon after that.

Five not-terribly-exciting days of hospital stay followed. I moved from only ice chips, to clear liquids, to a full diet. I worked up to progressively longer and longer walks. I took lots of naps, was given lots of drugs, and generally tried to be good natured about the whole thing, even when somebody was waking me up at 0300 to stick a needle in me.

We got the pathology report while I was still in the hospital, and I’m happy to say that this should be the end of this particular adventure: the mass they removed was a cancerous tumor, but it had not yet begun to spread. Having it removed was the only necessary treatment. I will be having yearly imaging follow-ups of the abdomen for the rest of my life, just to confirm something else hasn’t sprung up, but that’s a pretty small burden to bear.

I’ve been home for a little bit more than 48 hours now. Trying to settle back into a routine, hampered by the limitations of what my body still can’t do. Not quite stir-crazy yet, but I am getting to the point where I’m wishing I could push the “recovery montage” button and compress the next several weeks down into a 45 second burst of still shots and a driven soundtrack.

Please feel free to watch my Fitbit step count and yell at me on Twitter or Facebook or email if you don’t see a nice gradual increase in total steps there from day to day. I’ve got one more post-op follow-up appointment on Friday, to get the staples removed from the incision, and after that, I’m hoping the pace of the “back to normal” movement around here just continues to increase and we settle into a nice, quiet, drama-free summer.

Thanks again to everybody that helped out with this — Laura, my parents for coming out to help, all the doctors and nurses and other hospital staff, and last-but-not-least, all y’all, my Internet pals. Being able to share things and chat with people on Twitter and Facebook from my hospital bed was really an amazing thing, I think without that outlet, that stage of the process would have seemed so much worse. <3

The past few weeks have, most of the time, felt like the initial part of a rollercoaster ride — a rollercoaster you’ve never ridden before. Just sitting there, strapped down, no real control or ability to alter what’s going to happen, not really sure what is going to happen, just waiting, anticipating, as the car makes that long slow climb up to the top of the first drop.

Not really my favorite part of the ride.

Fortunately(?), that’s about over. After I post this, I’m going to go take my shower with the special anti-bacterial soap. I’m going to pack my overnight bag for the hospital. And then I’m going to fidget some more until it’s finally time to leave.

I report to the hospital at 10:45am PT. Last I heard, the operating room was booked from noon until 4pm (and here’s hoping they won’t use it for that whole time!) Not sure what time I might be expected to wake back up, but I would bet it’ll probably be early evening, Pacific Time. (If you’re curious about those times in your time zone, see this link which my crazy internet friends put together.)

Not sure when I’ll be back on the air, but I’m going to pass my phone over to Laura so she can tweet out any updates from my account. So watch @genehack for those updates, or maybe even her account, @mrsgenehack if you want to make sure you don’t miss anything.

I do want to thank everybody that was at YAPC::NA this week for all the support and distraction provided by interacting over Twitter and IRC. I didn’t end up watching that many talks but I’m looking forward to you all providing many distractions during my recovery process.

Special thanks to those of you that bought shirts, and extra special thanks to Stevan Little, Sawyer X, Mark Prather, and Chris “Bosley” Prather for organizing that whole effort.

Okay, just about at the top of the hill, so I should probably finish getting ready now.

(Put your hands up on the way down, that’s more fun!)

Today, I learned that my surgery has been scheduled for next Wednesday (the 10th). Upon learning this, I briefly considered the possibility of making it down to SLC for the first day of YAPC, and then dashing back home for the surgery — but that, with due consideration, seems like not the wisest course of action. So, YAPC::NA::2015 is definitely a miss for me.

However, since OSCON isn’t until later in July, I expect I’ll be able to make it up to Portland for a little hanging out while that’s going on, assuming all the surgical stuff and subsequent recovery goes as expected, so if you’re going to be in town for that, hit me up and we can grab a beer or whatever.

In other good news: the other odd-looking spots that were seen in my kidneys on the CAT scan have gone away in the MRI. They were probably somehow related to the bladder infection that originally led to the discovery of all these problems. This is good news because it confirms that just taking out the part of the kidney containing the tumor is the best course of action.

I just want to say, thanks again to everybody that has offered help and support while all of this has unfolded. It is really, deeply appreciated. I’m lucky to have some thoughtful friends in my life. 8^) <3

…just for a change.

As of yesterday, I’ve been cleared to discontinue the “workaround” and go back to peeing fully on my own! To celebrate, here in just a few minutes, I’m going to have my first cup of coffee since this nonsense started. It’s only been 1 month, 1 week, and 4 days since the last one, but who’s been counting? (Other than me, I mean.)

In kidney/surgery news — still nothing new to report. Pre-op doctor’s appointment on 01 June, so I expect to know something after that.

I talked to my urologist today. (Oy vey, I have a urologist, this is my life now…) She called to discuss next steps. She had been a little concerned about the odd area in my kidney seen on the CAT scan, and had wanted to research it a little and consult with some colleagues before making a plan on how to move forward.

Fortunately, that’s all completed now. She’s decided the odd area is probably just some old scar tissue or something like that, not anything to worry about. Consequently, we’re going to go forward with the heminephrectomy — which is doctor for “cuttin’ out about half your kidney”.

This is kinda good news, because ending up with 1.5 kidneys is better than having just one. (It turns out, if something goes wrong with the other one, you can eek it out on half a kidney and clean livin’…)

But it’s also kinda bad news, because in order to take out part of the kidney, she’s going to have to open me allll the way up, using something called a “flank incision”. According to Dr. Ganeshappa (my urologist, y’all, keep up), this is one of the more painful surgical incisions when it comes to healing. I’ll be in the hospital for 3 to 5 days after the surgery, and I’m probably going to have an epidural for at least part of that, because the pain will be that bad. (The epidural is preferred for pain management because it doesn’t have the constipation issues you can get with narcotics.)

As you can imagine, I’m eagerly looking forward to that phase of the process. (Only, not so much.) I bet I end up with a bitchin’ scar out of this though, so I’ve got that going for me.

Now, the really good news: she also confirmed that, assuming that the tumor is stage 1 (very likely, due to the relatively small size), once it’s cleanly excised, that’s it — I’m done. No chemo, no radiation. I’ll have periodic imaging follow-ups (on the order of once a year) for the rest of my life, but that’s it.

I still don’t have a date for the surgery — other than “some time within a month” — but I will share it when I do. Between then and now, I have to do a bunch of pre-op stuff (blood work, X-rays, and an MRI (to give Dr. G. a better idea of where things are, tumor-wise and kidney-wise)), and I’ve got a “pre-OP” appointment with Dr. Ganeshappa on June 1st, so it will be after that — but how much after, I’m not yet sure.

Thanks again for all the messages of support and offers of help. <3

Thank you to everybody that responded on Twitter, Facebook, sent email, or called in the wake of Friday’s post. I really appreciate the support, and particularly people’s willingness to volunteer to help in what is probably going to be a fairly crappy, trying period. Love to you all.

Damn, it’s all dusty up in here. Last entry in 2012?! Kee-rist, I’m a poor excuse for an olde skööl blogger…

So, as some of you are aware, or may have inferred from my social media postings, I’ve been having some health issues lately. It all started around the middle of April, when I sort of … lost my ability to pee. That’s lead to a massive upswing in the number of doctor appointments in my life, and has greatly increased the number of people that have handled my junk.

That’s sort of mostly okay at this point — I’m still not peeing all that great, and the workaround for that is not the most fun I’ve ever had, but it’s manageable, and every day I pee a little bit better. Hopefully soon, I won’t need the workaround anymore. (Email me if you really want details about the “workaround”, but trust me, it’s probably not your scene.)

But, that’s not really important to this post…

During the course of getting the not peeing thing cleared up, I found out that I have diabetes. This is also not turning out to be a huge deal — I immediately went on a low carb diet and some drugs, and a few weeks later my blood sugar levels are looking really good. I saw my primary care doc on Tuesday, and basically all he said was “keep it up” and “come back in three months”. I’m a little disappointed that I’ve eaten my last sandwich ever, but hey, them’s the breaks. I’m even pretty confident that, in time, I can get off the meds and manage things entirely with my diet.

Of course, the diabetes isn’t really what’s important to this post either…

During the course of getting the whole “Johnny can’t pee” thing evaluated, one of the tests they did was an ultrasound of my bladder and kidneys. And that ultrasound showed what the doctor calls a “renal mass” — which is doctor for “a chunk of shit in your kidney that shouldn’t be there”. The ultrasound was followed up with a CAT scan, which confirmed that the chunk of shit is indeed probably a tumor. (There’s a 5% chance it’s something else, which just looks like a tumor, but … it’s probably a tooo-moor.)

There’s also something else odd, in a different part of the same kidney. To quote the very experienced urologist that I’m seeing, “I’ve never seen anything like that before!” Could be the remnants from an old injury, could be … well, who knows.

So, right now, the plan is: cut some or all of that kidney out. The doc is going to put her head together with some other docs and see what the consensus is on the other weird stuff, and that’s going to determine whether they take out the whole kidney or just the part around the tumor. In general, from what the doc said, they like to remove as little as possible, but if it seems like the other stuff is going to be an issue, fuck it, let’s get the whole thing out. (I may be paraphrasing a little there.)

From her description of the alternatives, I’m actually kind of hoping for the “take it all!” route, because that can be done laparoscopically, which will make for a much easier recovery. If they decide to just take the tumor, I’ll have to be opened all the way up and will end up in the hospital for about a week.

So, obviously a shitty situation — but, looking on the bright side: this was completely unrelated to the issue with my inability to pee. The only reason it was caught was the ultrasound — and the only reason the ultrasound was done was because I happened to mention than an urgent care doc had said she was going to order one, so the urologist ordered it. She said normally, with my symptoms, she probably wouldn’t have bothered if I hadn’t mentioned it. The tumor is still pretty small (around 2.8 cM, which I guess is small as far as renal cell carcinomas go), which means the long-term survivability after removal is really good — 95-98%. This could have gone undetected for years, until I started pissing blood or something. So, while shitty, things could have worked out much, much worse.

Now, short-term consequences: I will not be at this year’s YAPC, I am very sad to say. I am also not going to be able to do {REDACTED VERY COOL THING}. It’s probably fortunate that my OSCON and OSB talks didn’t get accepted, because it saves me the trouble of canceling them. Instead of doing those things, I’m going to having surgery, probably in late May or early June, and then focusing on recovering and healing up, so I can do all those things next year. Because fuck cancer.

I intend to post updates on my condition here, but feel free to drop me an email, or poke me on Twitter or Facebook, and ask how things are going if it seems like it’s been too long since I’ve updated. And now … I think it may just be time for a nap. 8^)

Skotch.app

Like many, I haven’t been very pleased with the recent 2.x versions of Skitch. My main use for that app was to be able to right click an something — generally a screenshot — upload it to a remote server, and have the resulting URL put onto my clipboard so I could paste it into a chat channel or an email message. The new version doesn’t really support that workflow, and, further, the URLs have gotten incredibly ugly. Finally, while I use Evernote, I really don’t want my temporary scratch pastebin files getting imported into the same app where I keep stuff I want to annotate and search long term.

I realize I’m not alone in this position, as there’s been a moderate amount of grumbling on Twitter and in $WORK’s chat channels about the deficiencies of the new 2.x Skitch. Several replacements have been proposed, but none of them really had the ease of use I was looking for, and so one afternoon I finally broke down and wrote some Applescript. (I know, I know, I took a shower immediately afterwards.) Since I’m lazy, I’m really leveraging Sartak’s nopaste script to do all the hard work. I call the resulting conglomeration Skotch. (Insert your own “taped together” joke here.)

Skotch has two parts, an Applescript based app and a shell script that calls nopaste with the appropriate environment variables set. If you’d like to play with Skotch, grab the two pieces of code from this gist. Use ‘Applescript Editor’ to save the first code as ‘Skotch.app’ (and make sure to change the ‘File Format:’ dropdown to ‘Application’, and uncheck the two checkboxes). Use a plain text editor to save the second chunk of code as .skotch in your home directory. Modify the environment variables to match your path and server names, make sure you have the nopaste utility installed, and, finally, make sure you have SSH key-based auth working so you don’t get prompted for a password.

In order to get ‘Skotch.app’ to appear as an option in the ‘Open with…’ context menu, you need to modify the Contents/Info.plist file inside the application bundle. Add additional <string> sections inside the <key>CFBundleTypeExtensions</key> array (see here for background.) You may need to restart the Finder to get new entries to be recognized.

I was also asked for the recipe for the tomato balsamic soup I made for dinner last night. Here it is:

Creamy Tomato Balsamic Soup

(originally from Pinch Of Yum, but currently AWOL…)

Ingredients

  • 2 cups beef broth
  • 3 tablespoons brown sugar
  • 6 tablespoons balsamic vinegar
  • 2 tablespoons soy sauce
  • 1 cup coarsely chopped onion
  • 8 garlic cloves
  • 4 (28-ounce) cans whole tomatoes, drained
  • 1 cup heavy cream
  • Cracked black pepper

Directions

  1. Combine 1 cup of broth, sugar, vinegar, and soy sauce in a small bowl.
  2. Place onion, garlic, and tomatoes in a 13 x 9-inch Pyrex dish coated with cooking spray.
  3. Pour broth mixture over tomato mixture.
  4. Place dish onto foil-lined cookie sheet and bake at 500°F for 50 minutes or until vegetables are lightly browned.
  5. Place contents of dish, including all juices, into soup pot (4 qt is sufficient).
  6. Add remaining 1 cup broth and cream, and process with stick blender until smooth. (You can use a conventional blender or food processor if that’s all you have; if you do, you probably want to strain any remaining solids out before serving.)
  7. Top with grated cheese and garnish with cracked black pepper to taste.

Chili

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This time of year, I end up making a big pot of chili about once a week. It’s great, because it keeps well (in fact, it gets better as it sits in the fridge) and it makes for a quick and easy to reheat lunch. A couple of people have asked for my recipe, and I keep saying, “Oh, I’ll post that on the blog!” and I never do — so here we are.

I don’t really have a “recipe” for this as much as a decision tree — “chili” as a dish composes a very wide variation of preparations, so there’s a lot of room to play around. Generally I’m working in the ground-meat-plus-tomatoes section of the chili realm, so that’s what I’ll focus on here. My decision tree was heavily inspired by both Ürb’s chili con carne recipe and The Clothes Make The Girl’s “My Favorite Chili” recipe.

Genehack Chili

Ingredients

  • Meat: you want around 2 pounds of ground meat of some sort. I generally use a pound of chorizo pork sausage and a pound of whatever strikes my fancy and/or is on sale at the grocery store that week. I’ve tried beef, chicken, turkey, and more pork, and it all works. Still on the todo list: buffalo, lamb, ostrich…
  • Tomatoes: I use Muir Glen organic canned tomato products; you could use fresh but that’s generally more washing, slicing, and dicing than I’m looking for. You want somewhere between 20 and 40 ounces of tomatoes and juices. I generally use one 28oz can of whole peeled plum tomatoes, roughly chopped plus one 14 oz can of fire roasted diced tomatoes with garlic OR two 14 oz cans fire roasted diced tomatoes with garlic and/or green chiil OR one 14 oz can of diced tomatoes plus one small can of tomato paste
  • Beans: Some people have strong opinions about beans in chili; I tend to alternate between with beans and without. Depending on taste, add in one or two cans of black and/or pinto beans. Drain beans before use and rinse well. You want to rinse them until all the can juice is gone and the foamy stuff has rinsed away.
  • Other veg: One or two medium to large white, yellow, or sweet onions, roughly diced. Red onion would probably work too, if you have some you need to use up. A seeded, diced yellow or green bell pepper or two can provide some color and texture. Garlic to taste — which for me is somewhere between 4 and 10 cloves, minced. I also generally throw in 2 to 6 hot peppers — jalapeños, seranos, poblanos all work well. Make sure to remove all seeds and cut into a fine dice. You may want to wear gloves for this step.
  • Other ingredients: Depending on how much liquid you like in your chili, and what your tomato composition was, and how long you’re planning on simmering the chili, you may want to add some additional liquid — any where from 14 to 28 oz of a combination of beef broth, water, and/or wine generally works well.
  • Spices:
    • 2 to 4 heaping tablespoons chili powder
    • 2 to 3 heaping tablespoons ground cumin
    • 1 teaspoon oregano
    • salt to taste (i generally give a pretty good sprinkle)
    • black and/or red pepper to taste

Directions

The basic procedure here is: brown the meat, add in the veg, mix in the spices, add any additional liquid, bring to a boil, then drop to a simmer. I generally do this all in one pot, a 4 qt cast iron Dutch oven. If you’re planning on a long simmer, make sure you have a lid.

  • Brown meat: if you’re using a low-fat meat, add a tablespoon or two of coconut or olive oil to your pre-warmed pot, then brown the meat. Since I almost always have a pound of chorizo in the mix, I generally start cooking that first, and then add the other meat once some fat has come out of the pork. You could stop and drain the meat at this point, but I don’t — all that fat is going to help fill you up on small portions.
  • Add veg: chuck all your vegetables in the pot and stir it up
  • Add spices: toss in all the spices and stir everything up well
  • Add extra liquid: if you’re adding in extra broth, water, or wine, it goes in now
  • Bring to a boil: I generally just crank the burner all the way up. Give it a good stir every 3 or 4 minutes, particularly if your pot isn’t well-seasoned yet
  • Drop to a simmer: Once you’ve been at a boil for a minute or two, crank the burner down, put the lid on the pot, and let it be. You can stir it up every hour or so if you think you need to, but it’ll mostly be okay just sitting there on the stove

You can simmer this anywhere from 2 hours to overnight — I’ve gone as high as 25 hours once, due to a scheduling mistake (started chili going when we had a previous dinner engagement that evening, and just let it go until the next day). For longer simmers, depending on what you put in, you may want to adjust the liquid levels to keep things from drying out — you can always chuck in a cup or two of water. As it gets closer to serving time, if you find it’s too liquid for your tastes, uncover and elevate heat as needed to reduce.

Serve with grated sharp cheddar, raw white onion, additional hot sauce, and/or sour cream, to taste. Goes well in a bowl, over hot dogs, or with tortilla chips. Keeps well, can be frozen.