The appointment with Dr. Olsen, the cardiologist, left more to be desired for. Dr. Olsen told me that even though the amount of fluid in the heart sack has now built up to a quantity that equals the last time it was drained off, approximately 1.7 liters and maybe more, there was no need to drain it off at this point. He said the ultrasound showed my heart was beating normally, wasn't affected by the fluid and neither were the lungs. He also said that the pressure I felt was indeed likely to be the amount of fluid, but draining it off wouldn't relieve the discomfort. Apparently the last time the fluid built up to this level, it stretched out the sack and that is why I am not having the same difficulties this time, labored breathing and heavy chest pressure. I guess since I am not having any major difficulties, its best to hold off until I really need it drained, maybe a month from now. We then discussed the draining options. Dr. Olsen said that it wouldn't be as easy as sticking a needle in there and draining it off like the last time, aka pericardiocentisis. He said we would have to do a little more invasive surgical procedure involving installing the window and allowing the fluid to be drained into my abdomen where it would be reabsorbed. The reasoning is that there are several chambers inside the sack that collects the fluid. The needle would only tap one, maybe two, of these chambers. By doing the more invasive surgery, he could open up all the chambers into one where the window would be installed. Since this is more invasive, its best to wait until it absolutely needs to be done. The recovery time would be about 3-4 days in the hospital following surgery.

Beth and I left his office concerned with a couple of things, (1) We didn't feel comfortable with his demeanor and body language, and (2) I feel good and healthy now so getting it down now seems like it would allow me to better recover. First his demeanor and body language. I have considered Dr. Olsen to be my cardiologist this whole time but I have had little interaction with him, just the first time in the hospital right before being diagnosed with Lung Cancer and this appointment, I've been seen mostly by Dave Panther, the PAC. So I don't have a good feel for reading him. But, he didn't make much eye contact with me and often looked at the floor while discussing my situation. Maybe I am misreading him completely or injecting too many of my emotions into how I am reading him, but I felt as if he was "just wanting me to be comfortable." Almost as if it might be too late for me. I also understand that there is a certain amount of risk involved in this procedure, but common on, I have late stage lung cancer, I am on a combination of chemo drugs that kill healthy tissue as well as cancer and the risk for the procedure is about equal to the 5-year survival statistics of my disease. So, why not now why I am still at my healthiest? While I am not fully satisfied with this appointment, I am keeping a level head about it and won't quit seeing Dr. Olsen, there is still a lot I have to learn and understand. So, I will keep my appointment with Dr. Sytman for the 21st to get a second opinion. I will also discuss this with Dr. Chen, who seems more comfortable with Dr. Sytman, and certainly will discuss with Dr. Sodhi, who will never ever write me off until the last breath exhales from my body! A couple of things Dr. Olsen did say was that I should continue to ride the excercise bike since it will be good for me, but to take it easy, and that I should be safe to get through Christmas and that it if I physically felt like, I should go to California. When we discussed the sauna, he said to keep it in the low 100's and keep it short. Thats funny, I routinely push 200 and go for a minimum of 30 minutes, many times up to an hour. If I recall correctly, when Beth and I did the Indian sweat lodge with Rachel and John early last summer before they got married, we had it around 150 and was in there for at least 1.5 hours! Dr. Olsen then said for me to stay well hydrated and get out when I feel light headed and dizzy, duh! I mean no disrespect to Dr. Olsen, but I don't think he has much experience with dry saunas, or at least how we do them.

I spent the day reflecting on how that appointment went and I am still not sure. While I am certainly filled with emotions, I still feel like he could have made better eye contact with me. I do know that when making the appointment, there was debate as to whether I was to see Dr. Petersen or Dr. Olsen. I was told by the nurse, Bess, that Dr. Olsen wanted to see me since I was "initially his patient." So I know Dr. Olsen is sticking with me. Somewhere I read that when the heart is involved like mine is, there is a 50% chance of dying at 3-months and an 80% chance of dying at 6-months. I believe this to be the case with smokers and the elderly, but I have an extremely healthy ticker, its pink and it beats impressively, every doctor, even Dr. Olsen, has said so at one time or another. I want to do everything right by my heart, I feel strongly its key to my survival. So I just want my cardiologist to do whats best for my heart and not worry about keeping me comfortable. I will take some discomfort now to give me a long term chance. I told Beth last night that the first goal of survival is living to see April. I feel strongly that will be an easy goal and that will buck that 80% mortality rate. March will be the 6th month from September. But again, there are no guarantees in life so I remain humble and will continue the hard work on my healing process.

I woke up to a beautiful sunrise over Mt. Rainier this morning, it was white capped set against a flaming red sky and so clear, I felt I could reach out and touch the summit, it was perfect...