When You Have to Play with Snakes

by Larry Puls, @larrypulsauthor

Endometrial Cancer; Lymph Node Involvement

The CT scan tells a story. Maybe not the hopeful story we wanted. In the pelvis, there is an enlarged uterus and within its walls sits a cancer—now seeping blood. The biopsy confirms the diagnosis. The cells under the microscope show its cancerous pattern. And though this is not a good thing, it’s not the worst thing here. What is worse is the six-centimeter cancerous lymph node that has found a home on top of the vena cava—the largest vein in the human body. It jumps out from the images on the computer, almost taunting me.

Ruminating over the complexity of the forthcoming surgery, I find myself filled with trepidation. The vena cava is about two inches across and serves as a conduit for so much blood per second that it intimidates most surgeons. And the wall of that vessel is not much thicker or stronger than wet tissue paper. And in this case unfortunately, the devil is sitting on that vein.

Personal Reflections Before My Cancer Surgery; Chapter One; Coco's Journey

by Larry Puls, @larrypulsauthor

Personal Reflections Before My Cancer Surgery

Unsympathetically, the alarm clock blares. I wake, perplexed. How early is it? Studying the face of the clock, nothing registers. I rub my eyes... Three fifteen am. Then unexpectedly, fear sweeps in and pervades me. Reasons for the early morning hour come flooding into my head. Surgery is only five hours away.

Stubbing a toe on my way downstairs, I catch myself before falling. My legs wax unsteady. Rounding the corner to the kitchen, I turn on the lights and see my note. There is no coffee in the maker and I cannot have a cup today. Grrr. My shoulders shrug. I have nowhere else to go but to the kitchen table, where I sit. There in the window is a reflection of a woman who doesn’t really look like me—and yet I know that it is. How did I get here, in this place, in this predicament? I arrive at no answers.

A Christmas Story; Medical Training

by Larry Puls @larrypulsauthor

Christmas, Medical Education, Cancer

Our plane began its descent on the way to our destination. It was the week before Christmas and I was amazingly, or maybe stupidly, flying to my eighth interview in a short three months--yet another chance at landing a training fellowship. My wife, patient as she was, realized we had very little money left from all my traveling. Therefore, this trip was my Christmas present, the price required for me to have a shot at my dream.

Aa a Texan flying to New York, one can only imagine the thoughts swirling about in my mind, heading to such a faraway place in search of an elusive job. And yet there I was, flying to this interview, actually considering transplanting my wife and two young children to this cold climate—all in the name of my education.

Medicine in Third World Countries; Pregnancy; Unsuccessful Labor

By Larry Puls @Larrypulsauthor

Medicine in Third World Country; Pregnancy

The Jammu and Kashmir state in India are home to part of the Himalayan mountain range. Five doctors lived there and handled two hundred patient visits a day in this very remote and isolated area. When the story occurred, four of them left for their annual national meeting, leaving one physician behind to tend the flocks. At the same time, an American medical student arrived, enticed by an opportunity to gain an experience. And an experience is what he received. These events occurred before the birth of words like Internet, Google, or cell towers.

Choriocarcinoma, Treatment of Molar Pregnancy, Cure of Cancer

By Larry Puls  @larrypulsauthor

Choriocarcinoma; Cancer from Pregnancy

Standing outside the door, I collect my thoughts. Walking into her hospital room, I see the young lady who is struggling to breathe. Oxygen is flowing to her. At her rate of decline, she will be on the ventilator soon. And this will not change unless therapy is started quickly. Time becomes a key element. Her breathing is increasingly labored. Her diet is pure oxygen. It is the relative calm before the storm.

Treatment is defined by the word aggressive. A five-drug regimen going by the acronym EMACO. Etoposide. Methotrexate. Actinomycin-D. Cytoxan. Oncovin. Each of those successive letters standing for the listed drugs. But each represents different side effects. All with the potential to eradicate those rapidly growing cells--the little parasites taking over her body. And although they will all be administered through an IV, one is also given directly into her spine. A needle into the back. A drug that will bathe the nervous system with cancer poison. We have to hit the tumor where it lives and breathes--in her brain.

Choriocarcinoma, Cancer From Pregnancy, Hope

By Larry Puls @larrypulsauthor

Choriocarcinoma; Cancer from Pregnancy

It is tough enough to be pregnant, what with the backaches, the nausea, and the getting up and down all night. Guys like me will never really comprehend it, though we appreciate some of it while watching our sweet wives endure it. But I would say to those who have been pregnant, imagine how much tougher those inconveniences would be if the events surrounding that joyful time turned tragically against you. A life full of hope transforming into just hoping for a chance, all in the blink of an eye. Those are the events that shake our very foundations. That is what tests our faith. And interestingly, but not surprisingly, that is what grows us.

Hysterectomy; Trauma; The Uterus That Saved a Life

by Larry Puls @larrypulsauthor

Trauma; Hysterectomy

The uterus. Arguably, the most fascinating organ in the human body. No bigger than a tangerine ninety-eight percent of the time, no smaller than a watermelon the other two. Fertile soil, doubling as a temporary home, a safe haven, where the beginnings of life take hold. Where an embryo morphs and divides, transforming into billions of unique cells that make up the intricate pieces of the human body. All woven together and permanently bonded with a soul. The baby incubator that graciously and generously supplies all the nutrients and oxygen a small child will need to thrive. It provides the human race with the most beautiful, precious, amazing, heart-warming gifts we call children, made in the image of God.