“What’s up, Little One?”

“Mom…*pant*  There’s an ammalance…  *pant* Outside!”  She never gets tired of seeing the trucks.  She and her brother would visit once a shift when I worked at the little Mom and Pop place that had a station less than a mile away from the house.  She probably didn’t realize that the ammalance ambulance that she was drooling over was one that I worked out of for almost two years.  One that she’s explored more than once.  It didn’t matter to her…  She’s attracted to the lights.  Kinda like her mom.

What she (and my son) did notice was that the ambulance was sitting in the driveway of our elderly neighbor who we happen to be very friendly with.  When Jon and I had visited the house while it was for sale some six years ago the young couple who had it listed sold us quite literally because of the neighborhood and the people who lived there.  I remember meeting Gigi that same day.  She and her husband had greeted us with hand shakes.  By the time we climbed back into the car some 45 minutes later, we had already exchanged phone numbers.  We knew they were good people.  When we would leave the house for any period of time we felt safe knowing that Gigi and Ted would be watching, they always watched out for us.  Always.  With time they became surrogate grandparents.  They both offered advice on everything from how to replace a toilet rendered useless by a simple toy phone to why we REALLY needed to watch our garage to how to install a hot water spigot on the side of the house.

Ted passed just under six months ago.  I did my best to keep my kiddos from knowing about it, and honestly, I’m not sure why that is.  I guess I was stuck in the “shield-them-from-the-bad-stuff” mode.  But Gigi had been in fantastic health considering her age.  The woman worked out more than I did for Christ’s sake and she was at least 70.  (My apologies, she was 74.  Found that out tonight.  I started writing this over a week ago.)

I was watching the crew climb out when I realized that I knew one of them.  A medic I’ve known for a few years, but who has been working in the area as long or longer than just about anyone else I know. One of the good ones. One that I would trust with my kids.  That seems to be how we judge each other in EMS.  “Would you trust them with your kids or family?” If the answer is yes, you know they’re one of the good ones.

I hoped Gigi was going in for PT or to see an ortho doc, or for a podiatrist appointment, or for something…  I don’t know, benign.  I had only once seen an ambulance in front of that house (another post for another time), and it wasn’t even for her.  I knew she had a few setbacks in the last couple of years, two falls actually, but nothing that would imagine that leave her in the care of…  Them.  And I don’t mean that in a bad way.

“They” do the hospice runs.  Say what you will about them, but “they” are an amazing group of people.  They have a tough job. They may not be doing emergency runs on every shift, but it’s still an emotionally trying job when you primarily transport those who are within sometimes minutes of dying and most of the time are within mere days of leaving us. We’re trained on how to help folks. There’s very little training on how to allow someone to die with dignity and as pain free as possible.

Terminal illnesses… They’re a bitch.

I didn’t know she had one.  Had no idea.  I’m embarrassed as hell to admit that.

Two months ago she and I had a 45 minute conversation in her front yard about her garden, for crying out loud.  In the back of my head, I just…  I don’t know.  I’m pissed at myself for not paying closer attention.  How did I not know?

Had I watched I would have noticed the weight loss.  I would have noticed the home health care nurses showing up.  I would have realized that she just wasn’t outside as much.  She wasn’t in her front yard clipping flowers and fretting over whether or not she had watered enough.  I would have known.  I’m sure of it.  I couldn’t have done a damn thing about it, but I would have been aware.  I could have helped her family.  I would have been more than just someone who lived on her street.  Hindsight, I guess.

I watched through the window as the crew loaded her up, and only walked across the street when I saw her son struggling with the lock on front door. He wasn’t himself, he was a big guy who was the epitamy of strength and composure.  Today he was shaky.  I was nervous to approach him, I know the way that I feel as a provider when the neighbors come out and become involved while we’re on a run, but I did it anyway.  I ran barefoot across the street skipping over the puddles that three days of rain had left and whispered in his ear.

”Brett,hey… I know these folks. They’re good people.  They’ll take good care of her.  I promise. ”

“I can’t remember how to lock the damn door!”  His voice was trembling and there were tears running down his cheeks.  He looked like he had been crying for quite awhile.  His eyes were blood shot and tired.

Immediately I realized that Gigi wasn’t going to a podiatrist appointment.  My heart sank.

“Breathe. Okay?  It’s okay.  She’s in good hands.  Where are they taking her?”

I mentally crossed my fingers.  Please don’t say Hospice.  Please don’t say Hospice.  Please don’t say Ho–”

“Hospice. Just for a night. She’ll be back tomorrow.”

Damn.

I told him what I could without sugar coating it.  “Brett, those people are angels, she’ll be taken care of and treated like the queen she is.  If you need anything, you know where to find me.”

He swallowed hard, nodded, and climbed in the back of the squad.

The doors closed and I retreated back to the house. I haven’t seen him since. (I’ve seen the son a few times…  Mowing the lawn and taking care of Gigi’s flowers.)

I haven’t seen Gigi.

My little ones had questions, and I answered them as honestly as I could.

“People get sick. People die.  Sometimes they’re young, sometimes they’re older.  It just… It happens.  And there’s not a thing we can do about that.  We can be sad about that, of course we should be a little sad!  Of course we miss them!  But we shouldn’t be sad for too long.

Gigi is going to die.  And I don’t know if it’s going to be next week or a year from now, but she is going to die.  We’re all going to die some day.  Don’t be afraid for her, she’s done everything she’s wanted to do.  She has beautiful babies, just like I do…  And those babies have babies.  She has so many people who love her.

But her body is sick.  Think about how you feel when you’re really sick.  Can you imagine being so sick for so long that every part of your body hurt really badly?  Every second of every single day?  And nothing could make it better?”

My daughter was on the verge of tears. “Mom, can’t you take care of her?  That’s your job!”

I was fighting back tears myself, I knew I was going to be losing a friend, one of my people, soon.  “Baby, I wish I could.  I can help fix a few things, but no one can make her better now.  We can just make her feel better.  We can try to take her pain away.  I promise you that she isn’t scared, so there’s no reason for you to be afraid for her.  Do you understand?”

“I just don’t want her to hurt. They’re going to fix her hurts, right?”

“Yes, baby, they’re going to fix her hurts.  They’re going to let her get some sleep.”

The boy wanted to an excuse to go play on the computer.  He’s eleven.  I can’t fault him for wanting to find the nearest exit at this point.

SWR and I talked a bit longer, we shed a few more tears, but in the end I think she gets it.  Well, she may not get it, but she’s okay with it.  She’s okay with at the age of six, that which I could not grasp until I was 34.  (In the interest of being completely honest, I was 34plus 3-ish months.  As in…  Not that long ago.)

**********

She’s dead…  Gone.  Passed on. It was a several days later when a neighbor came over to tell me.  I knew it was coming, well, for a week and a few days, give or take, but it doesn’t make it sting anyless.  I went to the showing.  I talked to their kids.  I met their grandchildren.  I looked at pictures of them both, together, happy.  Ted in is Army uniform, and Gigi looking as beautiful as ever.  That picture had to be at least 50 years old.

And I smiled.

They’re together.  At last.  I can be happy with that.

But Christ almighty, do I hate cancer.  

Two of my very best friends are male.  We know we can call one another at any time of day for any reason at all.

I have one son and one brother who I love more than life itself and would walk through fire for.  I’d give my life for them.

I have a step-dad who has taken care of me and mine like we were his own, even though he didn’t have to.  I have three uncles who have teased me (and have provided me with infinite giggles) incessantly since birth. I have double the amount of male cousins than female cousins and growing up with them MADE my childhood.

Countless male coworkers, former partners and good friends who make the long shifts shorter, the the laughs even louder, and the times spent not working… Well, stress (and often EMS) free.

Men who have inspired me. Who have instructed me. Who have guided me through the good times and the bad. I am quite literally surrounded by guys. Working in EMS and coming from a family dominated by the XY chromosome… Well, it was bound to happen, yeah?

Why in the hell is she writing about loving guys? What kind of blog has this turned into? I’m going somewhere with this. Trust me, and read on, please?

There aren’t many guys out there who want to talk about prostate and testicular cancer. Hell, there aren’t many girls out there who want to talk about it either.

Repeat after me: ONE IN SIX. ONE IN SIX. ONE IN SIX. ONE IN SIX.

Say it with me, ya’ll. ONE IN SIX MEN WILL GET A MALE SPECIFIC CANCER.

But Epi! Do you realize how they test for that stuff? Yep. I sure do.  Us chicks have the delightful pap smear to contend with once a year, and of course the ever exciting mammogram.

Men, we feel your pain!

Here’s what I have to say.  We all feel invincible from time to time, but this is out there, and there’s a very good chance you or someone you know will have a target on their back at some point in their lifetime.  That should be enough to scare the hell out of you.  MAN THE HELL UP AND PAY ATTENTION TO YOUR JUNK. (And as NJDiveMedic pointed out via text, “The junk AND your trunk.”)

Let me tell you about a friend of mine. He uses the blogging name Hybrid Medic . I don’t consider myself “old” (most days… That’s another post for another time) at 35, but he is definitely younger than I am. He’s from my neck of the woods, hell, we have a mutual work partner in common.  He has a young family, a wife and a beautiful little boy. I came to know him through Twitter, and was happy to meet him at EMS Expo last year and again at EMS Today this year.

He’s one of the good ones out there.  I’m proud to call him one of my people.  The first real save I got as a paramedic… I remember calling him and saying… ”I LOVE this job.”

He’s young, he’s healthy and in good shape. He’s a firefighter and a paramedic in Memphis. Not someone you’d expect to end up with testicular cancer.

He did. I’ll never forget the day I got the text message from him and the lump in my throat and sick feeling when he confirmed that he now had cancer.  He went to war with it, and it looks like he’s come out on top, but it was a hell of a battle. That’s understating it.  And the scary thing is that he had it (relatively) easy.

It was caught early.  Guys, you need to be aware.

A few symptoms to watch out for:

• Weak or interrupted flow of urine.
• Frequent urination (especially at night).
• Trouble urinating.
• Pain or burning during urination.
• Blood in the urine or semen.
• A pain in the back, hips, or pelvis that just won’t go away.
• Painful ejaculation.

The above symptoms could point to prostate cancer (or another condition.) See a doctor!

A few more symptoms:

• Pain in the testicles.
• Lumps / masses in the testicles (with or without pain).
• Swelling in the testicles.
• Persistant lower back or stomach pain.
• Loss of sexual desire.
• Increased breast size.

These symptoms could point to testicular cancer (or another condition.) See a doctor!

Have you heard of Kilted To Kick Cancer?  Maybe you’ve seen some posts about it on the various EMS blogs.  A few of my favorite guys are taking part by wearing kilts for the entire month of September.  That’s right, the entire month.  When they aren’t working, they’re kilted.  Folks tend to ask questions when they see a guy in a kilt.  They ask a lot of questions when they see a group of guys in kilts.

“Hey fellas… What’s under the kilt?”

That’s it.  That’s all I have.  Be aware.

If you want to contribute to the cause (with the donations going to research), let me point you towards these folks:

My Blogfather, Ambulance Driver

Jay G. Of MArooned

The Dive Medic from A Look At EMS From 120 Feet Below

Medic Matthew from New Life Changes (GO GET ‘EM MATT!!!!)

Old NFO from Nobody Asked Me

Or really, anyone from this post.  The guys may have a friendly wager going on, but in all honesty, it’s not about bragging rights, it’s about doing the right thing.  Many of them have stories about why they’re participating… If you have five bucks, consider donating it.  Hell, I even have five bucks, and I’m a broke paramedic.

Next year, I’ll be kilted.  I guarantee it.

Be safe out there.

http://testicularcancerawarenessfoundation.org/signs-and-symptoms/

http://www.livestrong.com/article/14231-testicular-cancer/

http://www.pcf.org/site/c.leJRIROrEpH/b.5802031/k.6CE8/Prostate_Cancer_Symptoms.htm

http://www.cancer.gov/cancertopics/types/prostate

One of my favorite bloggers and good friend Happy Medic very recently wrote about a overcoming a fear from his childhood.  I was lucky enough to be around to  help drag him towards that evil clown witness the event… Honestly, it was one of the highlights of Expo week for me. 

Those who know me best know that I have a few irrational fears.  Flying is one of them. (Clowns is another one, but that’s another post for another time.)

I do not fly well. 

Actually, I don’t fly at all if I don’t have to, something about hurtling through the air at 40,000 feet in a metal tube is a little unsettling to me.  My fear of flying is so intense that in the past if I’ve needed to get somewhere that was less than a 24 hour drive, I’d hop in the car instead of flying.  Even if the cost of gas was more than the airfare.  Even if it meant I’d spend 48 hours less at my destination because of the long drive. When I learned that EMS World Expo was going to be in Las Vegas this year I knew that I was going to have to suck it up and fly out. 

And I did.  I hiked up my supergirl panties and stepped onboard.  The take off was just as nervewracking as I remember them being, which is to say I left nail imprints on the armrests of my seat.  It took a good thirty minutes of shaking like a leaf and suffering from a significant bout of anxiety induced tachycardia before the color slowly started to return to my face.  I swore that under no circumstance was I going to leave my seat until we were safely back on the ground.  I was convinced that if I tried to walk while we were in the air I would inevitably fall on my face due to my shaky legs.  It took an additional 15 minutes to get to the point where I could actually look out the window.

And you know what?  The view wasn’t half bad.

I had managed to relax enough to hold a conversation with the flight attendant sitting in the last row directly behind me.  We talked about careers, and what a typical work week was like for the both of us.  We agreed that we could never do the other’s job.  She claimed to pass out at the sight of blood, and I’d offered that I’d probably have a stroke if I had to spend hours a day in the air.  She was very sweet and I appreciated the distraction.  It was beginning to look like it was going to be an uneventful flight.  Just how they’re supposed to be.

I wouldn’t be writing this had the flight been uneventful. 

While the nice flight attendant had excused herself to go tend to a call light, I had cracked open a book and allowed myself to relax and enjoy the quiet time.  I was deeply engrossed in a novel about sparkly vampires (don’t judge me) when I heard what I could only describe as a sick thud followed by a frantic one-sided conversation coming from the fight attendant.  “What the… Jesus!… Hey… Are you okay?  Sir?”  I was turning around to look at the exact moment that she grabbed my shoulder and asked me to help.

There he was, splayed across the floor, directly in front of the rear restroom.  He couldn’t have been 30-years-old and looked to be in good physical shape. 

I knelt down next to him, checked for a pulse and gave him a wicked sternal rub. 

“HEY! Come on, You OKAY?

The flight attendant looked as white as a sheet.  “He just dropped, hit his head on the emergency exit door…”

I gave him another sternal rub that I can guarantee removed any chest hair he may have had remaining.  At that very second the bathroom door opened and a very shocked 70-year-old woman almost tripped over him.  She shrieked, which miraculously stirred our patient.  He opened his eyes slowly and began to rub his head.

Hallelujah.   My work here is done.

“Uhm… how… What happened?” He was trying to sit up.  I put a hand on his arm and suggested that perhaps he should stay put for a minute. I asked him his name.

“Erik,” He answered.  Erik had no medical history.  No allergies.  No alcohol or drugs on board.  He ate dinner on the way to the airport.  He was on Coumadin, but he didn’t know why.

Wait, didn’t he say he had no medical history?  

His pulse was steady and strong now, his color was better than mine. 

“I’m fine, I just need to pee.”  He was still rubbing his head. There was a pretty impressive bump there. 

“Okay, do you think you’re ready to try to stand up? How are you feeling?”

“I’m really okay, the pride took a hit is all.”  Erik stood up, he was taller than I was.  He was blushing and probably wanted to escape the worried eyes of the four flight staff who had congregated at the back of the plane with us. 

He took a step into the bathroom, turned to close the door, and collapsed like a sack of potatoes onto the toilet. His chin rested upon his chest, his arms dangling limp at his side.

“Oh, hell.  Help me get him to the floor.”  I grabbed under his arms, one flight attendant grabbed at his waist, and another pulled his legs. 

“YO!  ERIK!”  I was yelling at him while I checked for a pulse. I didn’t immediately feel one.  Without warning the plane hit some turbulence and I (irrationally — remember, irrational fear of flying) thought I might possibly be plummeting towards the ground in a pretty ugly way.  I grabbed onto the door to the restroom and said a silent prayer that A) I wasn’t going to fall out of the sky, and B) That I wasn’t going to have to do CPR on a 30-year-old man in an airplane somewhere over Nebraska.  Within a few seconds the turbulence subsided and I was able to think a bit more clearly.

Erik was cyanotic.  I’d tell you what I was thinking at this point, but you can probably imagine. 

I pulled his dark red tshirt up.  “I need a defibrillator… Do you have one?” I was asking the nice flight attendant who just a few minutes ago I had been having a nice calming discussion with.  “And a BVM.  Bring whatever medical supplies you have.”

Another flight attendant started yelling for a doctor as she sprinted to the front of the plane where everything we needed was located.

I checked for a pulse one more time. 

Please… Please… Don’t do this.  I don’t want to have to push on your chest.  I don’t want you to die up here.  It’s been a while since I’ve mentally begged a patient to do (or not do) something, but I’m not ashamed to admit that I did it on that flight. 

Erik, or God, or someone must have been listening.  He gasped.  I repositioned his head. Still, his eyes didn’t open.  Another pulse check revealed a slow, but very obvious pulse. I don’t know that it wasn’t there before.  What I knew was that I felt it at that point.

I was on my knees, in a freaking plane, and I had no idea what supplies I was going to have or what I was allowed to do with those supplies.  What I did know what that I had an unconscious bradycardic patient with very slow respirations. 

A defibrillator was handed to me.  Pads were applied. 

Another breath. 

I was handed an ambu bag.  I ripped the plastic open with my teeth and gave him a quick puff. 

There was another yell for a doctor by a frantic flight attendant.

I squeezed the bag again.

Come on, Dude. 

Another squeeze.  Another spontaneous breath, this one forceful.  It sounded like a breath one would take when staying underwater a few seconds longer than they were comfortable with. 

Oooh, he’s starting to pink up….

Another breath.  Another breath.  Another breath.

I checked Erik’s pulse again and he was around 60.  I thought I was going to cry.  His eyes opened and stared at the ceiling for a few seconds.

“HowlongwasIout?”  His words were blended together. Slurred.

“Entirely too long.  DON’T YOU DO THAT AGAIN!”  I was a little louder than I meant to be.  I hope he forgave me for that. 

“We have the Doc online,” someone offered… I couldn’t tell you who said it, although I’m sure it was one of the flight attendants.   A doctor who happend to be on the plane appeared and basically shoo’ed me aside.  I was fine with that.  I went back to my seat and exhaled.  I read about sparkly vampires for a bit and managed to nap for over an hour.  That’s something I haven’t been able to do on a plane since before 9/11. 

Erik was waiting for me at the end of the jetway when we landed.  “Hey, I just wanted to thank you…”

I gave him a quick hug.  “No problem.  Glad you’re feeling better.”

Fear of flying? 

Conquered.  (Well, for the most part.)

Number of grey hairs that sprouted within a ten minute period?

More than I’d care to admit. 

Stay safe out there!