August 29, 2017My Jewish Pup

I have no idea how Tilley became a Jew. I doubt that her mother was Jewish. I guess it will remain an open question. I know how I got to be Jewish. I chose Judaism. I was raised a Unitarian Universalist, like third generation U/U. They’re pretty rare. Most of the people I met as U/Us came from other religions. Not I. But I left for the same reason that those others left their prior religious institutions:  I no longer felt comfortable there. U/U folk used to be allowed to do things like pray and mention a supreme being. That started to be frowned on and the chorus against such things became louder. Then I attended the Bar Mitzvah of one Jordan Allen Gellis, the son of one of my oldest and dearest friends. He asked some very probing questions for which I may have had answers but I was never truly satisfied with them. He asked, “Do you really accept the idea of a ‘virgin birth?’ That was not the only thought provoking question in this dicourse with a 13 year old who was newly capable of making a minyan. There were other equally challenging questions that raised more issues with me. So, being a deist, I had to go somewhere else. Mainstream Christianity was out. I was never comfortable with three gods. So I chose Judaism. It took some time and some impetus from various relationships but I thought it was necesary to make a change. I attended an “Intro to Judaism” class taught by Reform, Conservative and Reconstructionist rabbis, each taking a turn at their preferred area of instruction: History, Litergy, Mysticism. I had instant rapport with the Reform rabbi, a fellow named Rabbi Peter Grumbacher and I was hooked. I converted and joined Congregation Beth Emeth in Wilmington Delaware.

In my tenth year as a synagogue member our dog went to heaven. I’m sure almost all dogs go to heaven just because they are faithful companions, extremely tolerant of sometimes intolerant owners and I’ve never heard a dog say an unkind word about anybody. So, I rest my case.

I don’t know what part of Heaven dogs go to. That’s on the assumption that there is a Buddist Heaven, a Methodist Heaven, a Catholic Heaven and so on. However, Gracie is there someplace. When the dog who took Gracie’s place in our hearts passes, I know Tilley will be in the Jewish sector of Heaven. I’m pretty sure of it. But I owe you some evidence.

Grace was a wire fox terrier and was so special. After about a three month mourning period we naturally tried to duplicate our incredible luck and my wife Betty contacted Mid-West Wire Fox Terrier Rescue to see if it was possible. When we got the word that they’d found a candidate we were elated. But the poor pup has some challenges. Having been one half a day away from euthenasia, she wasn’t in great shape. Fleas, kennel cough and other maladies vexed her so we waited until her foster parents in Monroe, North Carolina gave us the word she was ready. We piled into my wife’s ML350 and headed south. About 7 hours later we arrived.

Tilley (nee Agatha — renamed by the rescuers) was adorable. Full of energy, great personality and beautiful. And we found her to be a superior traveler. But she had quite a bit more energy as a young thing than did her predecessor. Despite the energy, she somehow found a way to meander into the family room where I was vainly attempting to learn to play the shofar, sit down next to me and listen. Whenever I tried to figure out the shofar, she appeared.

One evening the first 10 days with us, something on the other side of the fence in our backyard caught her attention. Bang! She was over the fence on a tear with a howl. Betty came to me sounding the alarm. “She’s so new here. She doesn’t know the neighborhood and how can she find her way home?” I had an idea.

Out to the front porch I went, shofar in hand. I sat and blew. Sure enough, Tilly flew around the side of the house and came to the bottom of the front stoop. I got up. I opened the front door and encouraged her to go in. But she was much smarter than I. I’m sure, were the roles reversed, that SHE would have shut the sliding glass door in the kitchen. I forgot. Out she went on a gallop, went right to that same place in the fence and hopped over it.

I thought, since the dog had responded once, why not try again. But I closed the sliding glass door this time. Out to the front stoop again went the Ba’al Tekiah (not!) who sat down on the stoop and blew again. My faith was rewarded again as Tilley once again raced toward me and accepted the invitation to enter the front hall. Again she tore off in the direction of the sliding glass door but this time it was closed.

No, that story is not enough proof. So I’ll share the clincher, in my humble opinion. Come with me as we approach eighteen minutes until sundown on a Friday night. Betty my love has not adopted my religious choice, although she supports it with generousity. She reseats the candles for the next Shabbat after Adonai puts them out. She insures the presence of the Challah and puts the wine, the Challah and the candles on the kitchen counter top on Friday night. And she joins in as the household Jew does the kiddush. As soon as the candle blessing begins, Tilley is heard scrambling for the kitchen. She scoots up close to my feet and looks up with an expression that I swear looks like glee!

As the chant of Borei peri ha gaffen rings out she is obviously excited. But she really gets going as we start to chant Ha Motzi. Our version contains the phrase, “Our voices rise in song together,” and it’s become traditional to rise on tip toes in unison with the lyric. And Tilley, not to be outdone, rises on her hind legs as we reach full tip-toe extension.

Not only is my dog Jewish, she’s an observant Jew. She participates. And when Ha Motzi is finished, she gets her piece of challah. As I said, I know how I got to be a Jew. But I have no idea how Tilley got to be a Jew. And with two of us under the same roof, I know there will always be at least three opinions.

I’ve been too quiet since my procedure and I owe you a story.

On 2/25 I checked into Hahnemann Hospital for outpatient surgery.  This was different in the sense that prior procedures were done by putting me on a breathing apparatus and entering my larynx through my mouth.  A year prior, that caused the issue that meant that a 1 1/2 hour procedure took over 5 hours and resulted in such swelling in my tongue that I couldn’t swallow.  People who can’t swallow don’t leave the hospital and I was there for four days.

This time, they cut a hole in my neck and went in that way.  The surgery was to graft adipose tissue from inside my cheek to the stiffened vocal fold thereby making that fold capable of playing the game again

On the procedure, they took material from inside my cheek, after entering around my Adam’s Apple, and grafted it into my right vocal fold.  I can feel the scar in my cheek after the sutures dissolved.  On my first follow-up visit after the surgery, I was an airhead.  The medical term is “subcutaneous emphysema of neck and periorbital edema (eyes swollen shut),” a circumstance that happens when surgically opening the airways and allows air to be trapped.  Since that’s the way they accessed my larynx, it happened to me.  I was extremely swollen, as air had gained access to my tissues causing the swelling.  I was told, “Oh, we should have warned you.”  But, I was also told that I could press on the tissue and express the excess air.  I tried it and it worked, at least for the tissue around my eyes, it made it possible to see.

At the point of the incision, my Adam’s Apple was extremely distended for the same reason.  One of the residents responded to my question about its state.  He opened a section near the excision with something like a pipette and let out the air.  Sure enough, the swelling dropped immediately.  

I don’t believe the graft portion of the procedure is fully healed to this day, something I’ve concluded after my visit on Monday (April Fools Day) with my Speech Pathologist who said, “Of course you’re still healing.  It was a complicated procedure and it will take time.”  I’m under strict instructions to use my voice “gently.”  Talking on the phone is not recommended.  I’m limiting any speech as much as possible.  I’ve got vocal exercises to do that involve gargling, blowing bubbles in a cup and adding vocalization to the the air flow, breathing and being aware of the support for voice around the diaphragm and watching myself in the mirror as I do.  

The days when I sounded like Mickey Mouse are gone.  I am so pleased with that.  But I’m limited to a ten minute interval per hour of either speech or the exercises.  At the very instant, I feels a bit like a guinea pig.  Google the following four words and see what I mean:  buccal graft vocal fold

I’m so very thankful for the prayers and good wishes from you.  I can’t go wrong.  I have a DAR Chaplain working in my behalf for a sister and I’d not be surprised to find that Quaker sister had the spirit move her to speak in Meeting?   Oh, what the hey!  So I’m gargling, cup bubbling and doing inhalation phonation.  One of these days, don’t be surprised, you might get a phone call from me.  Thank you all for your prayers, kind remarks and good wishes.

My last follow-up with Dr. Sataloff on December 4, 2018 was not pleasant. Although I’ve been committed to fighting my Acid-Reflux, there were signs that I’m losing and it might be understandable that he took it as evidence that I wasn’t being diligent. In addition, I’m showing a granuloma — a growth in my larynx he says was caused by reflux and stress caused by use of my false vocal folds.

I’d had some difficulty getting an appointment with a speech pathologist and it showed. I’m sounding like Mickey Mouse again. The good news is that the limit of therapy covered by Medicare has been eliminated. It used to be just over $2,000 per year. Now, even though the limit is gone, medical necessity must be indicated to have the therapy covered above the old limit. I’m over $2,600, including physical therapy as well as speech therapy and I suffered from communication failure with the therapist I had been seeing. Dr. Sataloff requied me to have six speech patholigist appointments before my next appointment on February 19th. I embarked on meeting that requirement and, with a little luck, will complete the required visits in time.

I confess I’m discouraged. But, at my first Sataloff appointment, he told me my case was not hopeless. I’m clinging to that memory. I’ll be sure to validate and renew the statement in February. In the meantime, I can’t deal with customer service that requires putting me through the voice recognition gauntlet with my voice as it is. The software causes me endless frustration, since there is no way to by-pass it when it is ineffective. Yes, I’m still discouraged. I am trying to remember that I’ve been overcoming setbacks for 75 years. Why should this be different.

So many friends are pulling and praying for me, I owe them all the latest news.  I’m not planning to post on Facebook unless I’m asked to do so.  Since I have alerted the world to this blog, I’m going to post here and let that be it.

So I’ve had several Speech pathologist appointment with Jesse Palmer, M.S. in Doctor Sataloff’s practice.  He’s been more than helpful and encouraging.  And, with his help, I’m making progress.  I’ve learned exercises and procedures that bring my voice along and give me the ability to leave Mickey Mouse behind.  I’m sure some of you remember my Mickey Mouse days when I couldn’t control my voice and I would squeak.  Dr. Sataloff admonished me to stop using my false vocal folds and concentrate on my true vocal folds.  Jesse and I concentrated on that.  He helped me find out what the difference was and I practice “brining my voice from my belly.”  It’s altogether fitting, since my June procedure was to rearrange my vocal folds and take adipose tissue from my belly and graft it into my larynx to close the gap that had been caused by repeated excision.  It worked.  The next task was to loosen the vocal folds from the tightness caused by the implant.  That’s happening.

So, in a session prior to the High Holy Days, I told Jesse that I actually expected to sing.  My range was minimal and I’m not altogether sure what’s going to come out but, again its progress.

Sure enough, Erev Rosh Hashanah found me in the synagogue in my favorite spot, in the end seat in the pew closest to the professional choir.  Congregation Beth Emeth has its own volunteer choir, but for the High Holy Days, our music director (Mr. Stewart) leads a group of professional singers in the litergy appropriate to the season.  They are wonderful to listen to and, as I’m right beside them, I hear them very well.  I’ll share with you that the musical expression of faith is very important to me and I was thoroughly depressed by my inability to sing along.  It kept me from services.  I would croak over kiddush (for the non-Jew and the people who haven’t seen the blog post of “My Jewish Dog,” kiddush is the blessing of the candles, wine and challah every Friday evening at 18 minutes before sundown.  It is the start of the sabbath.  When I was on total vocal rest, I used a playlist on my iPhone that substituted.

So I sang on Rosh Hashanah services as best I could.  And as I did, my voice became stronger and my range increased.  Ten days later, at Yom Kippur services, I did it again.  And again, my voice became more normal.

When I get tired or over work my voice, I can bring Mickey Mouse back.  Not on purpose, don’t get me wrong.  So I try not to overdo it.

In a prior entry, I spoke of my experience at Dr. Sataloff’s concert with chorus and orchestra when the superb sounds reminded me of 8th grade when I was chosen for All-County Chorus and I practiced with my music teacher in Withamsville Ohio before travelling to Batavia, the county seat for Clermont County.  We gathered in the auditorium for our rehearsal, the same auditorium where we would perform a public concert that evening.

I’ve alway been one of the tallest in class.  This was no exception so I was in the center of the risers in the top row — in the middle of all that music.  It was spine tingling to hear orchestra and chorus singing those separately rehearsed parts now melting together.  I was overwhelmed.  And I told Dr. Sataloff I had the same experience at his concert.  Anybody who knows me very well knows I gravitate to the front row.  My usual remark goes like, “There’s alway room at the top.  It’s the bottom that’s crowded.” So I’m in a great place to hear that incredible music, and I told Dr. Sataloff so.  He remarked, “At our December concert, I want you on the risers with us.”  Sounded like an encouraging promise to me.

At this rate, it just might be a reality.

I think I’ll start with a re-hash and bring my situation up to date.

Today, July 31st,  was another trip to 219. N. Broad Street, Tenth Floor, Philadelphia PA.  The Drexel Medical Building is the home of Philadelphia Ear, Nose and Throat and the office of Doctor Robert Thayer Sataloff.  It’s a place I’ve found myself visiting several times a year for the past two years.  On these visits, the news has been mixed.  I’ve experienced all forms of dysplasia (read — pre-cancerous cells) and one in-situ carcinoma (read– cancer) that had to be removed.  I’ve been resectioned, grafted and implanted.  This is a continuing saga, as I’ve noted previously in this blog.  It started with a biopsy in 2012 that found in-situ carcinoma.  That’s good news and bad news.  Every woman who has faced down breast cancer would love to be told it is insitu -.  That’s as opposed to invasive — the stuff that spreads.  So, I’ve now got a face of my vocal fold that’s missing some tissue.  And the doctor took more than he thought he had to, to insure a margin of good tissue was what was left.  What happened next was a version of watch and wait.  And in December of 2012, Dr. Kieran Connolly, my first ENT specialist who discovered my issues, scoped my vocal folds and saw something he didn’t like. “Van, where this leukoplakia is situated, I don’t feel comfortable excising it.  I think I want to refer you to the Helen Graham Cancer Center.”

I’d heard stories about radiation and vocal folds.  It was risky, in some cases.  I had enough risk already and didn’t want to make that choice.  I reminded Dr. Connolly of a prior conversation when he mentioned a colleague of his who was head of Otolaryngology at NYU.  He’d mentioned that Doctor Amin was skilled at laser surgery, even to the point of doing it in his office on the same day as the visit.  He agreed to refer me, so I’m off to NYU.  Milan Amin was a very nice man as were his associates like Ryan Branski, an associate professor of the Department of Otolaryngology.  After a thorough examination and a meeting with professors, department heads, fellows and students I was told the procedure wouldn’t lend itself to being performed in the office but would require an out-patient surgery which we scheduled for the following month.

January of 2013, I’m back at NYU but this time to the Langone Medical Center where they removed my leukoplakia successfully.  I did follow-up with both Dr. Connolly and Dr. Amin.  My leukoplakia was determined to return.  I again had one removed in 2014 and it was benign.  We removed another in 2015.  I have two very good friends who use their voices professionally.  Both of them had told me, “Go to see Dr. Sataloff.  He’s the best ENT specialist in the world.   And in 2016  I did.

A trip to Dr. Sataloff is very confidence building.  First of all, they warn you to expect to spend six to seven hours in your first visit.  While you wait to be seen, you are a room with three walls of 8×10 photographs of people you will probably recognize.  Peter, Paul and Mary, Charles Carault, Julie Andrews, Bobby Rydell, Pavorotti just to name a few.  All these photos have comments extolling the virtue of Dr. Bob

After a short wait, they give you a very thorough evaluation.  You see specialists in hearing, speech pathology, allergies and laryngology.  Everything is explained including the results of the testing.  But I left out the remarkable part.  I thought, “I’ll see all the underlings and they’ll show me into Sataloff’s presence for a honk and wave and then I’ll be sent home. ”  Not so!  HE WAS WITH ME MOST OF THE TIME.  I started with him.  Some of the first words out of his mouth were, “Van, your case is not hopeless.”  I had been afraid it was hopeless but had been fighting the thought.  It restored my confidence.

Then we did something else that had been glossed over.  It revolved around Acid Reflux, something from which I had apparently suffered since 1989.  At that time I shared with Dr. Suh, an ENT specialist who corrected my deviated septum, that I had urges to clear my throat.  His response:  “Don’t clear throat.”  We now know frequent throat clearing urge is a marker for Acid Reflux.

Dr. Connolly had diagnosed my Acid Reflux and prescribed medication.  Dr. Branski told me I was not using the medication properly and corrected it.  Dr. Sataloff elevated the problem to a religion.  I was introduced to two author who’d researched an published on the subject.  Result:  I bought 3 books on iTunes and started reading immediately.  My reading introduced me to the the idea that acid reflux was a proximate cause of my condition and if I couldn’t control that, there would be a very low chance of fixing things.  Dr. Sataloff asked me one question:  “If I did surgery on your arm and you dunked it in hydrocholoric acid, do you think it would heal well?”

Now, I take protonics a half hour before meals and eat within an hour of taking it.  I take Gaviscon ExtraStrength after meals and before bed.  I take two Zantac 150 before retiring.  I do not lie down within three hours of eating.  When I do, I avoid acid rich foods, onions, raw garlic, tomatoes, soda pop (a pH of stomach acid!), tobasco and hot peppers in general.  I also have a whole-bed wedge that raises the head of our bed by four inches and gradually declines to the foot of the bed.  At one point, I had a tube inserted into my esophagus to measure my acid situation.  I found the problem to be real but indicated my attempts to control it were effective.  Each time I re-visit the office at 219 N. Broad Street in Philadelphia, I am asked to confirm everything in the paragraph above is still being done.  With no disrespect to all the other ENT specialists with whom I worked, Sataloff is very thorough.

So, when Doctor Sataloff said that it was time to take the bull by the horns I wasn’t worried.  He wanted to rebuild the area on which so much attention had been lavished for six years.  As that attention was damaging to the amount of tissue left, his thought was to rebuild my vocal folds.

Vocal folds must touch for speech to sound normal.  Mine didn’t.  In the effort to remove cancer and dysplasia over the years, my vocal folds had become bowed.  Sataloff wanted to remove the convexity.  In February, we learned that was not going to be easy.  In my youth, I smoked cigarettes.  I quite over 30 years ago but perhaps the damage was still there.  In what was to be a one and one half hour procedure as an outpatient, Sataloff discovered that the base of my folds didn’t support the grafts he initially tried.  After five hours, with considerable stress on the organs pushed aside to sustain the surgery, I was moved to the ICU where I spent the night.  I was permitted to leave the hospital after four days, after my tongue has shrunk to only twice its normal size and I could swallow again.

Considerable time was spent healing from that experience and the next procedure was scheduled for June.  I was told we had a range of options to pursue and the doctor would choose as my body suggested.  When I came out of anesthesia, my wife and I were told that Sataloff has used the easiest choice successfully.  I went home to heal and he headed to the Chesapeake Bay for a working vacation to finish a book he was authoring.  This gets us to July 31st and the good news.

Every visit to an ENT specialist in this quest has one similarity — I get scoped.  A camera on a tube is inserted to view my vocal folds, either through my nose or into my mouth.  I can see the results, sometimes on the monitor while it happens but always after as it’s replayed for me and we discuss.  On July 31st, my vocal folds met.  That’s what they are supposed to do.  Now my job is to work with the speech pathologist to promote the use of my true vocal folds rather than the false ones.  (Here’s a link to explain, for the curious.) I’m scheduled to work with Jesse Palmer, a speech pathologist in Sataloff’s office next Monday, August 6.  And here is the good news:  Procedures from here on, if necessary, will involve tinkering.  In effect, Sataloff turned what looked like inpossible to probable.  My tightness will subside as the tissue involved in the June surgery softens.  By December (my next follow-up), my voice could even be termed “normal.”

I’ve always been the optimistic and hopeful type.  It’s who I’ve almost always been.  The past six years have really tested that posture.   With the help of many friends and family, I’ve been supported very lovingly.  I appreciate it more than I can say.

I’m running straight at it:  My diamond anniversary on this planet.  Come July 9th, that’s what it will be and I’m truly blessed.  And each day I’m on earth I see more and more for which I need to be grateful.

I owe you a list:

At the top of my list of blessings is the love of my life, Betty Olmstead.  I found her at West End Neighborhood House where she headed up Tiny Steps, an outreach program helping at-risk ladies who needed encouragement to find prenatal care.  That program was so effective that it raised the average birth weight in the state of Delaware.  This was sorely needed at the time, since Delaware was 49th in infant mortality, low birthweight and extra-low birthweight.  I am proud to say I had a small part in starting that program and, for that reason, they had placed me on the board of directors overseeing the endeavor.  That’s how we met.

Our first date happened because she, as a widow, wasn’t seeking a relationship and I, in the throes of a nasty divorce, didn’t want to get involved with anybody.  So when I asked her to accompany me to my masonic lodge’s ladies night, we were doing it for the same reason.

She was wonderful.  I knew that before we dated.  I watched her at Tiny Steps and saw how she treated people who offered her no personal gain.  She was calm, patient and caring.  But on April 26, 1997 she was so much more.  She was comfortable to be with.  She was tolerant of me putting her into a bunch of octogenarian with whom one would think she had nothing in common.  But she fit right in, could speak with anyone and make them feel important.  She did the same for me.   We left the Ladies Night and went looking for something more contemporary and found a street party with a live band.  We danced, talked and enjoyed ourselves.  Then I drove her to her house in Brandywine Hundred, dropped her of and went my house on 22nd Street in the city of Wilmington, DE.  Oh, I left out the kiss.  It was the first one Betty had in 26 years, other than from her late husband Tony.  Neither of us got sleep, even though we were in separate locations.

Life with Betty only gets better.  When Tony was alive, she’d participated with him and his road running friends but let that go in her mourning process.  When she joined the Girls on the Run “Couch to 5k” she encouraged me to come along.  I did.  Now that’s a shared experience with both of us having 5ks, 1/2 marathons and marathons in our history.  Betty does more of all three as well as some trail runs and 10ks mixed in.  She is a hero to the running community in Wilmington and I heard one race announcer say, as he was giving her the “First in her age group — 70 and over” medal, “It wouldn’t be a race without Betty Olmstead.

Betty is a wonderful mother as well as an incredible wife.

I have an unbelievable number of friends who have come out of the woodwork since I have had my vocal fold challenges.  They encourage me.  They pray for me.  They support me in countless ways.  They have helped me deal with difficult times and uphill battles and laugh with me at successes and victories. They are truly a blessing.

In 1983 a friend approached me with a proposition.  He reminded me of how good this community has been to me.  Didn’t I think it was time to give something back?  I was invited to go to a Kiwanis Club membership round-up.  I went to that round-up and joined.  What an incredible blessing that has been.  The things I have been blessed to be part of that have made this community better and stronger, the people I’ve worked with in community service and the people I’ve met worldwide with whom I share Kiwanis values are all unbelievable gifts.  They are true blessings.

When I was a teenager, my father brought home a 78 RPM record.  It was something he’d shared with men whom he supervised as a Regional Manager for Sun Oil.  It was “The Stangest Secret,” by Earl Nightingale, a record with which the self-help recording industry was founded.  I was forced to listen several times.  It had a profound effect on me, despite the fact that I resented it.  The lesson was biblical:  As a man thinketh, so is he.  What you think about you can become — without limit.  I think it gave me another blessing — my career of 45 years in financial services.  I was hired as a runner in the mailroom and now I’m Senior Vice President, Branch Manager and a principal of my firm.  Incredibly blessed?  Any success I have comes entirely from the trust people have invested in me.  It’s been privilege for me to know and work with them, some of them for the entire time I’ve been in the business.

There is a litany of additional blessing:  I was born in the United States of America and have grown up here, in various states — mostly in the Mid-west and Northeast.  I found my faith in the Supreme Architect of the Universe and have tried to observe his mitzvot.  I’ve been blessed to be a Free Mason for almost 40 years and have served my lodge as its master.  I’ve been privileged to travel outside of these United States, first in North America and later Europe and South America.  It make me love my native land more but also has taught me respect for other cultures.  I enjoy abiding and unshakable friendships.  I’ve been present at the birth of all three of my children.  I’ve been accepted and welcomed by the children of my spouse and their children.  I am in awe of the beauty that surrounds me.  Now that I’ve had half of my cataract operations, I’m rediscovering the brightness and color of planet earth.  I somehow found the ability to compose sonnets and fell in love with the art form.

Ok, it is a decent list.  I expect it will see additions and maybe amplifications.

Ok, here’s the scoop.  On 10/24/17 I get to see my E.N.T. specialist about my recent procedure.  I take solace in the fact that Dr. Sataloff didn’t call me.  Last time, when it was cancer, he called the next day to outline the fact that it was cancer and what our next steps were.  This time, I’ve heard nothing.  I’m hoping that means it’s better news.  I know I might be allowed to speak after 10/24 but it’ll be limited.  I can probably speak for 1 minute in 10.

I’ve had this damn cough.  Betty did a 10 mile trail run in Lancaster and brought home her second cold this summer.  I missed the first one.  I was hoping that I  might duplicate that.  But the second one I caught just at the wrong time.  I will have to ask Sataloff because coughing is forbidden.  Speaking, clearing throat, whispering and coughing are verboten.  It undoes everything the doctor tries to do.  I feel snake bit.  So I’ll find out if I’ve done damage.  Last time he told me I had.  Same deal.  Betty brought home a flipping cold and I got it.

So that where we stood.  Tuesday was  the magic day.!

My guess about the lack of a phone call being good news proved to be accurate.  When I got together with the gang a Dr. Sataloff’s office (there’s always a crowd that includes nurses, doctors, fellows and people who are learning from the master.) I learned there was indeed good news.  First a bit of a digression.

When a growth appears on vocal folds the approach is a biopsy.  My first one was in 2010.  The biopsy came back In-Situ Carcinoma.  That’s better than invasive — that’s the stuff that spreads through your system and puts cancer in other places beyond the place that was first identified.  That didn’t happen.  Once again, in August again we identified an In-Situ Carcinoma and again no serious evidence of invasive tendencies, although I’m still on watch for safety sake in some instances.  Well, each of the other times in my other 9 procedures they detected dysplasia.  Dysplasia is pre-cancerous cell formations.  They are graded.  The scale goes from mild to moderate to severe or high-grade dysplasia.  Each of the other times, I’d shown some evidence of some form of dysplasia, with the exception of 10/16/17.  No dysplasia.  Nothing!  They biopsied all over the place.  NOTHING!

I’m celebrating!  Betty is taking me out to dinner tonight.  (She has some coupons to cash.)  We’re going to celebrate.  I’m celebrating the power of prayer and good wishes of my incredible group of friends.  They are concentrated on social media, like Twitter, Instagram and Facebook but not limited to those avenues.  The outpouring is nothing short of amazing and I’m overwhelmed.  Now, I can’t say I’m speechless, although I am.  But that would be cheating.  I am speechless because I can’t speak.  I’m being weaned back to speech at the rate of one minute in ten.  Not that you can hear me yet.  But that will come with time.  I’m going to continue behaving as my doctors and speech pathologist suggest.  But nothing changes how grateful I am to all my many friends and their concern.  It makes me feel totally blessed.

Well, the 11/28/17 visit is over. The news isn’t good. As I suspected, two back-to-back upper respiratory infections did some damage due to persistent coughing. Dr. Sataloff has put me on another course of antibiotics and prednisone. I’m to go back next Thursday for a procedure in the office. So, my hope to get off the mi shebeirach list is dashed. I continue to offer prayers and ask you to join me. I have to do it silently, since I’m back on total vocal rest. I’m grateful that Facebook allows me a way to speak to my friends who have kept me in their hearts and prayers.

So, they through me a curve. I was planning to see Dr. Sataloff on Delaware Day — December 7th — but the office called and rescheduled. So the new day is 12/12. I’m still duct taped until then and it won’t stop on that day. They’ve scheduled me for in in-the-office procedure to clean up stuff. After that, I’ll be on renewed total vocal rest. We’ll see what the word is after that. Thank you again for the prayers and loving concern. You’re the reason people claim my attitude is so positive. How could it be any other way with such support.

The visit to Dr. Sataloff on 12/12/17 went well. It is sure much easier to have an office procedure than check in to Hahnemann Hospital at 6:00 A.M., do a wait of indeterminate length (depending on the degree of difficulty of my procedure — the tough ones goes last. I’ve been that guy once.). Then, after the procedure is over and the anesthesia wears off, Betty Olmstead drives me home. Shoots one-half a day and I’m groggy for the half that’s left. Today, the doctor was very encouraging. He said the nodules peeled off without breaking the epithelial of the vocal folds. Things also went much quicker. Betty got to watch the whole thing so she has some stories to share. I’m also only on one day of total vocal rest. I’m going to sound again like a broken record. If things turn out as they indicated to me, i’m gong to have to blame the power of prayer, positive wishes, guardian angels and friends who show how much they care. I was frightened at the way things looked at my last exam. But something good intervened. I think it was all of you. To you and God I offer my sincere thanks.

And the saga continues….

It was quite a while between visits.  My nest follow-up was Valentine’s Day 2018.  I hope I hear the words I’d been hoping for this entire excursion.

“Van,” said Dr. Sataloff, “I think it’s time to take the bull by the horns.  We will initially try by going to you vocal folds via your mouth.  The other option is to do an incision in your neck and access your voice box that way.  But will try though the mouth first.  We’ll remove the base of the  scare tissue and get that biopsied to know where we stand.  Then I’ll take mucosa from your cheeks and graft it on to your vocal folds.  We intend to over do it.  We’ll graft too much at first, knowing that will fix itself whereas to graft not enough would be a problem.  Now, you’ll have fine sutures that will be very delicate.  Don’t cough, speak or clear your throat as it may damage what we’ve done. ”

So the duct tape comes out again.  But, with the grace of God, in the week or two after my procedure, when I resume speech, my voice will be strong and Cookie Monster and Andy Devine will leave me.

Prayers and good wishes have been my ally so far, I’m hoping they continue.

Ok, here we go with the next installment.  What an ordeal. I stopped eating on 2/25/18 at about 8:00 P.M., in preparation for my visit to Dr. Sataloff and Drexel Medicine E.N.T. at Hahnemann Hospital.  Showed up like a good boy at 6:00 for a procedure that was to take, oh — about an hour and a half as an outpatient.  Betty made the trek with me to AT&T Station at Broad and Pattison for the Park and Ride and an Orange Line trip to Race/Vine.  It’s the exact block on Broad Street where Hahnemann is located and we showed up at exactly the appointed 6:00 A.M. hour.  That was the end of nominal.  Now we start on the ordeal.  The 1 1/2 hour procedure stretched to five hours as some complications ensued on the resection.  Yes, we removed scar tissue first and then the plan was for some skin grafting to give me a vocal fold edge, but when Dr. Sataloff tried to attach new tissue to the old, the old collapsed and the fun began.  I quit smoking when my first son was born.  I wish I knew what my youthful cigarette experience would cost me some 60 years later.  But Dr. S persevered  and beat me up in the process.  My tongue got clobbered.  I came off the anesthesia and was scooted off the ICU for the night.  Oh, don’t be concerned, Van.  The floor you were on didn’t have working Pulse-Ox, that little red light on your finger stating the fact that the quality of Oxygen in your blood stream was sufficient.  Ok, I’ll buy that — maybe.  Seems a bit extreme but I was beaten up.  Keeping an eye on me was sort of important.  My entire neck was swollen, almost to the size of my head.  My tongue was HUGE and set on an angle.  It was swollen about 6X. I was using suction to make it possible to clear my passages to be able to breathe.  And remember that dinner.   Good, because Sunday night was the last solid food until Thursday when the finally released me.  Out-patient surgery, you say? Nuh-uh!  Now, I has some very positive experiences working with some wonderful, competent, caring and thorough RNs.  Saw lots of them.  They moved me from floor to floor, 18 to 8 (ICU) and then to four for the balance of my stay.  Michele set me up on four and was the absolute height of efficiency as she positioned all the doo-dads they were using to monitor me in such a way that my body position required.  I couldn’t lie down.  The good in my throat gaged me.  Remember that tong? It was now obstructive.  If I went to sleep, my tongue flopped back in my throat and woke me up.  So, now we’re without sleep for a few days.  Let’s see, dextrose and saline IV to give me some nourishment, suction to make it possibly to do some breathing and wires everywhere.  What a picture.  With Karen’s help — lovely ICU nurse who worked with me initially, I did give it a try to use a bed but that was a total non-starter, so we went to a chair.  And I didn’t get to lie down until I got home on Thursday afternoon.  Oh, My God,  what a mess.  So many wires.  Move and one of them get’s unattached.  That’s why Michele’s attention to placement was so critical and she was brilliant at it. She then passed me to Nicole when Michele’s 7A.M. to 7 P.M shift ended.  Nicole was outstanding as well.  Nothing was done without notice and explanation as to the whys and wherefores.  That is with the exception of the compression boots I found stimulating my feet and legs electronically one time when I woke up.  (Yes, I actually got a wink or two, a couple of times during my stay. )

Each time the shift changed, so did the information on the wall over my bed.  It always listed the mm/dd/yyyy but the variables were my goals.  Priority started with pain control.  They did too good a job of that.  In the past, when it was truly outpatient, I would seize the control of that stuff and eliminate it as soon as I could.  Everything I ingested came through IV so that meant, BINGO — time for drugs — dosage.  Done. I was hoped up for four days.  Pain was controlled so that objective was achieved.  The next major goal was to swallow.  That was the signal that I could go home.  If I could swallow my meds myself, and even more importantly, swallow some nourishment, I would render the IV superfluous.  Swallowing with the big tongue was a trick and I couldn’t do it.  I couldn’t swallow the saliva in my mouth for days.  All this time, I had no idea as to the shape of my tongue.  I didn’t find it out until I went home and looked for myself.  I had clues as I moved the suction instrument around my mouth.

Every morning there was a parade through my room as the ENT staff would wander through and ask me questions about progress and goals.  It was usually Dr. Panossian who led the parade and he’d usual close the, “The Boss will be coming through pretty soon.”  Dr. P would bring along a nasal scope to review the surgical results,  They only did that the first day after the surgery to investigate the aftermath.  But, each day I would be treated to the squad of residents and fellows gleaning progress details and learning of my case.  Teaching hospitals are so much fun.  Especially, when the head of your teaching hospital’s Otolarynology department is the best in the world.

I got a self-diagnosed scare that gave me some grief.  During the re-sectioning, they transplanted some of my own tissue to the base of my vocal folds.  I mentioned the suction device?  It’s called the Yankauer with bulb tip.  I would vacuum up the excess fluid in my throat, along with stuff that was oozing and keeping me from sleeping.  The tube was transparent.  You could see the gook it was removing.  At one point, I was getting these tiny pink circles.  I’m thinking, “Oh, no!  I am vacuuming up the resectioning.  I saved one of those Yankauer tubes — easy to do because I kept dropping them and one of my nurses would dispatch herself to get me another.  I checked with Dr. Sataloff.  “Don’t work about it.  I looked at it.  And it looked great to me.  Just don’t undo it by talking, coughing, clearing your throat or anything else you might be temped to do.”

My last best nurse experience came after Nicole met my doctor parade and reported that I could swallow during the night.  They got all excited but LJ. (the last of the best nurses) wasn’t convinced.  She was afraid they’d send me home and I would have to return so she monitored my ingestion of Ensure Enlive — what an insult to an HFLC diet person.  It was 50 grams of carbs.  That lasts me two days, in normal time as I attempt to keep carbohydrate consumption to 20 grams a day.  But I got it down and L.J was somewhat mollified.

I wanted the heart monitor, the blood pressure monitor, the pulse ox and everything else gone.  L.J. didn’t deem it safe.  She won.  Eventually, at about 1:30 on Thursday afternoon, March 1, 2018 they turned me loose.  I went with a prescription for 1.  Tylenol #3; 2.  Prednisone,  3.  Cefalexin; 4.  Suction,

It time for a digression on the suction.  Dr. Panossian, a fine young doctor doing a fellowship with Dr. Sataloff, feels like a friend.  Each morn. ing, what a termed the Doctor Parade went through.  It was like rounds on TV but I don’t recal that happening between 7:00 A.M. and 8:00 A.M.  Three or four would make their way through my room, asked my white board how I’m doing, asked if my tongue throat swelling had subsided any.  On the day following surgery, Dr. Panossian brought a scope with the hope of inspecting the work.  At each visit the phrase would be trotted out, “The Boss will be here in a few minutes.”  Only once in my four days as an impatient did he not drop by for an evaluation and progress check.  Wednesday evening, I was determined to swallow something.  I knew that’s what I needed to do to escape, so I practiced.  Nurse Nicol was cheering for me when I wrote it on my whiteboard.  And I was loaded for bear when the Doctor Parade came through on Thursday morning.  I mentioned the suction and Dr. Panossian was quick to write me up a prescription.  In the healing process, there is lots of effluent distributed and I can gag one.  The shift changes at 7:00 and L.J wasn’t buying my homeward bound song.  She wanted proof.  So I did my best and the lovely lady who orders medical equipment for patients being discharged was very kind.  “You’re in Delaware and I’m looking for a Medical Supply house to provide the suction.”  I gave her Manor Pharmacy in Wilmington Manor — not only niece people but they’ll either provide the device or a referral.  That’s what happened here.  Manor Pharmacy referred to American Home Patient and the nice lady at Hahneman, who kept me in the loop the entire time, told me they’d deliver Thursday afternoon.  Maybe there’s a language barrier between Newark DE and Philadelphia.  Betty was concerned and called American Home Patient.  How they drew the inference that I wasn’t coming home until Monday is lost on me.  Fortunately, a very nice guy was contacted and he showed up Friday evening.  But they gave Hahnemann a bad name that I can testify was totally un-deserved.  I got my suction.  I still rely on it.  Its made by DeVilbiss and it’s not only 120 volt and cigar lighter powered, it’s battery back up.  So I toted it to the appointment this morning. It made people curious about the noise of the on the subway.

March 6th, 2018.  Follow-up appointment with Dr. Sataloff and the Otolaryngology team.

Got to AT&T station a bit before seven.  It’s usually a seventeen minute train jaunt down the Orange Line toward Center City.  Today was no different, but I was.  The procedure was on 2/26 and I still hurt.  I got rid of one of the extra tongues in my mouth but the two that are left are distended. One side lays flat while the other displays something reminiscent of Serpent Mound.  I’m attempting to work around my inability to chew (did you know how important a tongue is to that process?) Yesterday, in a freaky moment of devil-may-care bravery, I tried to chew a cracker with some creamy peanut butter on it.  That was a joke.  I would up wiping the thing out of my mouth and donating the half I hadn’t tried to eat to the dog.

I have learned a technique for getting down my pills.  Gotta start the day with Prednisone — multi tabs.  I push them up the length of my tongue as far as they will go and then put a straw in the place where they went over the horizon.   It’s not perfect.  Sometimes one of the suckers gets away and I have to repeat the trick.  Eventually, they all disappear.

The straw trick has afforded me all the nutrition I’ve ingested for the past week.  During my stay at Hahnemann, they gave me dextrose and saline, since I couldn’t swallow.  They wouldn’t let me leave until I could swallow something, as I mentioned, I scored a swallow on Wednesday night.  I would have been so totally destroyed if I had to stay another day in hospital.  I’m already on record with my love for the nurses who cared for me.  They were wonderful, each in their own special way.  But the stay in the hospital was debilitating.  And I got no sleep. Every time I started to nod off, my tongue rolled up in the back of my throat.  Second, I dropped 18 pounds from the admission to today.  I was in a cotton picking chair the whole time.  That made my feet and ankles swell.  Sitting up all the time will do that.  I got no exercise, save for the first day in ICU when the PT folk took me for a walk.  That didn’t help very much.  And I had a room-mate who was captivated by the Game Show Channel.  I’d attempting sleep and “Our Survey Said,” would wind its way through psyche.  I got to that fourth floor room at two P.M. and Game Show Channel was on until eleven.  Were I to pull another like him and I think it would kill me.  Betty was concerned that ENT folk were too eager to release me.  I understand her evidence but most of it derived from leaping to conclusions.  And, since I can’t speak, I can’t dissuade her worries.  So we have one of our very rare arguments.

Lastly, an update is due.  Dr. Sataloff is very positive as to the end result of Monday’s procedure.  He said the biopsy showed no cancer in the margins, perhaps a bit of dysplasia but it was all removed in the five-hour operation that was supposed to be 1 1/2 hours.  He was using words like “longest” and “most difficult,” to describe what had happened.  He also asked if I could stand something else he almost never did: could I be on total vocal rest for 3 weeks.  I said, yes.  So my next appointment is the first day of spring, March 21, 2018 at 7:30.  By then, I’m hoping I’ll be able to swallow, eat and breath without gagging.  I also hope my tongue is normal in size and it doesn’t fight with my ability to chew.

Today was to have been the day.  But the Weather Channel, who has started to name winter storms just last year, stuck the name Winter Storm Toby on a nor’easter that took aim on the Middle Atlantic States.  Since Philadelphia was expecting about 12 inches of snow, my doctor’s office called to reschedule my visit.  They extended my total vocal rest until 3/27/18.  At 9:30 on that date I’ll have an exam to determine the success degree of the last procedure.  Right now, I couldn’t speak, even if I were allowed to speak.  My tongue is not yet recovered from the torture of the five-hour operation.  My left side jaw pain has virtually gone, however, my right side jaw still hurts to move it.  I am still at risk of biting my tongue so I eat food on the left side of my mouth to avoid it.  I wouldn’t say this is all fun.  I trust I’m paying for my progress in advance.

With all these impediments to feeling better, I guess I should be thankful to mother nature for extending my vocal rest.  I do sense there is a  decline in the over-all size of my tongue.  I guess I now have a tongue and a quarter.  I can’t stick it out so I avoid seeing Nancy Pelosi on the tube, since that would be my normal response to the sight of her.  So,  I avoid Microsoft in addition to Pelosi, since both make me want to scream.

Again, I am full of gratitude for the outpouring of thoughts, prayers and support.  I’m thinking that this is all part of the bigger picture to which all of my friends made themselves invaluable contributors.  Love you all!  God bless you.

Today is March 27, 2018.  My appointment was this morning with Dr. Robert Sataloff of Drexel University Medical at 9:30.  I hopped the Orange Line at A.T&T. Station near the South Philadelphia Sports Complex.  I wanted to be a Super Vocal Fold Champion in the mold of the Philadelphia Eagles.  But I confess the apprehension I felt.  I’d had augmentation and some reconstruction in the past but something always derailed it in the healing process.  This time was fraught with all types of problems in the procedure and then the healing process.  Like before, a tickle in the back of my throat, probably from phlegm — also from the healing process.  As I said on Facebook where I’m so fortunate to have loyal supportive friends:  “This healing stuff has been hard work! Tomorrow morning is my second follow-up and the next set of limitations on speech. So far, it has been total. And considering that yesterday was a month of TOTAL VOCAL REST, I did pretty well. It still amazes me that my tongue still has not recovered and my jaw must have really been stretched because the right side still hurts. To bite ones tongue has proven to be too easy! But I slows my generations of training in eating too fast. I’ve regained some of the weight I had lost in the hospital and the first few days at home when swallowing was a stupendous effort but I’m still down 13 pounds from before the surgery. (Yes, I still know how to find the silver lining.) So, I’ll post an update when there is news after I see Dr. Sataloff.”

I reported, when I reported to Dr. Sataloff, that both sides of my jaws still gave me pain; eating was an adventure by virtue of an enlarged tongue with the wound from the procedure that led to a frequency of accidental tongue bites;  the phlegm forced coughing that I couldn’t avoid although I attempted to mitigate the severity of the cough using the suction machine that Hahnemann Hospital lined up for my assistance; and it is still a challenge to take oral meds — although I’ve developed a work-around that helped a lot.

Then the time came for the endoscope.   Dr. Heid Panossian usually wields the endoscope.  He puts on a white cloth glove and grabs my tongue, treating it like the starter cord on a pull-cord rotary gas-powered lawn mower.  With my wounded tongue in its current state, that procedure was less fun than usual but it’s necessary.  Though my open mouth goes the endoscope and I get to watch on the monitor.  It’s all recorded for review by Dr. Sataloff.

We were later joined by the Boss Himself and Dr. Sataloff said positive things.  Coughing had done some damage but it left intact in several areas the grafts that were the purpose of all this agony.  The healing process may continue to consolidate those gains.  We’re doing month-to-month re-evaluations.  I start with speech pathologist appointments for three weeks, starting April 3rd.  For today, to release me from total vocal rest, they introduced me to Michele Horman, MA CCC-SLP who helped me plan my return to the cohort of those who speak.  She gave me no time limits but did emphasize that I was to avoid prolonged usage, especially if I felt strain.

So, where does this leave us.  There are some aspects of my healing voice that are better than before, although — even a month after the surgery — it is early yet.  So I’m going to fight it out on this front, even if it takes all spring.   As I mentioned, I have speech pathologist visits scheduled and a follow-up with The Boss on May 9th.  I may close this portion of the blog after that and start new installments, but I will make that public before I do it.  In the meantime, those who want all the gory details will always be able to  find them here.

I should have mentioned that, even though I’m allowed to speak, I can’t.  I can make some noises that include words.  I can’t do anything with volume.  I know not what it will sound like in advance.  But as things heal, I’m trusting that things will improve.

It took a month and a half before I got my tongue back to normal size.  I no longer run the risk of biting the thing, due to it being distended on my right side.  My jaw no longer has pain at the hinges.  Now we’re working on the voice.  It’s pretty gravelly sounding and runs into a squeak.

Well, the saga continues.  May 9, 2018 was my next follow-up with Dr. Sataloff. It seems that much of the re-sectioning was displaced  by coughing, etc.  This is something I feared in my hospital stay.  I thought I’d seen some tissue in the suction device.  The doctors told me to ignore that.  But I was still fearful.  I had five sessions with the speech pathologist team.  I learned some tricks I can use to control my speech.  It’s not very productive.  I can use relaxation techniques to create a gravely voice that is difficult to maintain.  Doctor Sataloff suggested that I’ll not get where I want to be without another procedure.  He gave me the option to wait until the autumn or do it as soon as possible.  I chose soon.  So, I’ve got another procedure for June 18th.

I missed the winter concert that Doctor Sataloff conducts so I was not going to miss the April performance.  It was scheduled for April 27th, a Friday night.  Betty and I scooted to Marcus Hook, caught the SEPTA rail to Suburban Station and walked to St. Luke and the Epiphany on 13th Street in Philadelphia.  The program included Haydn’s Missa in tempore belli (English: Mass in Time of War) and some contemporary music sung by an incredible choir with a symphony orchestra accompanying.  It was spectacular.  At my follow-up meeting, I congratulated the conductor on an excellent performance.  I also related a time in my youth that still lives with me, despite it being sixty-one years ago.

I was chosen to be part of Clermont County Ohio’s All County Chorus.  We rehearsed at our local schools and met in the county seat — Batavia, Ohio — to be rehearsed by the director of the Cincinnati Symphony Orchestra and then, in the evening, to be led by him in the public performance.  Like Haydn’s Mass, we had an all county orchestra rehearsing and performing together.  To stand in the top row of that chorus, surrounded by incredible sounds was sensational.  I related the experience to Dr. Sataloff.   I probably put all the emotion I feel on that recollection into what I said, because he raised my expectations to follow the next procedure.  He said, “I want you on stage singing in the next concert.”  So do I.

So I’m building toward June 18, 2018.  We have scheduled a 2 hour procedure for additional re-sectioning of my vocal folds, moving somethings around a bit and filling in the lost tissue after the February procedure, a procedure that Dr. Satalof tells me was a record length of time.  I’m going to study how to not cough or clear my throat before the next time.  I’m going rely on the support of friends and family and pray for a good outcome.

I want to be released from the Mi Shebeirach list.

I’ve been a very dedicated Kiwanian since 1983. It’s an organization that makes service to others it’s highest priority. As a matter of fact, our mission statement is “Kiwanis is an international organization of volunteers, dedicated to changing the world, one child and one community at a time.” I doubt that anyone would argue that our mission is not worthy.

At the close of the Twentieth Century, Kiwanis had realized that it had an identity problem. People seemednot to know us and what we do! I actually found people who thought Kiwanis was a New Zealand airline or a fuzzy green fruit? Under the leadership of Kiwanis International President Dr. Will Blechman we decided to work on being more readily identified in peoples minds. Prior to that time we had a practice of creating “A Major Emphasis” in the year of each incoming International President. A new International President would introduce us to a public service endeavor that he encouraged us to work on during his year in office. Many clubs around the world would adopt the program and perhaps continue it after the introducing president had finished the one year term. Dr. Blechman and the international board felt that standardizing our mission would help people know better what we stand for and they introduced a Major Emphasis that was permanent: Young Child Priority One. It wasn’t really much of a change. One of the first service projects of the Detroit #1 club, founded in 1915, was exactly in that vein. They adopted a young boy in a broken home and cared for him financially and with leadership until his circumstances improved. So Young Child Priority One was a natural.

The organizational structure of Kiwanis bears note, as it provides the framework of the story I’m relating. At the top of the organization is the individual member. Members organize into clubs, clubs into divisions, divisions into districts and districts into Kiwanis International. I had the good fortune to be elected Lt. Governer-Elect of the Seventh Division, Capital District in 1990. A Lt. Governor-Elect, absent untoward behavior, will succeed his predecessor at the conclusion of the Lt. Governor’s term on September 30th after a year of service. So the Lt. Governor has a at least full year to plan the goals and projects for the term that will be filled.

The year I became Lt. Governor-Elect, the State of Delaware was not getting good press. In all the states of the USA, Delaware was 49th in low birth weight, ultra-low birth-weight and infant mortality. Only Mississippi and the District of Columbia were worse. Since “Young Child Priority One” concentrated on pre-natal through age five, this was in the heart of our mission and we hoped we could help in some way. We asked our YCPO partners for assistance and the March of Dimes was eager to participate. They provided the meeting site. We started frequent meetings, sometimes several in a month, in cooperation with the March of Dimes, the Delaware Department of Health and Human Services, United Way, the Key Clubs we sponsored, our Circle K Chapter and the ten clubs in Division Seven. We learned the cause of the problem: the at risk population — typically the disadvantaged — did not seek pre-natal care. That was deadly.

Kiwanis had a blanket umbrella insurance policy for service projects. It seemed logical that each club had outreach capabilities in their service areas that could be exploited in finding these at-risk ladies, speaking with them to encourage OB-Gyn appointments and driving them to the appointment, if necessary, taking full advantage of the Kiwanis Umbrella Liability coverage. All ten clubs agreed and we were to call the project “Adopt a Mom.” A couple clubs set up Baby Showers as well. We were excited at the prospects and I was looking forward to the start of my year as Lt. Governor stating in six weeks by that time.

It wasn’t going to be smooth, however. I received a phone call from DHSS, one of our partners in the inception of the project, asking me for the name of our paid administrator for the Adopt a Mom program. “Oh, Kiwanis is a totally volunteer organization,” I responded. “But the State of Delaware will not work with volunteers,” I was told, “you need a paid administrator and you should be able to show then at least two years salary in the bank — a number that should be about $70,000, if you’re going to be competitive.” I mentioned that this might have been discussed in the past 18 months.

With only six weeks left before we were planning to start this program, I was feeling a bit of panic. I reached out to a fellow Kiwanian who’d been my Community Service chair when I was President of the Kiwanis Club of Wilmington, a fellow named Paul Calistro.

“Van, you’re jumping up and down of a group of not-for-profit organization’s toes! You can’t hear them but I can. Second, the state of Delaware will wrap you up in so much red tape you’ll not be able to move,” said Mr. Calistro. There was no doubt that Mr. Calistro was in my camp. He and his spouse had experienced a still-birth that year. I thanked him for his encouragement and asked him to call me if he could find any way at all to save the program. I had to wait almost two weeks for that phone call.

The call began, “Van, it’s Paul. I’m going to do it.” Calistro was the Executive Director of the West End Neighborhood House, a century old community outreach program. In their mostly unfinished basement area, they boasted an office of WIC already. With the help of a challenge financial grant from MBNA and a match from United Way, they turned Adopt a Mom to a prenatal care program called “Tiny Steps.” Remodeling the basement, they created a waiting room, a day care for existing families, two examining rooms, a data processing center and an administrative office. I was drafted for the Board of Directors by Mr. Calistro. He mumbled something about me owing them my help, since it was my idea. Out Kiwanis Clubs maintained their participation with those baby showers and other assistance to the project.

We were pleased at the effects of the program. It was successful beyond our wildest dreams, raising the average birthweight in the State of Delaware. But I owe some elucidation on the title “Service is More Than It’s Own Reward!” The lady who was chosen to administer the Tiny Steps program is now my wife. We started speaking as she would call me with one of these type of questions: “Does any Kiwanis Club have some money in its service budget?” I would scurry about to see if a club wanted to fund stuff: pampers, prescription drugs, onesies, baby food and other goodies that babies need. It grew to a friendship and, after her husband’s death in 1995 made her a widow, we eventually stated dating. I asked her to go out because I’d had a relationship end and didn’t want to get involved with ANYBODY. She accepted for the same reason. We were married in 2000, after I got the “No” to turn to “Yes” when I proposed. I have never been so rewarded by a service project aimed at helping others.