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Timothy (Tim) Howard
May 24, 2016
Welcome to MyCaringBridge site. I've created it to keep friends and family updated. My family and friends appreciate your support and words of hope and encouragement during this time when it matters most. I wish that I could respond individually to people on this site but that is not how it is set up. Please know that I am very grateful for your presence, love, and support here.
My cough had been persistent for some time. Because I was finishing up a Fellowship in Sports Medicine, when it began to get more noticeable, I told myself that I would take care of it just as soon as the Fellowship was done, in about a month. That time successfully came but I began by treating it the way any Family Medicine trained physician would. At first I thought it was my reflux flaring up. This annoying condition came about under the stress of medical school in my second year. I knew that as it flared up, it could result in a cough, so I started to take prilosec or ranitidine hoping it would go away. While there was a tiny bit of improvement, I still coughed away. I then considered that it might be cough variant asthma or something related to exertional airway irritation. I got a script for an inhaler. While it again helped just a bit, the cough did not go away. Thinking it might be some new allergy or post nasal drip, I began to use mucinex to no avail. As it seemed to be worse at night, I began to do combinations of these medications so I could get to sleep. Once asleep, I felt like the cough was gone until I started to think about it the next day. Having finished the Fellowship and with baseball season at the AA level done (the NWA Naturals was the team I helped with), I celebrated by going on an Alaskan cruise my younger brother Joh had arranged. My girlfriend Christie joined me along with my nephew Stephen and his girlfriend Jen, and Zak one of Joh's friends from college. My mom was supposed to go on the cruise but got very sick just before we left so didn't attend. I told myself I would deal with the cough more aggressively when I got back from the cruise and got a job. The cough persisted but I found that a shot of alcohol seemed to burn going down which made it feel as if everything was clearing up, a temporary fix. Then it hit me: The cause was my blood pressure medication, lisinopril. This is an ACE-inhibitor with a notorious side effect of inducing a cough. I decided to take myself off of the medication for a couple weeks. If the cough disappeared, I would have my answer. The cough remained. By this point, I was back from Seattle and the cruise and into full-time job search mode. Because of my mom's illness, I made the decision that I would return to California and seek a job in the Merced area so that I could help assist in her care as needed. I began the very long process of applying for my California license. It usually takes 6-9 months for it to go through the system and be approved. In the meantime, I began to look for Locum's work. I figured that once I got a job, I would buy some health insurance (mine had run out at the end of the Fellowship) and go see a doctor for a formal work-up. My only requirement for the job was a need for schedule flexibility since I would need time off for the Boards, job interviews, CME re-certifications, several weddings of family and friends, and a vacation in the coming year. The first and most promising job was only willing to give me 2 weeks off for a year long contract and so I turned it down. The time and flexibility I needed was more important at that time. In retrospect, I guess that was a huge mistake. I continued to pursue job perspective after job perspective. In medicine, applying for a job is not the same as applying for a job at starbucks. Each application and verification process involves a mountain of paperwork, verifications, explanations, and record collection. They take between 6-8 weeks with every good job possibility. I had about 5 of those good possibilities after the first, each one chewing up more time while I waited for my California license to come through. I never got any of those positions which surprised me because they were locum tenens positions and meant to be short term. I think that by telling the recruiter that I planned to go to California as soon as my license came through put them in a difficult position with the hospitals/ clinics they were working with and all the possibilities fell through. And through this, I had no insurance so I did not go to the doctor. I slowly went through my savings reserve. I should have invested in insurance but I kept worrying about student loans and rent and more immediate needs. After 5 months, Christie had had enough of my cough. She conspired with my sister Bridget to get a little money together and then found me a Family physician. Dr Matthew Totten is a God send and a wonderful man. He never charged me for his time, but he did do what I had needed to have done for a long time; he did a chest xray. They found a mass that was later verified on CT and confirmed to be cancer on biopsy. So now I begin this journey. Oh, if I had not waited.