D.O.T. Health Card

Daily Quote: "When it is about you, your mind races.  Am I at fault?  Could I have done something differently?  What do I tell my children and wife?  What if I actually get cancer?  Have I done everything I set out to do in life?  I am a physician who gives advice for a living.  I have spent much of my professional life extolling the value of healthy eating and regular exercise, and I practice both?  So how in the world did this happen to me?  Part of the answer to that last question is luck of the draw."  --Dr. Mehmet Oz, Article, "What I Learned From My Cancer Scare," TIME Magazine, June 13, 2011, pg 52.

Needless to say, I totally identify with the above quote, but found it interesting that a popular surgeon who is often seen on Oprah's television show would have many questions regarding his cancer scare...makes me realize that it's indeed the luck of the draw and that all my concerns on rooting out the cause of my own cancer is pretty futile. 

The following TIME Magazine had a mention of the above Dr. Oz quote, which was in the "mail" section was letter from Ellen Werts, from Marana, Arizona:
I am a survivor of chronic myelogenous leukemia, successfully treated with two bone-marrow transplants.  Before diagnosis, I, like Oz, was very healthy. Although Oz's story stressing screenings will be helpful to some, I was dismayed by his initial reaction to his possible cancer.  "Am I at fault?  Could I have done something differently?"  Coming from an influential physician, this statement promulgates societal tendency to blame the victim for a diagnosis of cancer.  Believe me, no cancer patient needs to be subjected to this notion by anyone, especially treating physicians.  Myself, I'm not so hard on doctors or others who want do discover any possible cause-and-effects for my cancer.  My good friend at about.com forum site, Dr. Bosco, has been striving to discover what could have happened to cause me cancer, as he tries to attempt to help me and others with possible cancer causes...I definitely don't think Dr. Bosco is trying to "blame the victim."

Yesterday I went to Dr. Amir Nicknam's office as to get my D.O.T. (Department of Transportation) physical exam so I can get my D.O.T. Health Card...without my health card I would be unable to get my T.A. (Taxicab Authority) permit and would not be allowed to drive a cab.  Normally this would take only 25-30 minutes, but ended up lasting over three hours!

The first part of the D.O.T. Physical was the vision test where he uses the Snellen chart on the wall and recorded the distance vision at 20 feet.  Both of my eyes were perfect as my vision was 20/20 and my horizontal field of vision was 90 degrees.

The second part of the physical was my hearing where I must perceive forced whispered voice greater than five feet.  Both my ears heard the whispered voice at five feet.  So far so good!!

The third part of my physical was blood pressure/pulse rate.  My systolic blood pressure was 108 and my diastolic blood pressure was 68!  My recorded pulse rate was 62 bpm.  Many cab drivers, who tend to be obese, have problems with high blood pressure If they have blood pressure at 180/110 they'll be unable to drive a cab until they get their blood pressure lower (many do so by taking prescription drugs).  Also, if they have blood pressure in the lower 140-159/90-99 range the drivers have to take the physical test every three months.  My physical is moving right along, as it has only taken about 15 minutes so far in the testing!

The fourth part of my physical was the toughest part for me...Laboratory and other test findings.  Needless to say, I have no idea how many different chemo drugs are flowing through my body and with a certain amount of anxiety I had took the urinalysis.  Needless to say, cab drivers who are taking illegal drugs end up not passing the physical, BUT, protein, blood or sugar in the urine may be an indication for further testing to rule out any underlying medical problem.  The results of my urine test was: SP.GR: 1,030; PROTEIN: 30; BLOOD: Negative; SUGAR: Negative.  I also had normal ALT, AST, and Creatine. I have no idea what the acronyms are, but my protein in my urine was too high and the doctor said that this may be a kidney or liver problem and he asked me when was my last blood test...that was easy to answer, "I take a blood test every Monday!"  The doctor had me sign release forms to be faxed to Quest Diagnosis as to receive a copy of my latest blood test.  This would take me three hours of waiting before the doctor understood that the protein in my blood was the result of my chemotherapy treatments.

While they were waiting for my latest blood test I finished the rest of the physical examination, which I easily passed, although they did mention I was wearing a feeding tube:
I'm 72 inches tall and weigh 162 pounds.
Mouth and Throat: Checking for irremediable deformities likely to interfere with breathing or swallowing.
Heart: Checking for murmurs, extra sounds, enlarged heart, pacemaker, implantable defibrillator.
Lungs and chest:  Checking for Abnormal chest wall expansion, abnormal breath sounds including wheezes, alveolar rales, impaired respiratory function, cyanosis, Abnormal findings on physical exam may require further testing such as pulmonary tests and/or xray chest.
Abdomen and Viscera: Checking for Enlarged liver, enlarged spleen, masses bruits, hernia,significant abdominal wall muscle weakness.  Here the doctor noted my feeding tube.
Vascular System: Abnormal pulse and amplitude, cartoid or arterial bruits, varicose veins.  Here the doctor asked if my pulse rate is usually that low after running in place for one minute, I told him that I've been a runner since 1999.
Genito-urinary System:  Checking for hernias again.
Spine, other musculoskeletal:  Checking for previous surgery deformities, limitation of motion, tenderness.  Doctor mentioned that I could still touch my toes, while wearing a feeding tube!?! 
Neurological: Impaired equilibrium, coordination or speech patter; asymmetric deep tendon reflexes, sensory or positional abnormalities, abnormal patellar and Babinki's reflexes, ataxia.

The doctor told me that it's very rare that someone who is taking chemotherapy and radiation treatments for lung cancer and tongue cancer would still be driving a cab for 12-hours and he can't imagine how I could do it...I'm the only driver he knows that still works as many drivers take a medical leave.  I told him that driving a cab was better than the alternative of bankruptcy.  He asked if I smoked, which is the usual question I'm asked, and I stated that I've never smoked and have no relatives who had cancer, and in fact, no cancer risk factors.  He then shook my hand and wished me well as he rushed to his next driver.

I then received my new D.O.T. Health Card and doesn't expire for two years!  Needless to say, I've been driving for Checker Cab Company for 21 years and this was the most stressful D.O.T. physical I've ever taken!!  Would I have passed this test if I wasn't a runner?