Cancer Warrior

Naughty Bits

2005-09-18T22:35:00.000-07:00

In the interest of scientific completeness and because of the prurient interest of a couple of old Navy buddies I am reopening this blog to discuss the one side effect of my treatment I have not previously mentioned. That is of course the ability to “satisfy my marital responsibilities.”

Possible problem number one is in the design of the plumbing. A bundle of nerves that is attached to the surface of the prostate gland controls the ability to achieve an erection. If these nerves are damaged during the radiation treatment, it’s “Sorry Charley,” because nerves have little capacity for regeneration when damaged.

Problem number two is the swelling of the prostate gland due to the treatment. The prostate swells because the docs stuck 34 needles into the little bugger and nuked the tumor six times. The swelling pinches the urethra which is the tube running from the bladder to the penis—hence the difficulty and pain in peeing.

(Keep your pants on--I’ll get to the good stuff in a moment.)

I’ve had plenty of problem number two especially following the second treatment. Because of the discomfort, I was very reluctant to try out the full range of options, shall we say. In short, since it hurt to pee I was afraid it would hurt even more to make love.

So we waited nearly six weeks, took a Viagra (which one congressman has classified as a “recreational” drug by the way) and gave it a go.

With spectacular results I might say.

So, the plumbing still works--but I don’t want to get too cocky. (Now that was good!) The literature does say that some men regain potency for a time and then gradually diminish in capacity eventually reaching full and permanent impotence.

My strategy at this point is to follow the sound advice of English poet Robert Herrick.

Gather ye rosebuds while ye may,
Old Time is still a-flying;
And this same flower that smiles today
Tomorrow will be dying.

I’ll just keep at it til it goes away.

It’s a Wrap

2005-09-12T20:05:00.000-07:00

I’m gonna bring this chapter of the blog to a close with a few comments about the medical care I’ve received. One hears countless stories about cold, impersonal treatment but I’ve seen none of that. I’ve been treated with dignity and respect and with great patience when I asked tons of questions. I’ve been treated by my personal doctor, the radiologist, the urologist, the GammaWest clinic in Salt Lake, the hospital in which the clinic is located and our local hospital here in Cedar City. At every step I felt like I was a partner in my own treatment. A constant participant in making informed decisions.

The most impressive has been the clinic. They specialize in this treatment and it showed in their cool professionalism. I suppose that would have been enough for most people but these folks just seemed to go out of their way in caring about their patients. They were kind and loving and comforting way above what one might reasonably expect. Doctors, nurses, PA’s, technicians—the lot. One or two would have been impressive but 100% is just downright special.

Thank you all so much. Your cup will runneth over.

And to Doctor Hayes and his entire staff, send anyone you like to this blog or have them contact me by email if they are undecided or fearful. I’ll sing your praises.

Bless you.

The Long Haul

2005-09-12T19:19:00.000-07:00

Things seem to change slowly day by day but always in a more positive direction. I get tired easily but it doesn’t affect my abilities much except that I have to take occasional naps. My plumbing functions aren’t up to snuff but I see gradual improvement there as well.

Accordingly, because I keep repeating (and boring) myself, I’m gonna stop giving reports of my physical condition unless something dramatic happens.

I’m in good spirits all the way around thanks to tons of support from my sweet Betty Sue, all my kids and a host of friends at church and school. I also have too much to do to mope around and feel sorry for myself.

Long range, I have four checkups scheduled (Nov, Feb, May and Aug) and will then get a checkmark in the big box. The one that says, “Former Cancer Patient.”

Back in the Game

2005-09-08T23:07:00.000-07:00

It’s four weeks since my second treatment and I would judge I’m at about 85% of normal. I still struggle a bit peeing and I get tired pretty easy. I don’t walk these days, I amble. Luckily I don’t have a long walk to get to any of my classes. Overall I feel that recovery from treatment two is taking about a week longer which in the big picture is certainly no big deal. The real big deal is that I am recovering.

I guess it will be about a year before I’ll know if the docs can put a big check mark in the box labeled “cured.” During that time I will be tested four times, twice each at the hospital here and at the clinic in Salt Lake--which will give my sweet Betty Sue and I two more chances to go to that wonderful Japanese Restaurant. I think we’ll schedule the trips to SLC to include taking in a play at one of the many fine theatres in our bustling metropolis to the north.

Getting back to school has actually been good. Gets my mind off things, gives me something to do that I’ve always enjoyed. I took a reduced schedule to help me kind of ease back into the full swing of things. For the first semester in a long while I am not involved in designing a production which feels kinda strange. But it sure does feel good to be playing.

On Peeing

2005-08-28T21:36:00.000-07:00

Abnormal urination has been one of the most persistent symptoms I’ve experienced after both treatment cycles. It has also been more pronounced this time around. For about ten days I had blood in my urine and that’s pretty unsettling. It’s not surprising though considering that I had thirty four holes punched into my prostate gland which feeds directly into the urethra. As a consequence, it is necessary to wear an adult diaper.

These are pretty interesting gadgets. First of all the package claims they are simply “Underwear.” The word diaper is nowhere to be found. Sound marketing there. The package also claims they (brand name “Depend”) are :

Ideal for your active lifestyle. True enough. They definitely let you get out and about.

Easy to use—just pull on and off. Yup. No pins, no Velcro straps, no staples.

Latex free. Important because otherwise they would be unbearably hot

Soft, quiet, breathable. True on all counts. Quiet is important because you sure don’t want to crinkle or rustle.

What the package doesn’t say is that they will make you feel like you are permanently carrying a load in your trousers because they are bulky right between the legs. Not to worry however because they don’t show and nobody will notice them. It sure feels funny going out in public however. They also smell sort of hospitaly. Not bad or anything but just reminiscent of the clinic and the treatments.

I am now blood-spot free and I no longer dribble pee down my leg or into the Depend. And I can go all night without getting up two or three times. What does remain however is difficulty in getting a stream going when I have to go. I know that sounds illogical but now I have to strain and sort of force it in order to get anything out. I did discover a trick (?) though. If I strain just a bit and then relax and then strain a little again and then relax it seems to sort of build up to a good pee. All the while during this plumbing exercise, it hurts and you think nothing is going to happen but then it comes.

A quick related story. Couple of days ago the good PA Jeremy called (I think earlier I may have referred to him as a nurse—my apologies) and said I hadn’t posted anything to the blog for nearly a week and he was checking up on me.

Isn’t that amazing!

When we discussed my peeing trials, he called in a prescription to my pharmacist for Uroxytral a drug that aids urine flow. Cool.

School starts again tomorrow but my first class isn’t til Tuesday. I got really, really tired going to church today so we’ll see how classes work out.

Stay tuned.

Christmas Tree Balls

2005-08-28T21:14:00.000-07:00

I am home two and a half weeks at this point and haven’t had a pain killer (Loritab) for three days now. Boy it scares me to use those things and I have to be hurting pretty good to take them. I don’t even know if this particular drug is addictive but I sure don’t want to find out the hard way. Rush Limbaugh and all that. It was not the perineal wound but my innards that hurt. Up inside. The same place that hurt when they readjusted the needles. I don’t know if it was that event or the cumulative effect of the two treatments but whichever, there was a dull, deep and persistent ache whenever I shifted positions and especially when I walked. The jouncing would generate waves of ache that would last a half hour or more.

I remember an actor on TV commenting that the way to play the role of a very old man was to simply pretend that your testicles were Christmas tree ornaments. That exactly describes the way I’ve been walking and moving--like I might shatter something important at any moment. I wonder if Loritab will cure old age? Hmmm—must look into that.

Now, Let Me See …

2005-08-25T23:35:00.000-07:00

The six-hour wait between treatments on day two was spent very pleasantly watching old movies. I was offered a television set of my own but declined and just enjoyed my neighbor’s set. John Wayne in the old Louis L’Amour story, Hondo plus The Man From Snowy River. Didn’t actually watch much of either movie. Just listened and imagined which was easy because I had seen both movies before. Would occasionally turn my head and take a peek but, for the most part, ran the films in my head. It was intensely pleasant just laying there knowing that the whole treatment experience would be finished in a few hours.

There were three patients stacked up in a staging area and I was scheduled in last place. The first gent returned from his treatment and the second guy was taken away. Then I listened through the pull curtain while they removed the first fellow’s apparatus. He was just a few feet away and I will tell you it was an intensely sobering experience. The nurse explained to him that they were administering a pain killer through his IV which would help but would not stop all the pain. (I will add here that through every single step of the entire treatment regimen on both trips the hospital and clinic personnel did a wonderful job of explaining what they were doing. It helped tremendously.)

They next told him they were using a drug called Versed that would block out his memory of the next few minutes. I had never heard of such a thing. It seemed almost like science fiction to me. Then I listened while they removed the apparatus itself. It was obviously very painful for this poor gent. He groaned and swore and groaned again. The whole thing didn’t seem to take very long but he was certainly having an intensely unpleasant experience. I must admit it shook my confidence and pretty much wiped out the euphoria I had been floating through.

During my final treatment cycle I thought of very little except the knowledge that I would soon be undergoing what that fellow had been through. When I returned to the staging area, and they put the pain killer into the IV, I told the nurse they could put me as far out as they wished but she just smiled and assured me that everything was going to be fine. Just as they had done with the other guy they explained I would receive a drug called Versed that would inhibit my memory of the removal.

Now here’s the amazing thing. They were exactly right. I remember nothing whatever of the next few minutes. It’s not like going to sleep. It’s simply as if the next few minutes did not exist at all. I know I was fully awake and I probably groaned just like the other guy. I may have even turned the air blue with a little Navy talk. But I have no recollection.

Science truly is wonderful.

Tweedle Dumb

2005-08-17T22:35:00.000-07:00

Well, I guess I got a little cocky. Figured I had this whole thing pretty much licked but it didn’t turn out that way. The second go round was physically tougher than the first and I hurt more now than I did before. The additive effect of the two treatments has been significant.

The first day of treatment was pretty much of a breeze and I started thinking I had it made. In the morning they installed the “apparatus” then the first treatment took place that afternoon. I spent the entire evening and night “searching for O’Roark” (Navy-talk for barfing) but even that was pretty much expected because the same thing happened previously.

One funny note here. The only thing that helped even a little with the tummy was popcicles. During the night I ate a double grape one that came up so fast it still tasted good on the way back. OK, OK. Well the nurses thot it was funny.

Reality hit just before my second treatment the next morning. To ensure that the apparatus has remained precisely where it was installed, they X-Ray the affair. Bad news—mine had shifted (just an eighth of an inch)—probably during my retching fits of the night previous. The good nurse Jeremy had to reset the position of the needles. With a touch of Demerol to “take the edge off” he gently twisted and pressed on the whole affair and I thought he had pierced right through to my eyeballs. He explained they couldn’t take me far enough out to eliminate the pain altogether without an anesthesiologist and an Operating Room. So just grit and bear it. The only redeeming aspect was that the nurse obviously knew his business and the discomfort lasted only a moment. It was, however, a very “rich” moment.

I regained my appetite after the first treatment and had some scrambled eggs and a muffin. Ahhh, the delights of hospital food. To tell the truth I wasn’t much interested in food at all. Wasn’t especially hungry and certainly wasn’t uncomfortable—stomach growling and all that. The body seems to have the capacity to shut that function down or at least diminish it when needed.

I’ll wrap up the hospital saga in the next installment. There is an interesting tale to tell there.

The Other Side

2005-08-13T20:43:00.000-07:00

It’s great to be home. It’s been four days and I’m finally able to sit up for 15-20 minutes so will send up a brief entry tonight.

Part of the immediate recovery treatment at home is to soak your bottom several times a day in the bath and then apply ice packs between the legs to reduce the swelling. I can tell you that the very, very first thing I did when I got home was to take a long, long hot bath. As I stood there under the steaming water a feeling of the most intense physical and mental relief hit me with the force of a storm. I shook so hard I could barely stand. I moaned long and hard and tears welled up in my eyes (good thing the water was running or I might have been accused of crying). We’re so tough. Us guys.

I have so much to be grateful for. Giving back is gonna be a big job.

You’re all in my thoughts tonight.

Wizard Redux

2005-08-06T19:59:00.000-07:00

It’ll be different this time around.

Last time I actually took my laptop computer thinking I might have the chance to use it a bit from my bed—maybe even to draft an entry for this blog. Right! I also took a couple of books to while away the time. Ha! Along with a change of clothing. Sure!

I used none of this stuff. Didn’t want to and couldn’t have if I did.

This time it’ll be the shaving kit and a set of undies.

Last time I was entirely focused on the treatment and what it might be like. This time I already know what the treatment and the recovery period will consist of so I’m looking past those things to the longer range picture. I am even thinking about the time when I’ll just be Jim again instead of Jim-who-has-cancer. Lopping off those extra words will be very satisfying. Of course I know I will always be Jim-the-cancer-survivor but there is a real bonus to that label. I’ll have the power to help others facing what I have gone through. It’s almost like being an ex-sailor. I always enjoy being asked for advice by a young person considering joining the military. Now I’ll be a wise old cancer guru.

I have one other thing in my kit bag I’ll be taking up to Salt Lake tomorrow—the accumulated kind thoughts, prayers, good wishes, blue lights and love of many of you, my readers.

I love you one and all.

See you on the other side.

Marking Time

2005-07-31T19:01:00.000-07:00

I feel great—whenever I’m awake. Never in my life have I slept so much. For as long as I can remember I’ve gotten by on six hours or so a night. And I’ve never been a nap person. Now I am sleeping ten hours a night regularly and taking naps about every other day. Long naps. Four or five hour naps. It is a strange effect because I don’t feel exhausted at all when I’m awake. I just sort of hit a wall and get horizontal and poof--down for the count.

I think three things are contributing to this rather radical behavioral. First, two of the medicines I’m taking say on the label they may cause drowsiness. Second, on the docs instruction I have managed to quit entirely the use of caffeine--specifically in the form of my oh-so favorite drink, Diet Dr. Pepper. Going without that fine stimulant has made me slow down a bit I suppose.

Thirdly, I just think my body is reacting naturally to what it has interpreted as a brutal injury. I’m probably a walking toxin factory using up a great deal of energy disposing with the killed cancer cells. My immune e system is probably sending me a message, “Get some rest while we take care of this mess.”

Anyway, it is not unpleasant at all. Most of my waking moments I feel good and have managed to get some work done. It’s just weird getting fourteen hours of sleep a day.

Another positive indicator is that I have regained full bladder control although it takes me a moment to get a flow going. This is very comforting because I can once again be a public person. And I’m taking full advantage of it.

This week Betty and I saw four plays. Dr Faustus and Stones in His Pockets at the Utah Shakespearean Festival plus Chapter Two and Lost in Yonkers at the Neil Simon Festival. A fine, fine week. And next week we’ll try to see Love’s Labour’s Lost and Romeo & Juliet to round out the season.I hope to see most of these more than once but we wanted to be sure we got all of them in while I was feeling up to snuff.

A week from today (Aug 7) it’s back to Salt Lake City for round two on the eighth and ninth. The plan is to go to church then leave immediately so we’ll arrive before dark.

My spirits are high because I came through the first round in decent shape. I’m ready to move on.

Think good thoughts.

Current Status—July 24.

2005-07-25T00:00:00.000-07:00

I feel pretty darn good although I tire easily. This morning I got up at 5:30 am for an early, two-hour church meeting then attended services at 11:00. Came home early skipping Sunday School and the Priesthood meeting. I then took a five-hour nap. Before all this I would routinely get about six hours sleep a night but am now running eight to ten hours a night. My back has cleared up and the cold and cough are 95 percent gone.

A dear friend asked me in an email when I would know if the treatment had succeeded. From what I understand it will be something like a year before we will know for certain. I will return to Salt Lake City August 8-11 for one more treatment cycle same as the first. Two or three weeks after that they will run another PSA test and if that is around zero it will be nearly conclusive that I have whipped the disease. But I must return for checkups every three months for a year alternating between Doc Crouch here and the GammaWest clinic in Salt Lake.

Tomorrow I’ll go to the gym for a little workout to start phasing myself back into a regular schedule.

All is well thanks to your kind thoughts and prayers.

Recovery

2005-07-24T23:58:00.000-07:00

It is eleven days since my treatment and I am back to 85 percent or so. The first couple of days after the treatment are miserable because I can’t sit for more than a few minutes due to the (nicely healing wounds) 'tween my legs. I am fairly comfortable lying down but can only take a few hours of that. My lower back is very sore and tender and it takes me a while to realize I am sore because of the constant cough I had for most of my stay in the hospital. Coughing hard without being able to sit really wears one out. On Friday the day after we get home, I submit myself to the magic fingers of Dr. Ed, my chiropractor. I set up appointments with him for every Friday all during my treatment and recovery. His magic works and I begin intense back-stretching exercises on a large blown up blue ball.

I had hoped I would be able to jump back into workouts at the gym but it is not to be because I have almost no bladder control for the first week home. I wore adult diapers for about a week mainly to have something to bleed onto and to catch the dribbles from my bladder. I am still passing blood although it is diminishing rapidly. The doc says blood in the urine is to be expected and could continue for several weeks although I think mine is just about wrapped up.

Bladder control has been troublesome. I will feel a huge need to urinate then must struggle and push to get a stream started. This seems to be the most lasting effect after eleven days (also a common symptom). Betty and I enjoyed a fine funny moment the second day home. She had bought a package of diapers for me and I couldn’t find them. She was in the bedroom and I came in with furled brow and asked, “Honey where’d you put my diapers?” She started laughing and apologizing at the same time. And indeed it was funny. It is surprising how quickly that kind of embarrassment disappeared. After all the ravages and terrifying experiences, wearing a diaper seems like nothing at all.

After just seven days I felt good enough to drive to St George for a little shopping. Had to sit up on a large fluffy pillow but we made it fine. Stopped at a new Mongolian Barbeque restaurant there and had a terrific lunch. Them Mongolians do taste great but I’ve heard they are really tough to clean.

Final Treatment

2005-07-21T14:18:00.000-07:00

Such a breeze I don’t even remember the music. As soon as the radiation robot is turned off, they pull the needles out and snip the sutures holding the template in place. I don’t feel a thing. Within a half hour of completion, I am dressed wearing an adult diaper mainly to sop up the modest blood seeping from my multiple wounds. After a wheelchair ride out to the curb, Betty brings the car up and I manage to get into the front seat, woozy but undaunted.

We check back into the motel then, head for a Denny’s restaurant simply because it’s just a block away. I have French toast and bacon for supper. Mmmm mmmm.

The next day we drive home in hundred-plus heat and I am truly whipped by the time we get home. But Ohhh, it so good to be there.

Second Treatment

2005-07-21T14:17:00.000-07:00

Nothing changes but the music. The Beatles AND The Doors. Could life be any better? My attitude does soar, however. Knowing what to expect in the treatments removes all apprehension. I get a ham sandwich with white bread and mayo plus some soup for lunch. Pretty tasteless but the food makes me hungry. Coming down the home stretch.

Final treatment is delayed for a couple of hours because the doctor is locked up in a traffic jam. GammaWest has several clinics in the area so the doctors dash from one to the other to oversee the procedures.

Three of us are stacked up in the holding area. I’m scheduled in third place so I settle in for a long wait. Oscar is the guy to my right and his wife is with him so for the most part the curtain is pulled between us. The fellow to my left is Mr. Sherratt and somehow I overhear that he is also from Cedar City. He is several slots down the hall from me so we can’t chat without shouting so I ask (male) Nurse Allgood (not a joke) if my neighbor is perhaps related to our Mayor Jerry Sherratt whom I know quite well. Turns out he is hizzoner’s first cousin. Small world.

During the wait a funny thing happens. A small but very rotund gent is pushed through the hall in a wheelchair by his wife. He is little but has one of those bullhorn voices that could penetrate Saddam’s best bunker. His doctor has recommended the treatment we are receiving but he wants to see the facility first. His escort indicates that the three of are taking this treatment and he immediately jumps right into our party and throws down a barrage of questions.

It was a great scene. This fellow is really horrified by the thought of seventeen needles, “up my bum” as he says. We three turn into shameless salesmen trying to convince this poor fellow that the treatment is essentially painless and nowhere near as bad as it sounds. He departs somewhat relieved but not entirely convinced. The good Nurse Allgood apologizes for the intrusion assuring us the episode is not typical. We laugh it off and invite him to bring round all the uncertain prospects he wants.

Another interesting thing happened during the wait. After the doc arrived and got Oscar started on his treatment he came round my bed to chat. Turned out he was a huge fan of the Utah Shakespearean Festival where Betty and I both volunteer. He had seen all six plays the previous week and attended all the literary seminars. He wanted my opinion on donating to the festival by sponsoring individual actors. We soon discovered that we had both attended the same actor’s seminar four days earlier. Small world indeed.

Overnight Wait

2005-07-15T22:06:00.000-07:00

Back in my room, early evening. The morphine has dissipated. I feel decent and get some supper. Tomato bisque and chocolate pudding which taste absolutely, faint-headedly, wonderful and stay down for all of two or three minutes before I barf the whole load. It’s a strange effect because I don’t feel nauseous at all.

At ten pm or so the nurse brings meds. Four or five small tablets some of which are to settle my stomach. I throw them back with a slug of water and within fifteen seconds get them back again with whatever was left of my modest supper. Over the next couple of hours I get a couple of pills to stay down by taking them one at a time with a sip of water. I think they did some sort of IV thing as well.

Thinking I’ll just drift off for a nice long sleep, I start coughing. Deep down, gut-wrenching, snot-flinging, snorting, choking, rumbling stuff. Trying to pull flem up from my toes without success kind of coughing. It goes on for two hours and I’m ready to ring the panic bell but from somewhere, deep in my inner storehouse, I think to try a Yoga technique called “Square Breathing.” I breathe in as deep and hard as I can for four counts then hold it for four counts, let it out for four more and hold that then do it all over again. Do this for two or three cycles then take a sip of water. Repeat.

A miracle occurs. I stop coughing in just a few minutes and drift off to a peaceful sleep from about two until six am. Fully rested, ready to go.

I polish off some cold scrambled eggs and a muffin and some juice. It’s Wednesday morning and I have not eaten since Sunday. I’m amazed I have no sign of last night’s upchuck problem and the nurse tells me the spinal/morphine combo sometimes has that effect but it's now worn off.

Halfway there. Let’s go. I’m ready for the rest of it.

First Treatment

2005-07-15T22:05:00.000-07:00

Interestingly there is virtually no sensation. They wheel my bed into a cabinet about six feet deep and eight feet wide. Painted white with a cheerful painting on the wall above my face. I had already decided I would attempt to meditate during this radiation phase to keep my mind occupied. Fat chance however. There are two speakers on the wall playing golden oldies rock and roll. While I’m trying to call up a Yoga chant, I’ve got Elton John going to town. Loud. So I just grooved instead.

I am impressed by the technicians operating the machinery. They are swift and sure and pleasant. Each of the needles is outfitted with a blank stainless steel probe to provide stability. First step is to remove each of these probes which they simply leave lying between my legs. The rotary head of the radiation monster is then attached to the flange that is sewn onto me. Everything after that is computer controlled and the only sensation I have is of a very faint whirring and clicks as the Iridium 192 pellet travels down each needle starting and stopping on its journey of fire. No pain, no tickle, no smoke, no writhing, just, “Click, click, click,” and Philadelphia Freedom. Go John!

Installation

2005-07-15T22:03:00.000-07:00

I will attempt in the next several posts to describe my treatment. As a general comment, the thought of what they did to me is horrifying but the actuality was much less so. I guess that is one of life’s constant lessons. The thing is less than the fear of the thing.

We checked in a little after nine am and I went right to a prep room. Remove everything—even the wedding band which required a liberal dose of slippery goo. The anesthesiologist, a nice lady with a steely glint in her eye, asks once again about height, weight, allergies and such and off to the operating room we went. By now the fact that I have been without meaningful food for some thirty–six hours is the furthest thing from my mind.

They sit me on the edge of the operating table leaning on a pillow in the arms of a chubby little nurse for whom, in spite of my nakedness, I have no passion whatever. The knockout doc apologizes for having to shave a little patch of hair off my back. Tells me it will be something to remember her by for a week or so. Her finger probes my spine and there is a sharp but endurable prick as she inserts the needle and I remember absolutely nothing until I come to in my room with the apparatus in place.

What a blessing.

They inserted seventeen needles, seven inches deep into my body through a circular flange that was then sewn onto my body. I thought I would be awake, trapped there on the torture table listening to these ghouls go about their bloody business.

Instead I took a nap.

And when I awoke I had no pain, not even discomfort. It was troubling to realize I was going to have to lay splayed out on my back for two days with this thing between my legs. I couldn’t imagine how uncomfortable I would become lying there like that--able only to barely roll an eighth of a turn. These wizards solved that problem by wrapping inflatable cuffs around my lower legs that inflated every several minutes for about thirty seconds. I got a constant massage for two days and my legs felt great.

No lunch afterwards though. Too soon after the spinal but I don’t care. The morphine polishes all my edges.

Rock and Roll

2005-07-15T12:01:00.000-07:00

4:30 pm. Sitting in a motel room in Salt Lake City waiting for a mega-laxative to do its thing. The box says it should ummm … produce results … in 30 minutes to six hours. It had better be far less than six hours cause I’m supposed to repeat the treatment four hours from now. I have a feeling this is not something one ought to stack up.

I’m doing better than anticipated at this point. Cough is just about gone and that’s a real blessing. The main thing is that the all-liquid diet has been pretty easy. If I go without eating for this long, I typically start getting a headache but all OK now. Had a 32 ounce glass of ice water with a dash of lemon for breakfast, a diet soda for lunch, and nothing but grape juice and a few Lifesaver candies since then. If I’m lucky, I’ll be so busy in the bingo (potty for you westerners) for the next several hours I won’t miss dinner.

I’ve learned it’s tough not to think about food when you watch TV while you’re hungry. Boy are there a lot of food commercials on TV. Worst so far was Red Lobster. Crab legs dipped in butter. Ohh. I feel faint. It’s even worse knowing that salmon teriyaki and tempura are just fifteen minutes away.

5:30 pm. Victory! Science is wonderful!

7:30 am. Packing up for the drive to the clinic. A restless night but I can definitely assure the reader that my insides are clean as a whistle. Our check in time is 9:30.

Three days later. Now at home and posting this. More later.

Off to See the Wizard—Or Not

2005-07-10T15:29:00.000-07:00

We leave for Salt Lake about nine tomorrow morning depending on what the doc says about my cough and congested lungs. Just haven’t been able to shake this blasted cold all the way off. There is a chance I’ll have to delay the treatment which would be the pits because it takes my recovery right up to the start of the Fall Semester.

We’ll get there early enough to roam through bookstores for a couple of hours but in spite of that beloved activity, I dread the day. Seems I can’t have anything to eat the entire day except clear liquids basically defined as fruit juice, bouillon, jello, and hard candy. At four pm and again at eight I get to take a dose of volcanic laxative—the instructions tell me to expect to live on the pot for an hour or more each time. Then at ten comes the enema. Joy is mine!

On Tues morning I check into the clinic. Don’t know exactly what time yet but will find out tomorrow for certain.

I think I'll take my laptop computer along so I can perhaps work on a play in between treatments. Or even write a blog chapter or two for you my faithful readers. Hope I am awake and alert enough to do that. Or to at least read—I’m about two-thirds of the way through John Grisham’s The Broker.

Well, me buckos, I’m gonna wrap this up and get a couple of other loose ends tied up. On the outside I may appear calm and brave but believe me, inside there is a wide-eyed maniac screaming, “Noooo! Don’t make me go!”

I’m glad you can’t see him.

Plan Ahead—Right!

2005-07-07T23:01:00.000-07:00

The cold that threatened last week jumped on me like a chicken on a June bug. Whipped my fanny. When I get a cold, the worst symptom is a nagging, persistent cough. In bed, I hack and hack trying to bring up the gunk from my lungs and eventually have to move to the living room couch. Then try to sleep sitting up. So, I’ve had little sleep and no exercise for the past week. Just trying to get by.

Last Friday I had all my lab work done at the local hospital in preparation for the radiation implant next week. Took a gallon of blood and did an EKG. Good news. I did have some blood left and my heart still beats.

Today the anesthesiologist called from Salt Lake to ask me about:

Age, height & weight
Smoke or drink
Allergies. Medications
Heart Attacks Strokes

And thus and such.

I did manage to complete the sound design package for Farley Family Reunion, a play being put on by the Neil Simon Festival here in Cedar City.

It was the one play (out of three) I chose to keep when I was diagnosed. I would much rather have done one of the other two because the plays—Chapter Two and Lost in Yonkers—are much more interesting and the sound design substantially more involved and challenging.

I am still working on designing a database for the Dean of the College of Performing and Visual Arts where I go to school. It was part of my assistantship last semester and this summer. Events slowed me down there but I should have it completed in a few weeks.

So here I sit. Coughing and hacking and dreading another night on the couch. And just wanting to get this damned thing out of the way so I can get on with my life—however it may be altered.

As somebody well-known said, “Bring ‘em on!”

Collateral Damage--Duck!

2005-07-01T17:34:00.000-07:00

We’ve had huge wildfires to the south of us for several weeks. The closest was twenty miles away in New Harmony where we used to live. I-15 has been closed briefly several times. To this point there have been no homes destroyed but it sure makes folks jumpy. There was an article in the local paper this morning announcing that any fires in Cedar City started by fireworks will cost the perp 360 bucks an hour for the putout.

The smoke in the air has been a real problem for many, however, including your beloved writer. My throat got raspy and is now sore and I’m fighting like the dickens to prevent a full-blown cold from developing. That often happens to me in April or May when the pollen comes in so I thot maybe I had managed to escape it this year. I sure don’t want to go up to the hospital for my first radiation treatment in ten days with a cold.

I suspect the tension has caught up with me a bit as well. Have just been is a slight funk for several days and last night I don’t think I got even a full hours’ sleep. Have really been whipped today.

I catch myself just staring at the horizon sometimes pondering what’s about to happen to me. The most difficult aspect is the uncertainty of the whole situation. The side effects of this treatment (or collateral damage if you will) can be real ugly and it’s difficult avoiding thinking about them. This is probably a bad time to write about this subject because I’m tired but maybe it’s a good time to just get this off my chest. The potential collateral damage includes:

Loss of Appetite. This is a problem? Get rid of this paunch and back to fighting weight. Yahoo!

Fatigue and loss of motivation. Cool—good excuse to take an extended vacation, lots of reading, TV, sit around working on my plays. I could handle that except that it could last 12-18 months.

Incontinence. Two kinds—bladder and bowel. Manifested by loss of control and/or frequent evacuation. In short, need to go all the time and can’t hold it in. Can last a few days, 12-18 months or—horrors—become permanent. If severe may necessitate wearing a diaper or even an external bag. This would really be the pits. I appear in public regularly in several ways. As a student I often give classroom presentations. I am also a volunteer usher for the Utah Shakespearean Festival (very high class, Tony Award-winning, regional theatre) which means I wear a coat and tie, check tickets, show people to their seats, handle customer inquiries and so on. Thirdly, I serve in a leadership position in my church and speak or teach frequently. None of those activities goes very well with having to go potty every fifteen minutes.

Impotence. Nerves that control the male erection run along the surface of the prostate gland (distinctly poor engineering in my judgment). Radiation or surgery can damage these nerves producing not a loss of desire but an inability to perform. As above, this effect can last a few days, many months or even be permanent.

That’s a pretty heavy load. Dr. Hayes, my oncologist in Salt Lake, summed it all up this way:

Twenty percent of his patients have virtually no side effects.
Sixty percent have serious but treatable side effects.
Twenty percent experience severe side effects.

Somehow eighty percent full doesn’t seem to outweigh twenty percent empty.

On Dying

2005-06-26T22:34:00.000-07:00

I quit smoking two decades ago after 25 years as a tobacco addict. During my Navy career (1959-83) smoking was the norm and “Sea Store” cigarettes could be purchased (onboard ships at sea) for just $1.00 per CARTON. I quit smoking a thousand times over the years but in 1985, I finally kicked the habit once and for all, never to smoke a single cigarette again. Not a single puff.

What enabled me to conquer that pernicious demon was the sudden realization one day that I was really, indeed, actually, inevitably, irrevocably, and without fail—going to die. Someday. Soon after I was struck sharply by a second thought--later would be better than sooner. So I quit.

In a sense that was the day I became an adult.

The passing of my own and my wife’s parents shaped my attitude as well. Both our fathers went quickly but our mothers went slowly and we were able to be with them. I spent the last three weeks of my mother’s life at her side and even held her hand during the final moments.

Since then I’ve been fairly comfortable with the notion of my own demise. I’m sure that comfort stems mainly from my spiritual and intellectual conviction that a) man is constituted of a spirit residing in a physical body b) death is a process that separates these two components of life, c) spirits are immortal, however and thus d) the essence of what we know as Jim Lord will continue to exist and grow and learn after my physical death.

I don’t fear death but still feel that later is better than sooner. I am near terrified, however, about the possible side effects of the treatment. As Jeff Metcalf, an English Professor at the University of Utah and a fellow Cancer Warrior puts it,

“It is, rather simply, a tremendous inconvenience, isn't it?”

(Click here for an excellent hour-long radio program featuring Prof. Metcalf.)

Doing What I Can--My Prep

2005-06-23T23:20:00.000-07:00

When Dr. Crouch informed me of the biopsy results, he didn’t want to discuss treatment options until I had done some research on prostate cancer. He told me to take some time to think though the situation, talk to others who had faced cancer and even to pray. (Not often you find doctors suggesting that approach—and he’s not even LDS!). I appreciated that advice a great deal and interpreted it as an invitation to participate in the decision. He made me feel like a full partner in the process.

One of things I found in my research was a Duke University website with a document titled, A Cancer Patient’s Guide to Complementary and Alternative Medicine (CAM). I was never temped to turn to any alternative treatment—that is, anything that substituted for whatever the docs recommended. But the whole topic of complimentary treatment was greatly interesting. I became convinced to do whatever I could to a) increase my general wellness, b) counteract the potential side effects of the treatment, and c) assist in the treatment itself. Here’s the list of things I’m doing.

Diet. Trying to eliminate meat, sugar and processed flour. Eating lots of fruits, veggies, beans and grains. I can’t admit to actually becoming a vegetarian but I sure am trying to clean up my act.

Supplements. Adding Shaklee products to my regimen. Lots of C, E and alfalfa.

Exercise. We live a block and a half from a great health club where we’ve been members for going on three years although I had fallen off the wagon a bit after hurting my back. I’ve returned to an hour a day six days a week. Thirty minutes on weight machines and another thirty aerobics. To protect my still-tender back, I am only working on torso and lower body. That’s where the treatment will focus anyway. Since these folks will be traumatizing my crotch, I thought I’d do what I could to buff it up a bit. Additionally, I plan to continue after the radiation treatments as a way to combat the fatigue that is a common side effect. And yes I realize that sounds counterintuitive but several of my research resources suggested it. We’ll see how it works out.

Chiropractic. I’ve been a long time consumer sometimes even going in just for a “tuneup.” I’m lucky to have a gifted practitioner here in our little town—Doctor Ed Hunt—who uses Trigger Point Therapy. Starting next week I will ramp up to a once-a-week schedule.

Meditation. I’m spending an hour a day concentrating on general wellness and on the specific health of my prostate and surrounding areas that might be affected by the radiation. Nearly thirty years ago, I took a three-week meditation course (in California naturally) that I found most beneficial. I have continued to employ some of the techniques all this time but fell away from any really concentrated effort.

Yoga. The course mentioned above included some Yoga postures and breathing exercises so I already know a little bit here but have picked up a couple of books and am doing some fairly simple things mainly to aid in the meditation mentioned above.

Prayer and Fasting. Doing both on a personal basis. Others in my family and in my church are doing the same. Week after next a group of men will be holding a group fast on my behalf.

Specific Blessings. In the LDS Church we believe in specific blessings for the healing and comfort of the sick by the laying on of hands by priesthood members. I received a blessing by my Stake President (roughly equivalent to a Bishop in the Catholic Church) after I learned of my cancer and will receive others prior to my radiation treatments.

This Blog. Keeping a journal was actually one of the techniques mentioned in the Duke University manual cited above. My kids and several friends have been very enthusiastic and I admit it helps to both keep focused and to get things off my chest. And to help others I hope.

To sum things up, being a victim just doesn’t suit me and doing all the above things gives me a way to do something positive. I think I can honestly say I don’t feel like a Pollyanna. Indeed if things turn out badly, I think I am prepared. I just want to be sure when the smoke clears that I did what I could. If I go out, I’m going to do it with a smile.

Strange Feelings

2005-06-21T21:10:00.000-07:00

It’s very strange being seriously ill but having no visible symptoms. It’s like the egg of some evil, murderous creature is silently growing inside my body waiting silently for the right moment to burst forth and lay waste.

It is strange telling people you have cancer. They instinctively want to do things for you. Some get teary-eyed. Indeed, that part works both ways--I’ve gotten teary-eyed telling some people, especially those closest to me.

This disease changes your relationship with people. Uncertainty abounds and many things go unsaid in conversations. Jokes go untold—especially those that begin, “This guy died and went to heaven …”

Looking at people face to face is different. There are thoughts behind their eyes. Thoughts like, “Gee he doesn’t look any different.” It is strange because I don’t feel uncomfortable except that watching others being uncomfortable is unpleasant.

Priorities start changing as the magnitude of the situation crystallizes. Things you thought were important slowly become less so. Other things that have been taken for granted increase in importance. I have always been a reader. Got it from my Mom. Betty and I have a dozen bookshelves in our little house. Every room has bookcases—all overflowing. I’ll bet I’ve bought fifteen books in the past four weeks since I first learned about my cancer. Some primal, desperate thirst for truth and knowledge seems to be pushing me harder than usual. It’s almost as if my psyche is whispering, “You’d better get these books read while you have the chance--just in case, you know.”

When we went to Salt Lake for the consult, we could have driven home that evening but stayed the night just so we could have dinner at some nice ethnic restaurant and wander for a few hours through some used book stores. Two of our most favorite pastimes. We found wonderful spots for each.

Kyoto’s Japanese Restaurant
Sam Weller’s Zion Bookstore
Ken Sander’s Rare Books

Some things that were big important goals for me for this summer have now faded into obscurity. I had been working for several months on forming a new non-profit company this summer to raise money for the arts. Writing a mission statement, creating goals and objectives, PowerPoint presentations and business plans—now all on the shelf.

I signed on as Sound Designer for three plays for our local Neil Simon Festival this summer. The project was about 60-70% done but I had to turn everything over to another designer. I also wanted to work on two plays I am writing—one short and one long. Indeed, if the side effects of my treatment will allow, this may be the one project that I do get to do this summer.

In short, I am trying to sort of ration my energy because I don’t know for certain how much I’ll have three weeks from now.

Well I’m starting to ramble on a bit so think I will put this post to bed.

I am so grateful for the many friends I have and for those who have expressed their encouragement. I am a rich man indeed.

A final thought, I did not intend for this blog to be a private affair. Please share it with anyone you think might find some value herein.

OK—Here’s What We’re Gonna Do …

2005-06-21T10:01:00.000-07:00

The trip to Salt Lake is great. The consult is informative and comforting in several ways and we had a nice time to boot.

We spent about an hour and a half at the main office of the GammaWest Brachytherapy Clinic which is located at the Salt Lake Regional Medical Center (on South Temple street ten blocks east of the Salt Lake LDS Temple).

We met with Dr. John Hayes, (see his pic on the website) the founder of the clinic who has performed my procedure over 2,000 times. If you look up the word “comforting” in the dictionary, it says “2,000 times”. First he gives me his diagnosis based on all the test results and it matches Doctor Crouch’s conclusions right down the line. Nonetheless, I’m still happy to get a second opinion. Then he lays out the treatment strategy.

Specifically, I will be treated with High Dose Rate (HDR) Temporary Implants which I will not describe in detail here cause the website is very thorough including pictures. This treatment method is chosen because the tumor is a) small and b) contained within the prostate. The treatment delivers a higher dosage of radiation than is possible with other methods and does so with great precision. The word “Temporary” indicates the radioactive implants are only put in place temporarily 15-30 minutes) instead of permanently as is the case with Low Dose Rate Permanent Implants.

Here’s the process. We’ll drive from Cedar to Salt Lake on Monday and spend the night in a motel. I’ll be admitted early on Tuesday morning (12 July). In the Operating Room, I’ll be anesthetized from the waist down and then 17 hollow plastic needles (eighth inch in diameter) will be inserted through my perineum into the prostate. (For those who lost their anatomy books, that’s the cute little area between the scrotum and the rectum.) The needles are threaded through a circular template which is then sutured onto myself to keep the needles locked in place for reasons that will soon become obvious.

The precise needle placement is done using X-Ray and Ultrasound pictures. As I understand it, the end result is that the needle tips form a sort of cage around the tumor. There’s a nice pic on the GammaWest website at the Treatment link.

Back to the room for lunch (lime jello and apple juice--yummm) and a little pinochle with the staff. In the afternoon they haul me off to the treatment room where radioactive probes (Iridium 192 to be exact) are inserted down into the needles. This part of the process is precision controlled by a computer. When surrounding the tumor, the probes are “stepped” through a precise pattern to ensure a) maximum delivery of radiation directly to the tumor and b) prevention of damage to the surrounding areas. (Lots of important plumbing in the neighborhood like bladder, nerves, rectum etc.) The whole thing takes just 15 to 30 minutes.

Then it’s back to the room for a nappie-poo, dinner (cherry jello and grape juice—double yummm), more games with the staff and a chemically motivated good night’s sleep. And yes, the needles stay in place all night. Next morning it’s another treatment—same as the first. After lunch, back for a third blast following which the whole contraption is removed. After a couple of hours in recovery, I’ll be released late afternoon. We’ll spend another night in the motel and drive home on Thursday.

Then on August 7-10 we do it all over again. The good news is we don’t have to go to St. George daily for five weeks (50 miles down the road) for external radiation treatments as was previously discussed. Yahooo!

Scan Results--And the Winner Is …

2005-06-19T18:04:00.000-07:00

Both scans come back negative. Specifically, “No pattern suggestive of Metastatic disease.” This means the tumor is indeed confined to the prostate. I check the actual films out of the hospital to take to Salt Lake to be sure the doctor there has all the test results.

Next stop is a consult at the clinic in Salt Lake City where the treatment will take place.

A Peek Inside—This Dog is Dead!

2005-06-17T23:36:00.000-07:00

A man takes his dog to the Vet and asks for an examination. He puts the poor critter on the table and after a brief look, the Vet tells him his dog is dead. “That’s not possible, says the man. “He was running around like a puppy just this morning. Isn’t there another test you can run?”

The Vet brings in a cat and puts it on the table. The cat sniffs the dog’s carcass and wanders off. “Like I said, sir, this dog is dead.”

“Well, I’m just heartbroken,” replies the man. “How much do I owe you?”

“Two-hundred and twenty dollars,” says the Vet.

“Two-hundred twenty dollars?” shouts the man. “How could it possibly be that much? I’ve only been here for five minutes?”

The Vet responds, “Well the office visit is twenty dollars and then there’s another two-hundred for the CAT Scan.”

A CT Scan (also called a CAT Scan) is a very fancy X-Ray that allows examination of soft tissues of the body such as prostate glands and tumors. (WebMD has a very complete description.)

They actually used two cats for my procedure. First the technician put an IV into my arm. And there’s a nice little story that goes along with this part. I was scheduled for a CT Scan at 10 am and then an injection at 11 in preparation for my bone scan at 2 pm. The bone scan guy read my order and saw that I was having the CT scan done so he came in and put his stuff into the IV meaning that I wouldn’t have to have a separate injection just an hour later. This kind soul, whose name I never even learned, saved me from having to be punctured twice when once would serve just fine.

It’s not much but it was very thoughtful and after I realized what had happened, I was most grateful. Whoever you are, sir, thank you so much.

The first CT took ten minutes or so. Since they scanned my pelvis only, I never had to experience going up into a claustrophobic donut or anything like that. There was no sensation at all while the scan was running.

Then the tech released the stuff (called “contrast material”) in the IV. She told me it would only take a moment to disperse and she was correct. She started the second scan and warned me that I would feel a warm feeling through the center of my body and boy was she ever right. It was one of the weirdest things I’ve ever encountered. It was more than simply warm; in fact it was just almost hot and seemed to be isolated to the very center core of my body. It was like I had a three inch wide pipe running the whole length of my torso and it had very hot water running through it. And it spread very fast. The speed of the reaction was almost as surprising as the effect itself.

In a flash it got almost to the point of discomfort. It fact, it happened so fast, I felt like it was going to become painful but it never did. The effect lasted only a couple of minutes and then dissipated. The rest of the test was uneventful and again took only a few minutes. I think the whole thing lasted 36 minutes and I was out of there.

Here’s a good tip if you, dear reader ever need to have a CT or Bone Scan. Wear sweatpants with a string (no zippers or snaps) and a T-shirt. No belt, nothing in pockets, no jewelry, etc. This may help you avoid having to change into one of those darling little gowns. Anything you can do to retain even a smidgen of your dignity is good.

The Bone Scan lasted a good deal longer because it involved scanning my whole body from the top and then again from the bottom and then several scans of extremities (hands, arms, shoulders etc.) I guess many people are freaked out by having to slide into this big ring but I just closed my eyes and meditated through the entire process. Got a nice rest for more than an hour.

My sweatpants and tennis shoes came in handy again saving me once more from the dreaded skimpy gown. I was impressed with one aspect of the test. The technician wanted me to lay on my back with my feet together and keep them like that for the whole test which would have been uncomfortable and very tiring. So he whipped out a roll of masking tape and taped my toes together. I also had to lay my arms at my sides palms up which was an unnatural position so he put my arms into a cross-body sling affair that fastened with Velcro. By placing the sling across my body right at the elbows, my arms could relax completely with no strain whatsoever. Trussed up like a Christmas turkey, I closed my eyes and concentrated on my breathing and relaxation technique. Piece of cake.

The scanning data from this test is fed directly into a computer and the picture is completed as soon as the test is done. The technician gave me an “unofficial” result immediately. I had a couple of small spots on two of my ribs in the back but he made it clear they were not necessarily related to the cancer. Indeed he didn’t think they would be significant. Other than that, the test looked positive to him.

I don’t know if it was a side effect of the two scans/injections or simply a reaction to the generalized stress of my situation, but I was really tired the afternoon of the tests and the next day. Took naps of several hours duration each day and I’m not really a nap guy.

My friends, this cancer business is hard work I’m finding out.

Decision Delayed—Hold On There!

2005-06-15T19:55:00.000-07:00

On May 31, Doc Crouch recommends High Dose Radiation as the treatment method because the tumor is contained within the prostate gland. The treatment involves inserting 17 hollow, plastic needles (about one-eighth inch in diameter) into the gland so that the tips of the needles surround the tumor. Radioactive probes are then threaded down the needles and shoot their dosage directly into the tumor from short range. The whole thing is computer controlled and highly accurate I am told.

My big concern at this point is the accuracy of the conclusion that the tumor has not spread out of the prostate. So I ask what evidence he has to support the conclusion. If the treatment is limited to just the tumor found in the prostate and even a small infection has migrated somewhere else, it would be bad. The Doc says the fact that my PSA, although elevated (at 9.4) is not up at the level that would indicate a widespread problem (hundreds or thousands). Nonetheless, since my life could very well depend on the accuracy of this conclusion, I ask for further tests and he readily goes along with the request.

He orders up a Pelvic CT Scan and a Bone Scan. A few days later I report to Radiology.

Research—Digging It Out

2005-06-14T17:25:00.000-07:00

This step was pretty straightforward for me. Five years as a free-lance writer gave me some fair proficiency on the Internet. I spent several days digging through dozens of websites and found the following to be the most useful:

Yahoo (list of 25 links—a great place to start)
WebMD An Internet standard
Mayo Clinic A fabulous resource
Fred Hutchinson Cancer Research Center
Prostate-Help (run by an unaffiliated warrior who simply puts in the time to gather and evaluate material that might help others. There’ll be a very comfortable spot in Heaven for this guy.
Duke University Guide to Complementary and Alternative Medicine.

That list isn’t very long but several of these sites have links to other places and they have links and so on.

At the end of the week I felt ready to discuss the treatment options with Doc Crouch.

Status—June 14, 2005

2005-06-14T14:45:00.000-07:00

Looks like I need to jump ahead to the present and provide a current status.

I have an early stage prostate cancer. The tumor is small and contained within the prostate gland but is very aggressive in nature. Other than an elevated PSA and a slightly enlarged prostate I have no other symptoms—indeed, I feel just fine.

On July 12 and again on August 8, I am scheduled for High Dose Radiation treatments in Salt Lake City. I’ll be describing that process in more detail in other posts to come.

The docs tell me my prognosis is excellent because the cancer was detected early. On the other hand, the standard calculus in the cancer business is to predict no further out than ten years. Evidently, none of the numbers is reliable past then.

On the other, other hand, the side effects of the treatment have about a 20% chance of being severe. I’ll also cover that subject in more detail later on.

Related to that, I think I did have some unpleasant reaction to a couple of the tests (CT and Bone Scans). They unexpectedly knocked me on my butt for a couple of days. I can certainly imagine that my reaction could have been caused purely by the stress of all this which is significant.

Anybody at age 65 knows they are going to pass on some day but learning you have cancer certainly gets one’s attention and rattles the confidence.

I’ve been awfully lucky to be able to remain as active as I have been at this stage and it has been a hard mental challenge to think I may have to slow down or stop some of my activities. For those reading this who don’t know me personally, I’ll be posting a bit more about myself later as well.

Bottom line is my condition is causing me no physical distress. I am scheduled for treatment to begin in less than a month and my chances are as good as could be hoped. If I have to play in this game, it looks like I got dealt a pretty good hand.

Biopsy Results--the Ax Falls

2005-06-14T09:52:00.000-07:00

“You do have some cancer in the prostate,” doctor said, his voice flat and neutral. His name was Crouch and he had had this conversation thousands of times over 25 years.

It was my first time, however. I have no idea what I mumbled in reply as my emotions tumbled around.

The bad news is the tumor has a Gleason Score of 8/10—a very high score indicating the tumor is aggressive and thus quite dangerous. On the plus side of the ledger, Dr. Crouch tells me the tumor is small and contained within the prostate gland. This is a critical finding for it means the tumor was found in its early stages and treatment can be localized. The trick is to kill it before it spreads and this gives us a chance to do that. On the other hand six in ten of these tumors spread outside the prostate in the following ten years of the patient’s life so, no matter how great the treatment results are, this little beast must be dealt with for a long time.

I really appreciate the next step the doctor took. After explaining the details of my situation, he told me to come back in a week to discuss treatment options. “Get on the Internet and do some research,” he said. “Talk to someone who’s gone through this. Then we can talk.”

He then briefly explained several treatment options so I would have a better idea of where to focus my research.
Not having to make a treatment choice at that meeting was very comforting. Additionally, I started to feel that I was a partner in and not just the recipient of the treatment. The sense that I had not lost control was important somehow and this feeling would intensify over the next few weeks.

The Biopsy--Going Boldly

2005-06-13T22:13:00.000-07:00

No fun here. The procedure itself wasn’t really painful but it was definitely unpleasant mainly (I suspect) because the lubrication seemed inadequate. A good description of a prostate biopsy is found (here) on the Mayo Clinic website (which I highly recommend, by the way). In my case, 12 tissue samples were taken spread out in a pattern across the surface of the prostate gland. Each time the needle gun fires, it makes a sharp, hard rap way up in your innards. Ugghhh.

It was particularly unpleasant when the doc had to twist and probe with both the needle gun and ultrasound wand and the whole thing starts feeling like he’s using a fence post back there. One of those split rail jobs with all the splinters. With chunks of barbed wire still attached.

The whole thing lasted 30 minutes or so and I drove myself home. It was mildly uncomfortable to sit for two or three days after that.

Just a note here—when these guys use the word “digital” they don’t mean computerized.

Without a doubt the worst part of the biopsy, however, was having to wait two-weeks for the results.

Why I Got Tested--The Eyes Have It

2005-06-13T12:07:00.000-07:00

I have recently been increasingly bothered with eye problems. The slightest irritation—glare, dust, wind, even watching a movie or a play—made them water like crazy. The incessant burning and itching finally drove me to see Dr. North, our family doctor, to arrange an appointment at the eye clinic.

North was actually my wife’s doctor. I hadn’t seen a doctor for over seven years. Like many men of my generation (I turn 65 in a few weeks), I have an irrational dislike of the medical profession. Always have had.

Because I had gone so long without one, Dr. North ran a standard blood test. It revealed an elevated (9.4 compared to 0-4.5 normal range for my age) PSA (Prostate Specific Antigen) indicating the need for further testing. A biopsy was ordered which subsequently revealed the tumor.