The Bell and the Micro Nuclear Air Strike

The Final Bell

Some serious catch-up is in order. I did finish the external beam radiation after five weeks of treatment. When you are done, you get to walk down the hall and ring the bell, which I did. Everyone in the Cancer Center and the John Zay house was kind and supportive, both the staff and the patients I came to know over my five weeks.

The radiation treatments were in themselves painless but the effects on my bladder and urinary system were not. There was a little pain during urination but the worst effect was the diminution of bladder control. Urgency took on a new meaning for me.

I remained on my hormone treatments during the holidays and in January my wife Barbara and I made ready to go to Seattle for the brachytherapy. I had been accepted as a patient by Dr. Peter Grimm who is one of the pioneer medical practitioners in this field. I had met with him in November and we spent a detailed hour together discussing the data he has accumulated over the years to indicate which would be the best treatment course for me. I like data, especially good, accurate data, which Dr. Grimm had aplenty. Next up was the actual brachytherapy itself, scheduled for January 14th in Seattle during which he would call in what I referred to as a micro nuclear air strike on the cancer in my prostate which was still reeling from the external beam attack in Colorado.

Of course, when Barbara and I began our three and half hour drive to the airport in Denver, it was cold, snowing and the roads were icy. We made it on time, put the car in the long term lot and took off for Seattle.

On Wednesday morning, up way too early, we caught an Uber ride to the surgery center.  For some reason I wasn't nervous, like I anticipated. Everyone was both professional and very kind. After dressing in my funny clothes and meeting briefly with Dr. Grimm,  I walked into the OR, go on the table and while the anestheologist was hooking me up and we were chatting about something I awoke in the recovery room two hours later.

Details aren't really necessary except to say that, as I was told earlier, the recovery was over about a two month period, made difficult by both frequent and painful urination. I got up one night six different times, although that was the record. I have medication to help which it does. I am now tapering off of that and slowly getting back to normal. My PSA dropped to 0.05, or basically undetectable. I am getting off the hormones and will be monitoring the PSA every three months. The latest studies show the treatment I have done is about 95% successful over ten years.

The most important things I have learned are: if you have prostate cancer, take your time to understand what kind (aggressive or "normal"), get an oncologist, not a urologist or radiologist who are specialists and want to practice their specialty. Most men do not need to rush into treatment. Don't do anything until you have at least another opinion from a non-specialist. I learned that you should buy and read "The Invasion of the Prostate Snatchers" by Sholz and Bloom. You should get on the PCRI website and read all you can. Don't listen to rumors, Google and people who are free with medical advice but not the knowledge that should come with it.

I've learned that life is short, it's all you are going to get, so live it with gusto and quality.

If anyone needs to talk about this further, comment on this blog and I'll send you my email address or call you.

If It Had Been a Snake...

My grandmother used to say to me, when I was looking for something that was obviously around but I just couldn't see it, "If it had been a snake it would have bit you." True enough.

I used to think this applied only to physical objects that had been placed so obviously in view that they disappeared, but now, having been through the radiation therapy part of my cancer battle (we won't know if it is 'cured' until later, if ever), I think that the snake analogy works for other, more important and non-material aspects of life. Like, living it.

I've read a few books quite a number of times, books that have a particular resonance with me, and Hemingway's The Sun Also Rises is near the top of that short list. I am reading it yet again, finding things in there that, while I must have previously read them, didn't stick in my memory. One of those is where Jake Barnes is thinking about life. He says,

"I did not care what it was all about. All I wanted to know was how to live in it. Maybe if you found out how to live in it you learned from that what it was all about."

After years of reading and searching and talking about life and it's possible meanings for me and everyone else, this was like the snake that could have bitten me.

There are a gazillion interpretations and beliefs of the meaning of life, including Monty Python's, and, obviously they can't all be right. I suspect that it is an unanswerable question and has no real meaning in respect to how and why a human lives. I certainly don't cotton to anyone else telling me what life means and how to live mine. How could they know? I discount supernatural answers, forces and beings from consideration. That's the same as saying we don't know.

Now, after hearing the doorbell of mortality ringing, ringing for me, I think the answer to the meaning of my life is like that snake, only, this time it bit me. Yes, now I want to understand how to live in it, and maybe, as Jake thought, that might teach me something about what it is all about

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Next to Last Day

Tomorrow will be my last radiation treatment day. Aside from some urinary changes and increasing fatigue I am handling this OK. In fact, I have come to the notion that having prostate cancer has been a kind of wakeup call for me. We all know that everyone is going to die, but somehow, that doesn't apply to us. Well, when you get the cancer greeting, that exemption suddenly expires.

Why would this be a good thing? It could be worse, and it provides a good reality check. Just what the hell are you doing with what's left of your life? Waiting for something so that something else will happen? Putting off dealing with that little dictator in your head that talks to you all of the time about crap you really should care less about? Beginning to wonder what actually happens to people, or the consciousness that identifies individual people, after they die? More importantly, wondering what kind of life one wishes to lead during the time left. That's what PC did for me. Woke me up.

 

Be Cheerful, sir.
Our revels now are ended. These our actors,
As I foretold you, were all spirits and
Are melted into air, into thin air:
And, like the baseless fabric of this vision,
The cloud-capp'd towers, the gorgeous palaces,
The solemn temples, the great globe itself,
Yea all which it inherit, shall dissolve
And like this insubstantial pageant faded,
Leave not a rack behind. We are such stuff
As dreams are made on, and our little life
Is rounded with a sleep.

- Prospero
The Tempest
Shakespeare

Well, everything in the world has been bloody sanitised with health and safety, hasn’t it. There isn’t really anything left in the world where you can go out and actually kill yourself. I like being in control of my own destiny, really. You can go out racing on your bike, make one little mistake, and that’s it: you’re dead. I love all that. Being so near yet so far.

Guy Martin

 

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Twenty Down, Five to Go

It's been pretty routine so far. Today I finished treatment #20. Five to go and I'm ready for that. I've suffered few side effects, other than being separated from my wife and home for too many days, living here in Colorado Springs during the week. I could feel it today. I had a good night's sleep and still awoke tired. I sometimes nod off watching a video. I yawn more than I used to.

So, today I think I'll climb into the car and go back to my Japanese restaurant and treat myself to some good food. I'm keeping my weight pretty even, which is sometimes a problem especially on the hormone treatement program that I am also doing.

For any of you in my general situatioin, I'd say it's important to do new things. Get outside. Excercise and get your mind involved in new things and new situations. Break the path to depression.

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A Lonely Weekend and a Broken Car

So, bad news follows bad I guess. I took the car into the dealer for a checkup while I am living here in the "big city" and was told that it has problems. It's running and all, but sometime not too far down the line, it will need some serious maintenance. Now, I love my car. I've had it since it was new and it's served us well. Besides, it's fun to drive, but it's also approaching eleventh year and major issues can be expected. So, on top of everything else, I have been car shopping, which, as you know, can suck. I've finally narrowed it down to two dealers and am looking for the best price. Now, all I have to do is figure out how to pay for it.

I stayed here over the weekend because we are moving treatment up to Sunday so that I can leave for home after my Wednesday treatment and spend Thanksgiving there. I'm really looking forward to it. I miss my wife and home and need a break from this routine. Up in the morning and make myself have a good breakfast. Make sure I drink enough water before the treatment so my bladder is extended and out of the way of the radiation beam. Walk across the street. Check in with my own bar code badge and wander down to the radiation reception. I'm beginning to see familiar faces waiting their turn.

Last week while I was waiting, someone down the hall struck a large bell three times. The sound rang though the ward and people applauded. Hanging near the entrance to the radiation area is a real, brass bell with a small hammer attached. When a patient is done with the course, he or she gets to smack the bell three times, signaling that their course is over and they are going home. Man, I'm gonna smack that thing pretty soon.

This weekend has shown me that the most difficult part of this so far is the fact that I have to be away from home and from my wife for five weeks. Living alone is not what some people fantasize. I've had friends tell me that they would love to live by themselves but I think now that they don't know what they are talking about. If that's the way one has been for years then it's probably no big deal (but I might not believe that either) but for me, not having my wife and friends around, not being in my home or own bed at night is more like punishment. Sure, you can go visit a museum, eat out, go to a movie, walk in the part, wander around downtown keeping an eye on the crazoids, but when that's done, where do you return? To a small empty apartment with really nothing much to do.

OK, pity party over. I've got only two more days and I get to go home. For a while.

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In Treatment

Since my last post, I've essentially moved into the John Zay Guest House in Colorado Springs which is across the street from the Cancer Center at Penrose Hospital. We found this place by my doctor telling us that the hospital has a place where I might stay during my five weeks of radiation treatment. I had a kind offer from a friend to stay at his place, but it is half an hour or more outside of town and, being winter here, the daily commute to get my treatment might have been subject to the weather. In fact, the first week I was here was extremely cold and, of course, snowing. Here, at the John Zay House, I only have to walk across the street, and believe me, when it is 7º outside and the wind is blowing, it can be mighty cold.

The hardest thing about this is not the treatments, they are relative quick and painless even though they have to be done regularly. It is the need to be away from home and my wife. She is so important to me, and such a support, that being half way across the state from her is hard. I'm sure it is hard on her as well and I so much appreciate her taking care of our home while I'm here.

The house here is full of people undergoing various health issues, or supporting family as they go through healing and treatment, so we share a lot in common. One thing, of many, that has come from having and dealing with cancer is that I am much more open minded and polite that I was before. Dealing with a serious illness, or condition (I don't feel particularly 'ill') is that one's perspective on life and what it is about changes. Moreso than in the obvious ways. There has been, with me, a subtle and fundamental change in how I fit into and relate to the world. I don't think there is any reason why I, or anyone else, exists but I do think I have an obligation to be kind and helpful and as little judgemental as I can be. This, especially for me, is not easy, but understanding that we all have a short time on the earth and what we do here amongst our loved ones and neighbors is important to the quality of our lives and perception of ourselves is making me a better and more peaceful person.

Every day I walk to the Cancer Center, check in with my own bar-coded badge and walk back to the radiation thearpy area where I'm always greeted cheerfully by the technicians there. When my turn on the machine comes, I get my warm blanket and lay back on the table. My feet and legs are supported by shaped dense foam pads and I'm given a large foam donut to hold. This keeps my hands occupied and my arms from floating around. When the treatment starts and the machine moves, clicks, whirrs and whines around me, I have found it easy to begin a kind of meditaton in which I concentrate on my breathing and the environment around me. When thoughts come, I recognize that there is a thought, then somehow send it on its way recognizing it is a thought and not the thinker. I manage to become, for brief moments strung together, part of the world around me, not apart from it, an observer, but more of an experiencer. Difficult to describe.

Soon, some indeterminate time after it's begun, it is over. I leave and walk to the hospital cafeteria for lunch. It's a good place to eat since they offer both nutritious and mostly well-prepared food at very reasonable prices. Then I have almost twenty-four long hours before I get to do that all over again.

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Tattoos

I don't have any tattoos, even after eight years in the Navy and traveling around most of the world, I managed to avoid them. Not that some aren't interesting. A good friend in the Navy, Chuck Soper and I, used to visit the tattoo parlors on Broadway in San Diego and watch the sailors and Marines getting inked there. None of the available tattoos were really appealing though and we never got drunk enough to just get one for the hell of it.

A few years later when my ship pulled into Pearl Harbor I went to the sub base to visit Chuck who had been stationed there after our various fire control schools. At lunch, he showed me his new tattoo. Seems he had gotten involved with a local woman who knew this old Chinese tattoo artist in Honolulu. The man was a traditionalist and made his own tattoo needles from bamboo. He laboriously pricked the ink into the skin by hand, working from his own designs. Chuck had a marvelously done dragon entertwined among bamboo. I loved it. But, learning that it had taken a couple of months to complete, and me having only a few days in port, it was not to be.

My wife got a tattoo in California when our children were young. A nice bracelet with two pendants engraved with the initials of our kids.

Now, on Monday next, it appears I'll be getting my first tattoo. I'll undergo a "dry run" for the beam radiation treatments that will locate the exact area to be zapped during the upcoming real treatments. To mark the spots, small tattooed dots will be place into my skin. Not exactly what I had in mind, but you have to go with what works.

I have been considering getting an actual artistic tattoo to commemorate this part of my life and to remind me of what is important and inevitable for all of us. I'm leaning toward a colorful representation of The Day of the Dead sugar skull. We celebrate The Day of the Dead here in the southwest USA because it is a time of remembrance and respect for those who have gone from us. It's a journey we all must make and the life we lead toward that end is important. This has become increasingly obvious to me of late.

Something we all should consider when we are sidetracked by life's clamor and craziness that is really irrelevant to living a good life as we can.