6 month check. A very scary week

Before I begin let me say that I'm fine.  If you'd have asked me that two days ago you would have received a very different answer.

Guys, pay attention.  This could prevent you some grief in the future.

I went in to my Doc at the Seattle Swedish Prostate Cancer Institute, whom I would highly recommend, for my six-month check.  I didn't think that this would be anything other than the 'how you feeling, PSA looks good, see you in 3 months' type visit.  Although I have been having some frequent and very unpleasant GI issues and was wondering how much the radiation was causing my symptoms.  After discussing what was going on, the Doc reassured me that what I was experiencing was unrelated. (Good I guess, but now I have another battery of tests to go through.  I'm assuming it's an ulcer.)

He excused himself to go get my PSA results from the blood work I had done that morning.

If everything was in order I should see a PSA lower than 2.0, or somewhere around there.  Pre-brachytherpay my PSA was at 4.4.  At three months it was 2.1.  So this check should be lower as the cancer cells continue to die.  There is a thing called the 'PSA Bounce' that occurs in a certain percentage of men around the 1 year mark and is expected, but I'm 6 months away and should still be on the decline.

So when he came back into the office with a concerned look on his face I knew right away something wasn't right.

"Hmmm . . . ", he said, scowling at the paperwork he held in his hand, "well.  Looks like your PSA has climbed a bit."

"Oh.  Okay.  What is it?"

He looked again.  "3.0."

That's a jump of almost a full point.  Not good at this stage of the game.

"Wow", I said, somewhat in shock, "I wasn't expecting that."

"Me either," he said.

We then discussed what this meant and he was very kind and reassuring but in my head it was a very different story.  All I could think about was all of the people in my life that had passed from cancer, and how it always started with "You're going to be fine." and then the "Well, we've hit a little snag in the treatment."

Was this my 'little snag'?

We talked about the PSA 'bump', and the percentage of men that don't respond to brachytherapy and everything under the sun.  The bottom line was that while he was a little concerned he thought we should stay the course and check again in three months.  If the PSA doubled, or continued a steady climb for the next 6 months then it would be time to worry.

Easy for him to say.

We talked about the kinds of thing that can effect PSA.  Vigorous exercise, sex, motorcycle or bicycle riding - any of these activities performed within 3 days prior to the test could give a false reading.  I had been swimming - quite hard - in the days before the test.  He also explained that different labs could give different results.  I did have the 3 month and 6 month tests done at different labs, but he explained that for discrepancy to be that large would be highly unusual.

I knew all of these things on an intellectual level, but the visceral part of me could only imagine the worst.  I'd read other case histories of men whose cancer metastasisized, breaking the boundary of the prostate to attack other organs and areas in the body, or a prostate cancer that suddenly became very aggressive.

And, let's admit it.  I don't have a great track record when it comes to health.

So, as I'm sure you'll understand this made for a very, very long weekend.  Talk about the extremes of emotion.

I thought long and hard, talked it over with Suzanne, and decided that I would have my PSA re-checked on Monday - at the same lab where I had it tested before - as I had to go into my Doc for my stomach issues anyway.  It would be a good time as I hadn't rode the bike in over a week, hadn't been swimming for a few days, and with the way we were feeling sex was about the last thing on our minds.

So, into the Doc I went.  Got the blood drawn and then had to wait 24 hours for the results.

It was a long, long, long 24 hours.  Thank God for 'Skyrim - The Elder Scrolls'.  Killing Dragons and Falmer with my 'Ebony Gauntlets of Major Bitchslappery',  (They shouldn't let you name your own weapons in Skyrim),  kept my mind occupied so it couldn't cannibalize itself.  Video games have once again saved my life.    So take that Florida Rep. Chris Stearns.

Yesterday afternoon I walked into the clinic, picked up my paperwork, and took a deep breath.  I'd prepared myself.  If the number was higher then that would be confirmation - for me anyway - that something was wrong.  I could handle it if the PSA was the same or slightly lower.  That was my best-case scenario.

I couldn't even wait to get away from the labs reception desk.  I looked.  Did a double take.  Looked again.

The PSA was 1.6.  Exactly where it should be.  Almost half of the test a week ago.

I gave a shout of "YES" and, I'm not too proud to say, a mighty fist-pump.  Which I'm sure was highly amusing to the people in the waiting room but didn't matter to me at all.

So men, if you take anything away from this remember:  If you're going to have a PSA test watch the exercise, the sex, and anything else that would put pressure on or squeeze the prostate for a few days prior.  And if you get an aberrant reading, get it tested again.  And again if necessary.  Everyone makes mistakes.

Me?  I'm so relieved I don't even know what to say.

I'll keep you posted on the progress.

Little to report, but an interesting article

Nothing really to report.  Everything is chugging along quite nicely.

I will go see my oncologist next month for my 6 month check and PSA.  I'm not expecting any surprises, but I'll let you know what the good Doc says.

In the meantime, here's a very interesting article.  Well worth the read for anyone with prostate cancer, or a loved one with prostate cancer.

http://www.sacbee.com/2012/01/31/4227238/prostate-cancer-surgery-myths.html

Chugging along

I've said it before, but no news is great news. :)

I'm doing well.  Still a little burning and the occasional start-stop-start when urinating, but if I had to live with this level of symptom for the rest of my life I would feel like a very lucky man.

Onward to a new year!

No News Is Good News

Nothing really to report, which is good news.

I'm playing the same 'symptom - no symptom' game.  Still have some burning and pain but nothing extreme.

The fatigue and nausea are almost completely gone.  I'm back swimming 4 days a week, and while I'm not up to my peak-performance workouts I'm still managing 2500 to 3000 yards a day.  My stamina has grown by leaps and bounds over the last two weeks.  It's nice to feel myself getting stronger instead of weaker.

So, no news is not only good - it's great.

Mummies with prostate cancer

A very fascinating read.

Mummy Had Prostate Cancer

Some things don't change.  But I'm damn glad I live in the day and age that I do.

Good News Everyone! (Redux)

I went in for my three month PSA check this morning and everything is chugging along right on schedule.

My PSA dropped from 4.8 right before the procedure, to 2.09 this morning. That's great news.

We also discussed my persistent side effects. And, unfortunately, those are normal and on schedule.

So all-in-all I couldn't be happier.

I'll be checked again in three months. That will be the schedule for the next few years.

So . . . yay!

3 Months - The peak of radiation.

So, here I am at the 3 month mark.

The radiation has peaked, and should start dropping off which means my side effects should really start tapering off. Good.

I went in for a PSA test today, the first since the procedure. They will monitor the PSA every three months for the next two years. That's about the only way they have to see if the treatment was effective. The PSA levels can bounce all over the place for the first year or so with brachytherapy. So, I'm not looking for a miracle on this first test.

I'll see the Doc in a couple of days, get the results of the test, and take it from there.

I'll post when I know more.

The Problem With A Compromised Immune System

As I'm sure you'll understand I have a bit of a problem with my immune system.

This isn't something new - it is related to the Prolactinoma, and possibly the arthritis. But with the prostate cancer and the radiation it seems to be a bit worse.

Which brings me to last week.

I got, what I realize now, was a touch of the flu. But when you're sick any little thing sets of a roller coaster of turmoil. Is it the cancer? Side effects of treatment? Or, and this is the scary one, something new?

Because, you know, I just don't spend enough time thinking about my health. I would love to take a vacation for a few days. Unfortunately, it's impossible to vacation from yourself.

Well, not without anesthesia. :)

But I'm back baby! Ready to go. Now if I just had last week back . . . :)

And another week down

It's been an interesting week.

The fatigue is gone, the nausea is gone, and the other symptoms seem to each have their 'special day'. One day, I'll have a restricted urinary flow, the next . . . well, there's an analogy about a race horse in there somewhere. Use your imagination.

It's interesting. In a clinical sort of way.

The other side effects come and go. None of them are incapacitating. Just irritating. Well, and sometimes painful.

I'm also getting that feeling of 'sitting on a golf ball' that some patients have reported. That's okay, I don't like hard chairs. :)

I am very much looking forward to the next couple of months and slowly returning back to 'normal'. Whatever that is.

I had an appointment with my endocrinologist the other day. (For an unrelated condition - a Prolacinoma) I did not take the hormone therapy because this lovely little nugget I have in my noggin suppresses testosterone. I had been on bi-monthly injections until the diagnosis in April. Anyway, we were discussing when I could start the testosterone again because honestly - the side effects from the brachytherapy are irritating, but the lack of testosterone permeates every part of my life. It's kind of a double whammy.

It's not looking like he will be willing to start the treatments any time in the near future.

That sucks.

Side Effect Redeux

Well, I seem to be on a 'side effect' roller coaster.

Just when I think I've put some things behind me . . . BOOM! There they are again.

It's not incapacitating. It's just a little miserable. And annoying.

Dang will I be glad with the next few months are over.

Of course, I also know that if I could get back on the bike my perspective would be much better. I really thought I would get to catch a little bit of summer, but no such luck.

Well, that's what heated clothing is for. :)

Exactly what I've been saying

I don't know why the doctors continue to paint such rosy pictures for normalcy after prostate cancer. Each of the docs I went to said "The other therapies leave significant side effects, but not mine."

Then they would offer reassuring words, give me a handout with statistics to back up what they had said, and out the door I went.

Here is the sobering truth.

“I had surgery by a doctor who said 98 percent of my patients are perfectly fine,” said Mr. Nelson, now 51. “Of course, I wasn’t perfectly fine.”

The Side Effects? Well, There Is One...

Realistic expectations MUST be communicated. Otherwise you set men up for a double-whammy.

But I have a feeling that it once again comes down to money. Physicians don't follow the #1 rule of a great business - under promise and over deliver.

But then again, we don't have a lot of choice, do we?

Guess I didn't know . . .

You ever notice that sometimes you don't know how sick you are until you start to feel better?

That's what happened to me this weekend.

Finally the fatigue and nausea lifted. I've actually spent the last 5 days or so with little to no nausea. That's a big difference.

And a welcome one.

But it does make me look back over the last few weeks since the procedure, and realize that I have been very, very sick.

I think one of the main things that has bothered me about this whole process is that every piece of literature I've read - regardless of the method of treatment - lists the possible side effects but ends with 'but you'll be fine'. So, we expect to feel bad for a couple of weeks and then get on with our lives close to normal.

A few weeks ago a study came out showing that men that have had prostate surgery are deeply regretful about 2 years after the fact. The medical community kind of tossed it's hands in the air and said that the patients were 'overly optimistic' regarding their recovery and the life-ling impacts of the surgery. They couldn't understand why the men aren't getting the message.

Life After Prostate Surgery Worse Than Men Expect

Well, that's because side effects are downplayed. In the literature AND in the physicians office.

Over-promised and under-delivered. That's a recipe for dissatisfaction.

I'm still glad I had the radiation. I think.

I guess we will have to see where the next couple of years takes me.

Whine, whine, whine

Okay, I think I've been very patient. Hardly whiny at all.

Mostly.

Ask my wife Suzanne. She will tell you that's one of the first signs of me feeling better.

But now that I can no longer ignore the fact that it is fall - after a full three weeks of summer here in the northwest - it's ticking me off that I can't ride my bike.

I know, I know . . . small price to pay and all that.

But my motorcycle is what keeps me sane. Honestly. Riding is a form of therapy - a zen-like state of machine melded with the forces of physics into a symphony of gravity and acceleration. Punctuated only by teen-age girls on cell phones.

It has now been a little over three months since my posterior graced the saddle, and I'm gettin' a tad twitchy.

I know that I still have a couple of weeks to go before my butt hits the seat. And as I watch the days get shorter and the temps fall, it feels like I'm in a race for those last few magical days of non-rainy riding.

In the meantime I plan to start back on my regular swim schedule. The local pool has been closed for a bit and now that it's all shiny and clean, it's time to get back to my other home - the water. I won't be back to full workouts for a while, but I know swimming will be a boon to my soul as well as my body.

But still, it's not like a few hours riding around Mt. Rainier, or hopping over Chinook pass. Twisting and turning up those hills with Suzanne in the seat behind me, stopping for lunch or a picnic beside a quiet river - that's what's required to make me feel . . . normal.

That's really all the therapy I need.

A rant on life by Dennis Leary

Ran across this first thing this morning and I thought I would share:

“Most people think life sucks, and then you die. Not me. I beg to differ. I think life sucks, then you get cancer, then your dog dies, your wife leaves you, the cancer goes into remission, you get a new dog, you get remarried, you owe ten million dollars in medical bills but you work hard for thirty-five years and you pay it back and then -- one day -- you have a massive stroke, your whole right side is paralyzed, you have to limp along the streets and speak out of the left side of your mouth and drool but you go into rehabilitation and regain the power to walk and the power to talk and then -- one day -- you step off a curb at Sixty-seventh Street, and BANG you get hit by a city bus and then you die. Maybe.”

--Dennis Leary

The Doc Visit And Pesticides

So my Doc visit two days ago was a non-event.

Quick physical check, a few questions about side-effects, and I was given two thumbs up and a 'right on schedule'.

That's good news. No, that's great news!

Doc was also ecstatic that the placement of the seeds were "spot on", and he estimated target coverage at 98%. That's also great news.

But it still astounds me that something that looms so large in my life is, in reality, just a blip in the machinery of modern medicine. Day procedures and follow-up visits. Honestly, when I had my gall bladder out back in the early '90s, (and yes, this was RIGHT before the laparoscopic procedure was developed), it was a much larger event than this prostate cancer.

It's not that I want to be in the hospital, or undergo a series of procedures or radiation - I am very, very fortunate on that front, but I don't know how to explain it - it all seems sort of anti-climactic.

Now we follow with blood tests every 3 months and watch the PSA levels.

The radiation will peak in another month and a half, then start a slow decline as the radiation from the seeds begin to diminish. So a few more weeks of intense side-effects and then a gradual decline.

That will be nice.

Of course I also understand that I'm not out of the woods just yet. That story will be told over the next 18 to 24 months as we watch the PSA. I'm not really concerned - I'm just going to assume that the radiation did the trick.

That's kind of the way I approach most things anymore: I can either dream and fantasize failure or victory. Cure or curse. Whatever I spend my time contemplating isn't going to change the outcome one iota, so why not think positively? Otherwise I'm thinking of all the horrible things that could happen, and doing that - and you'll have to trust me on this - robs you of today. That's no way to live.

So, now you are all caught up.

As I've said before there are a slew of reports that come out everyday concerning prostate cancer. My inbox is stuffed every morning with articles and new drug therapies and all the latest advances. Some are encouraging, some are not.

One that caught my attention is this one:

Pesticide - Prostate Cancer Link

Well pugnuts. Yes, I said pugnuts.

I grew up in a small town in eastern Washington until I was 9 years old. My family then moved to 'the coast'. Which, for anyone living in eastern WA meant everything west of the Cascades. Like most of the people I knew, our house was surrounded by apple orchards. And I mean surrounded. Huge orchards that stretched forever. The apple trees bordered my backyard - and continued across the dirt road in front of my house for another good stretch. Other huge tracts of fruit trees lined the two-lane highway that bisected our small town. I could almost chuck an apple from my front yard across the blacktop into the other orchard.

I guess looking back it was one huge orchard with a few houses clustered here and there.

I also remember the tractors pulling the big tanks with the huge fans on the back that drove between the trees flooding the orchard with pesticides. Sometimes it was my Dad driving. He would come home for lunch - his clothes literally dripping with the stuff - and the house would fill with the peppery/chemical/acrid odor of the spray.

But my family followed safety precautions. I wasn't allowed to go outside to play until the fog had settled, and I had to stay at least two orchard-rows away from where they were spraying. Then I had to be careful not to walk under the trees while they were wet and dripping but we were kids and didn't listen as we should.

I won't even get into how they kept the frost off the trees back then. Let me say that it involved hundreds of 'smudge-pots' lining the rows, filled with oil - coal oil I think - and set afire to keep the frost away. I always knew when the mornings were cold because the thick smokey fog permeated everything, seeping into the house like an unwelcome guest.

Now I realize just how horrible all of this sounds. But it really was a different time. My family had been working in and around orchards for years. It was just part of the job and not a big deal.

Now you tell me times haven't changed.

And for the better.

But still, I think back and wonder how many of my health problems originated in those orchards.

Probably more than I would ever want to know.

My First Doc Visit

Today I get to go see my Doc.

This will be the first post-procedure visit.

I hardly know what to expect. Oh, I know I'll be poked and prodded - that's a given - but beyond that what will transpire will be a mystery.

There will be a lot of talking, of that I'm sure.

I'm doing better than I was last week. And certainly better than the week before, so there is progress. Just not fast enough for me. :)

And I probably won't mention all of the stupid stuff I did at my daughter's wedding last week. I'll just skirt that issue thank you.

But for some reason I'm a little nervous.

I'll let you know what happens.

I Loves Me A Good Joke

So, I've lost a little weight.

It's the nausea and fatigue.

I haven't lost a tremendous amount, but enough that people are noticing. And they tell me, repeatedly how good I'm looking.

To which I reply, "It's that new cancer diet. It's effective, but I wouldn't recommend it."


LOL. I crack me up.

A Little Over A Month In

Been a busy couple of weeks around the old homefront.

My oldest daughter was married to a wonderful man, and the wedding came off without a hitch. We couldn't be happier.

With the wedding came two-weeks of frantic preparation, family in town, new family in town, dinners and airports and a general level of chaos that's pretty rare around the empty nest these days.

I did pretty well, although the fatigue and nausea are my constant companions. Add the arthritis and it makes for some difficult times.

They keep telling me that only two more months and the side-effects should subside. Can't happen soon enough for me.

I had someone come up to me after the wedding and ask me if I was having a good day or putting on a 'stiff upper lip'.

Well, a little of both. I danced with my daughter sans cane, was on my feet more in one day than I usually am in a week, and never stopped moving for hours. But it was worth it.

Sometimes you just have to push on and pay for it later.

Back to the pool

Got back in the water for the first time in a month yesterday.

It felt good.

I took it very easy, completing abut 1/3 of my usual workout, and even that wore me out a bit.

Still, the physical exercise does wonders not only for the body, but the mind and soul as well.

And, it was REALLY nice to get back to some sort of a routine, even if that routine is an abbreviated version of my regular day. It makes me feel 'normal'. Well, normal for me.

Plus I've got a huge group of friends at the pool. It felt like going home again. If by home I mean a wet, humid, chlorine-filled environment.

Every day is a little better. I know I'll have my ups and downs, as everyone does, but it's nice to see some progress.

Damn Cancer. Always with the problems.

Well, the nausea and fatigue didn't really go away - it just changed patterns.

That should not be allowed by the rules.

I like my life like I likes me womenz: Strong, dark, and bitter.

No wait, that's not right. That's coffee. OH! I know! I like my life to be somewhat consistent.

Stop laughing.

Anyway, I'm still experiencing some secondary side-effects. They get worse, then they get a little better giving me some hope that I'm on the downhill side, and then they get worse again.

I can handle the discomfort. I can handle the pain. I can handle the nausea and fatigue.

What I can't handle is every time I go to the bathroom wondering if the next time I'll have to be cathed. Interesting, because I've become a tad phobic about being cathed. (You can't see me right now, but I gots me a case of the 'willy-shivers' going on.) And it's so stupid, because I've been cathed quite a few times and while uncomfortable, it really isn't that big of a deal.

So, this will be the pattern for the next few months to a year. Although, if I can make it a couple more weeks, the odds that I'll have to have 'the tube' drop significantly.

I think it's more the idea than the physical actuality.

But, that's a hell of a lot of life, isn't it? The reality is often much more benign than thoughts that precede. Stupid humans.

There have been a couple of times over the last few days when I wondered if I'd selected the right treatment. With surgery it would have been done. Over. On to recovery.

Now it's like pulling a splinter out of your finger ever so slowly.

Of course with surgery it would have been like amputating the finger to get the splinter.

Damn cancer. Always with the problems.