Driving Kate to Lisa’s office for her annual physical, then heading on to Lone Tree, another 20 minutes. Dressed in blue sweats and my radiation hazard t-shirt from Los Alamos. This first day I’m going to choose The Band for my Pandora station. Tomorrow baroque.
I had a light supper last night, as suggested. Egg drop soup and a cookie. I’m on my second glass of water this morning. Hydration is important. I want Patty to tell me again that my bladder’s a perfect size.
Woke up at 3:30, not ruminating, but uneasy. Went back to sleep for an hour. Up at my usual 5:00. Fed the dogs, got the paper. Came up here to the loft.
The next seven weeks are about healing, staying with the protocols, adjusting to the unknown. Not daunting, but not easy either. Tomorrow is the Lupron injection.
Leaving the mountain top, going down the hill. From cool (44 right now) to hot. 75 at noon in Lone Tree. Well, that’s hot to us. Will get hotter as the weeks roll by.
Tom and the Woollies are going boating on Lake Minnetonka today. A floating meeting. Tom will motor over from Shorewood to a Wayzata dock to pick up the guys. A better parking lot, a bit easier access from the Cities. Had my druthers, I’d be there instead of staring at the Cyber Knife listening to When They Drove Old Dixie Down.
Father’s Day. A Hallmark holiday. Yes. A secondary holiday to Mother’s Day. For most, yes. Yet still powerful. Powerful enough to generate happy moments. Guilty moments. Moments of regret.
Not an easy day for me relative to my Dad. With Jon and Joseph, it’s wonderful. And when I extend the idea to grandfather, it becomes sublime. Why? They will live on, into the hot and dusty future, carrying the life of our family, its values. In a straight line? No. But that’s as it should be.
Not sure how often I’ve written about my father here. Let me say this. He was a man loved by many. In our small town of Alexandria most knew him and liked him. He walked its streets long after retirement, holding onto a small role for the Times-Tribune as its circulation manager. Oddly, a role I held for one year or two during high school.
I am his son. I write. I have strong opinions. I’m not afraid to express them and will not back down from a public fight. I’m curious about life’s strangeness, its uniqueness. After retiring, Dad would drive the roads of Indiana with his second wife Rosemary, looking for the river that suddenly disappeared into the earth or a small town with an unusual claim to fame. Like the giant paint ball in Alexandria.
I am not his son. I vowed to never let anything come between my children and me. Anything. Not choosing the military as a profession. Not repeated self-injury and a sometimes violent temper. Nothing will break my bond with them. Ever.
Yesterday we went to Biker Jim’s Gourmet Hot Dogs. I had the day wrong in my last post. Underwhelmed by the coca-cola drenched onions. My German veal hot dog was, meh. The fries, too. The chocolate shake, yumm.
I’m not giving up. There were many other choices and I chose the original, just to see what it was like. Jon said he’d bought hot dogs from Biker Jim’s food cart before he transitioned to the restaurant. I’m not giving up because from now on hot dogs, bacon, salami, pastrami and the like are now off my grocery list permanently. Carne vale. Farewell to meat. Processed meat, that is.
Ruth introduced me to, wait for it, fried macaroni. Oh boy. This is state fair worthy. Shoulda been on a stick. She had a Jack-a-lope hot dog, cherries and jalapenos. Very good, she said. Jon got the classic hot dog. Not sure about Gabe. Kate’s stomach was in its delicate mode, as it often is, so she had a chocolate milkshake.
Gabe gave Jon a coffee cup that holds a half-gallon. It says, I’ll just have one cup. That Gabe. Ruth got him a thermos with super powers. Jon’s done well with them. Their relationships, all of them, are much healthier now than a year ago. Their affection for each other is obvious and touching.
Jon and Gabe made me cards. I’ll take a photograph of them, but they’re downstairs right now.
This is my last weekend before radiation and Lupron change me. Strange to consider, but true. Though life affirming in their essence, both will alter me substantially. Radiation has the potential for long-term bladder and bowel damage. Lupron has the potential for, well, lots of stuff, but it is meant to be temporary. It’s easy to get focused on the side effects and forgot the non-side effect: kill the cancer cells.
Lupron cuts off prostate cancer’s prime energy source: testosterone. Radiation damages cancer cell DNA. Lupron is systemic so it affects every part of the body. Radiation is localized and the more localized the better. However. If too localized, it chances missing cancer cells that, if they survive, will begin replicating again and cause a reemergence.
There is a fascinating book by Faiz Khan, The Physics of Radiation Therapy, which describes in great detail how radiation therapy works. Khan is a professor emeritus of the University of Minnesota School of Medicine. His book is the practical manual for radiation oncologists, medical physicists, and dosists.
After having scanned some of the chapters, I have an appreciation for the difficulties and nuances involved in planning and executing my therapy. Without getting technical let me say, it’s really f…ng hard. Glad to have folks experienced in the 3-D version. They need (and have) both a high degree of knowledge and the leavening of that knowledge with experience.
This father, after this father’s day, will be irradiated. Weird. And, in a peculiar way, wonderful.
Kate’s stamina has improved so much. Thursday. Mussar in the afternoon and a board meeting in the evening. Last night we went to the Gospel Shabbat. The Beth Evergreen singers, supplemented by members of the Evergreen Chorale, were led by Val, a committed choir director with a lot of energy, plus a fine pianist added to the CBE band.
It was high, good energy and Kate stayed the whole time, including for a bit of the oneg. (oneg is snacks and goodies provided after a service.) Her hip bothered her a bit, but she walked and stood, clapped and sang. A real simcha.
Rabbi Jamie came by yesterday around lunch time to see how I was doing. We fed him chicken pot pie (mine) and watermelon, then he and I retired to my loft. He’s a good guy. A dog person. His first dog was a wolf hybrid, 105 pounds, that lived an astonishing 18 years.
He lost a dog recently to a porcupine. Awful way to die. But natural. We agreed it was a good death, both animals doing what evolution had taught them.
Tomorrow, for father’s day, Jon, Ruth, Gabe, Kate and I are going, at my request, to Biker Jim’s Gourmet Dogs. No less a foody than Anthony Bourdain recommended Biker Jim’s. Apparently he soaks his onions in Coca-Cola. After Biker Jim’s hot dogs will become a special occasion treat for me, no longer in my diet. Other processed meats, too. Gonna miss’em.
Each day now I’m privileging exercise over other activities. I usually get in at least two, aiming for three resistance sessions a week. Three now for sure. On the other days I do cardio, planning to start back on my interval training tomorrow. I want to get out and hike, but somehow haven’t. Just the press of things, I think.
Also, beginning Monday we’re going to focus on more healthy eating. Our diet’s not bad, but it could be better. Less red meat, more chicken, fish, pork. More vegetables and fruit. Importantly for the radiation, too, avoiding foods that cause gas. Why? Because of bubbles in the rectum. Geez, how silly that sounds. But it screws up the location of things in my gut. Bad for aiming the beam.
As Kate feels better, we’re gradually getting back to CBE. We both went to mussar yesterday afternoon and Kate went to her board meeting last night.
We also agreed to lead the discussion for a bagel table. A bagel table is a Saturday morning discussion held in lieu of a service on Friday night. This one will be on September 14th, after radiation is done and the Lupron is in full swing.
Here’s the description:
Wonderful! Thank you SO much – what a huge help! Basically, you prepare a discussion on the week’s reading (which for that week is Ki Teitzei / Deuteronomy 21:10 – 25:19). If there are enough people you can say kaddish, but you don’t have to. We will have bagels and goodies present for noshing; you may need to set them out but you won’t be responsible for buying anything. I think that’s it! If you come up with a theme for the discussion before mid-August, I can put it in the Shofar, but that’s not necessary either. Overall it should be a pretty easy gig. Thank you so much for agreeing to lead it!
Made a decision about the commute for radiation. Gonna go home through Deer Creek Canyon. Use the Canyon for its consolation. I did that today after picking up another O2 concentrator for Kate.
The sky was blue with cumulus clouds rising high above the mountains. Deer Creek ran fast down the canyon, fed by the now melting snow, late and in large volume. The rocky sides of the mountains, sometimes square, sometimes fragmented, sometimes rising in sheer cliffs sported lodgepole pines on either side of the road.
Looked up at the clouds. Then to the mountains, the rock, their height, lifting on either side of the canyon created by the running water, Deer Creek. Oh. We look at the mountains and we see permanence, stolidity. Mass unmovable and unmoved. We look at the clouds and we think evanescence, temporary. Gone as the heat rises or as the night cools.
But. We’re wrong. The clouds are only a visual manifestation of the water that is of this earth. It moves in cycles. Down the creek. Filling reservoirs and lakes. It evaporates and rises until, chilled by the cooler altitudes, it forms clouds. The temporary appearance of the clouds is an illusion, a trick of what Alfred North Whitehead would call a fallacy of misplaced concreteness. We see them as objects isolated against the blue sky. They’re not. They’re a particular manifestation of the water cycle and their essence, water itself, is not lost when the clouds disappear.
The mountain’s permanence is, as I’ve written here before, also an illusion. The snowmelt now feeding mountain streams all over the state takes a swipe, a soft swipe at the rock, dislodging particles created by the freeze and thaw cycles of winter. The lodgepole pines, scenic, supported by these rock behemoths, dig in, too, their roots spreading in crevices, forcing pebbles and small rocks to roll down hill. These are young mountains, these Rockies. Some day they will be rolling hills like the Appalachians.
Then, of course, there is the day itself. In this case warm, even hot. But the heat will flee the setting of the sun. Yes, the earth will continue to radiate heat, but not as much, when the sun sets. And the season, leaves coming, flowers blooming, deer fawns and elk calves following more mature animals, will get hotter and hotter. The fawns and calves will grow. The leaves will die back. Cold will come again. Another cycle.
I look at my hands on the steering wheel. These are old man’s hands. Wrinkled, blue veined, knuckles a bit swollen. My life is another cycle. I’m not permanent. Neither is the mountain. Neither are those fawns and calves.
This is maya. We see the cloud and think of its short existence. We see the mountain and think of its long existence. We feel the warmth of the day and imagine each day just like this one. No. The Great Wheel turns. It’s turning reminds us of the impermanence of all things.
Paradoxically though all things are permanent, too. They may change organization as entropy, the change agent of this universe, works its destructive powers, yet becomes the unwitting supplier of parts for the next mountain, the next human, the next cloud.
Next week Monday is my first radiation treatment. On Tuesday the first Lupron injection. The radiation continues every weekday until August 6th, which is both the Hiroshima anniversary and Raeone’s birthday. (Raeone is my ex) Not sure what to make of that. Also, Sunday is Father’s Day. I told Kate I wanted a Geiger counter. Hope she knows that was a joke.
Gonna try to have a little fun with this. Don’t want things grim, mordant. I found a gift shop in Los Alamos and bought a couple of t-shirts. Only found an image I could reproduce for one. I intend to wear both of them, off and on, for my treatments. As soon as they get here.
Been reading a book about Androgen Deprivation Therapy. Helpful. It may not be as bad as it sounds, at least for me. The longest I’ll be on Lupron is two years, probably less. The intense side effects seem to emerge over longer periods of time. Hope so.
In a twist not unlike prostate cancer treatment the day after Father’s Day and ending on the Hiroshima anniversary Kate continues to improve markedly as my journey heads into a difficult period. Her affect is almost bubbly. Sort of. Not sure Norwegians do bubbly, but she’s feeling good.
Her weight is at 99.4! Wow. 76 was the nadir back in February, I think. The j-tube feedings, with some minor exceptions, go well and she’s able to eat more, too. We had shrimp scampi, rice, and Brussels sprouts last night and she ate a full plate.
Our relationship has had the sort of strains that you might infer from a long, long bout of medically related bad news. Eight and a half months now since her bleed and she was not well before then. But open communication kept us out of any deep potholes.
Our partnership, this marriage that got started in the seats of the Ordway Theatre, St. Paul Chamber Orchestra concerts, is stronger than ever. I wrote much earlier that adversity unveils gratitude. So many people show so much caring. Well, I would add to that today that adversity deepens love.
Air conditioning is important in our house. Kate and I both prefer cool weather to warm, cold weather a lot more than hot weather. Explains our maybe incomprehensible to some commitment to living on top of Shadow Mountain. 8,800 provides natural air conditioning.
When the a/c in the 2011 Rav4 began to sputter three years ago, I began a series of missions to get it fixed. Cost me basically zero. I’d take it in, they’d put die (oops. dye. what’s on my mind?) in it, charge it up and not give me a bill. They never found a leak. This year I decided, time to solve this. But. As I wrote below, we’d end up with a $3,200 or so bill and no assurance that it was fixed.
I’m more tolerant of heat than Kate though not by a lot. It was time to do something. Buying a car (like buying a house) gives me the heeby-jeebies, I don’t like the sense of manipulation. I don’t want to get a bad deal. Yet, we need transportation and shelter.
Kate came out to Colorado, worked with a real estate agent and found our home here on Black Mountain Drive. I would have dithered. I asked Kate to head up the car situation. She did. We have a new car.
Kate, “Medical school trained the dithers out of me.” How? “Code red.” Oh. A philosophy major and a theology degree trained me in the fine art of dithering, the paralysis of analysis. Good thing I’m married to Kate. In so many ways.
Part of the urgency was anticipation of 70 hour long trips to and from Lone Tree for visits to the Cyber Knife. All in late June, July, and early August. Heat. Don’t need exasperation from an a/c-less car to go with radiation and Lupron. Bad combo.
Not an easy decision in a financial sense since it draws down the corpus of our IRA, but the now to be known as the white car was no longer adequate. Also, Kate and I have been musing over these last medical months that we don’t need to have our money last into our 90’s since we probably won’t.
At 6:30 am I sent Anova Cancer Care an email saying that, on rethinking my decision, I’d decided to do my radiation with them. When 8 am rolled around, I decided to call, too. I did. Things happened pretty fast.
A nurse called. How far was I from Lone Tree? About an hour, depending on traffic. 45 minutes minimum. Were there any vacations she needed to work around? No. When would you like to start? As soon as possible.
Well, our dosist (a medical physicist) leaves the country tomorrow for a month. Unless you can come in today, you’ll have to wait until July 1st. He has, I learned, family in China and returns for a month each summer. Let’s do it today.
I’ll call back.
She did. I was on the treadmill this whole time. Slightly out of breath, I answered. Can you be here by 11:30? It was about 10:15. Sure. I left my sweats on. At 11:25, after having gone to the breast cancer Invision center by mistake, I found Patty.
Patty is a 30 something, attractive, well-dressed woman. Who called herself a girl. I’m one of the girls you’ll be working with during your treatments. I don’t get why that’s come back into vogue. But, not the point here.
She was kind, though, and direct. Character traits I’ve come to seek out in medical professionals. Did you have a good bowel movement this morning? Well. How about your bladder? Is it full? No clue. They put me in the ct and took a look.
You have a gas bubble in your rectum. I’m going to send you to the bathroom to get rid of that. Please don’t empty your bladder, it’s the perfect size right now. Patty says the sweetest things.
The scan, when it happened about twenty minutes later, took about a minute. I’d had to drink a gulp sized styrofoam cup of water to get my bladder back to perfect.
Over to Anova to sign the consent forms, discuss possible side effects of the radiation, recuperation. Turns out Dr. Gilroy had already told me most of the side effects though I didn’t register what he said as side effects. So he told me again. Recuperation, after the seven weeks, takes about a month usually, gradually feeling more and more normal. But, for me, I’ll have the Lupron working, too, complicating a return to normal.
I told Kate yesterday evening that I’m more concerned about the Lupron than the radiation. The radiation is precise, controlled, localized. The Lupron is systemic. It goes throughout the body, effecting many things not directly related to testosterone. Thus, the side effects. How and which of those side effects will manifest in me is unknown. So is the duration and intensity of them.
Oh, and today we’re going to pick out a new vehicle. Keeping the Rav4, but getting a Toyota with functional AC and better appointments. Kate’s in charge. The process of buying a new car is too much for me at the moment. A bit distracted.