Category Archives: Health

GeekWorld, Health

Getting Down To Business

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Beltane and the Recovery Moon

my best friend for 35 dates. not found on Tinder.

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.

ct scan

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.

Health, Science, Third Phase

Getting that inner glow

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Beltane and the Recovery Moon

On the way over for my planning ct I thought about cancer from a Great Wheel perspective. Winter is coming for us all. We know that and the Great Wheel reminds us that the cycle is the same for all humans. On NPR long ago I heard a doctor say, “Everyone forgets that the death rate for each generation is 100%.” Oh. Right.

Cancer is one of the many guarantors of our personal winter. A friend of mine decided to see cancer not as an aggressor, but as a visitor, a guest in her body. All right, if that’s the way you see it.

I look at it differently. I do not see cancer as a visitor or a guest, certainly not as a friend. I don’t see it as an enemy either. Rather, thinking again in a Great Wheel way, I view cancer as a weed. One definition of a weed is a plant out of place. Not sure if cancer has a place in the same that way a dandelion or a Canadian thistle does, but the idea is very similar.

2013, Andover

Cancer, like a weed, wants to thrive, needs to thrive, at the expense of the garden in which it grows, my body. It’s not evil; it has no intention beyond survival, but its survival and mine are incompatible. So I want to get down on my hands and knees, take out my favorite Japanese gardening knife and cut the little bastard out.

Since I don’t have, like Archimedes wanted, a place to stand to do this task, I’ve chosen the folks at Anova Cancer Care and their Japanese gardening knife equivalent, the Cyber Knife. Just like in a garden, it’s important to remove the weed and not damage the tomato plant or the carrot or the bean plant growing next to it. Care must be taken.

Today the inner landscapers of Anova looked at my pelvic area under a ct. Their goal was to establish firmly the boundaries of my garden, the weedless part of my body. They do this by locating my pelvic bones, my bladder, my rectum, then drawing a cyber-volume of space in the prostate fossa. That space comes up to the edge of the rectum, “kisses the bladder” as Dr. Gilroy said, and has wide enough margins to include as much of that volume as possible without doing damage.

2013, the healthy garden, Andover

Inside that volume is the weed. The cancer. Each day, five days a week, from June 17th to August 6th (no glowing on the 4th and 5th of July, God bless America) the cyber knife will beam 200 cGys of radiation into that small plot, a now empty and weedy bed. Over the 35 treatments I’ll get a full 7000 cGys of radiation, hopefully enough to weed this troublesome patch of my garden.

On Tuesday, June 18th, I go to Anova for my first Lupron shot. This is the second gardening tool. It focuses on what feeds the weed, testosterone. And removes it. It’s a blunt instrument though, unlike the cyber knife. It goes into the whole body and shuts down the testicles and the adrenal glands as far as testosterone production goes. It is, in effect, chemical castration. Oh, goody.

I’ve said, not in jest, that I knew I was a gardener when I began to side with Farmer McGregor in the Tale of Peter Rabbit. Now I’m on the side of brother radiation and sister Lupron. Weed out those wee bastards. Just go for it.

What Lupron will achieve for me

Here is a list of the common side effects from Lupron. Other than these it makes you feel great.

  • redness/burning/stinging/pain/bruising at the injection site,
  • hot flashes (flushing),
  • increased sweating,
  • night sweats,
  • tiredness,
  • headache,
  • upset stomach,
  • nausea,
  • diarrhea,
  • constipation,
  • stomach pain,
  • breast swelling or tenderness,
  • acne,
  • joint/muscle aches or pain,
  • trouble sleeping (insomnia),
  • reduced sexual interest,
  • vaginal discomfort/dryness/itching/discharge,
  • vaginal bleeding,
  • swelling of the ankles/feet,
  • increased urination at night,
  • dizziness,
  • breakthrough bleeding in a female child during the first 2 months of leuprolide treatment,
  • weakness,
  • chills,
  • clammy skin,
  • skin redness,
  • itching or scaling,
  • testicle pain,
  • impotence,
  • depression,
  • increased growth of facial hair, or
  • memory problems.

Art and Culture, Health, Reimagine. Reconstruct. Reenchant., Third Phase

A Skeptical Realist

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Beltane and the Recovery Moon

32 degrees this morning on Shadow Mountain, raining. Fog grays out Black Mountain. So far our usual summertime foe, wildfire, looks less formidable. At least for this year.

Office, Edward Hopper, American realist

And, yes, if you, reader of Ancientrails, are tired of the medical overcast here, so am I. However.

As Kate and I talked yesterday, I told her about my new friend David, who has a prostate cancer situation more dire than mine. His has metastasized. He said, “I’m good at compartmentalization.” I’m not. Don’t want to be.

I’m a realist. Neither optimist nor pessimist. I want to know what is. There’s good evidence in psychological studies of depression that realists end up depressed more than optimists. That optimists are happier than realists or pessimists. May be. Still can’t look away.

That’s what you’re reading here. My attempt to see. Inside and out. And, even though I learned from Cosmos and Psyche that skepticism is a tool, not a lifeway, surprise; it’s a tool I’ve used so long that I can’t put it back in the toolbox, hang it on its little outline on the pegboard of my mind. Skepticism and realism have never made me the life of the party. Debbie Downer might be more apt.

Yet some deep commitment to honesty, learned I’m not sure where, keeps me realist and skeptic. I don’t like being manipulated, by others, by institutions, by myself. So I long ago chose to deal with the psychological fall out of the examined life, a fair exchange in my world. Not always pleasant, but cleaner. Candid.

Aging, Health, Science, Third Phase

Uncertainties

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Beltane and the Recovery Moon

Important note. Whether or not I get a cure from this combination of radiation and hormone therapy, together they will slow down the cancer. That means I’ll live longer than I would with no treatment. If a cure doesn’t happen, I may live into another period of advances in treatment.

Still absorbing. I’ve passed the shock of omg I’ve got cancer again! I’ve passed through struggles over imaging. Now, I have data. Two negative imaging studies and a PSA of high velocity, 3.01 in the last test. I prefer knowing what’s going on.

I’m in a different location now. A treatment plan in place. (see post below) Within that decision was a secondary but important choice. To go after the cancer aggressively. The addition of the lupron reflects that choice.

Sometime next week I’ll get calls from a nurse practitioner who administers and manages the lupron injections. She’ll give me more information about what to expect, what to do. In my instance I’ll get injections every three months for up to two years.

Also next week I’ll get a call from the radiation therapy folks at Littleton Adventist. We’ll set up a schedule for my 35 sessions. They call this fractionation. My prescription is 70 Gy’s (a measure of radiation) spread out over 35 10-minute doses, fractions.

When you get into cancer treatment, the brutality of it, a therapeutic necessity for much of what’s on offer, presents its own set of problems. What doesn’t kill you may cure you, but not without a price. How high a price is different for each individual and unknown at this point for me as a result.

I’m stage III

That does make the upcoming weeks and months more fraught. In addition to the question of how therapeutic the radiation and the Lupron are there is question of how severe their side effects will be. There’s a deep irony in this reality. What’s curing is hurting.

Am I concerned about all this? Yes. It gives the time ahead two different sorts of uncertainty. Wish it were as clean as my initial decision to get my prostate out of my body. That was straightforward. Surgery. Recovery. Done.

Not these treatments. Some side effects of the radiation may not manifest for years. Side effects of the Lupron will be more immediate.

Aging, Health, Science, Third Phase

Radiation and Lupron

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Beltane and the Recovery Moon

So. Cancer treatment plan. After negative findings for bone lesions and metastases in the thorax-most excellent news-we’re left with the rising PSA as evidence of a cancer return. Since my PSA jumped from 1.3 to 3.01 in two months, this is a more aggressive bugger, but likely confined still to the prosate fossa (bed) where my prostate isn’t.

In my situation Gilroy has recommended 70 Gy’s of radiation over 35 sessions, 5 days a week for 7 weeks. This is a usual plan. He also recommended, due to the PSA jump, the addition of Lupron, a testosterone suppressing drug. Both can have significant side effects, but I’ll deal with those if and as they come.

I chose Littleton hospital as the site for my radiation because it’s a bit easier to access than Gilroy’s shop. Kate has had several imaging studies there and my bone scan and ct were there. I’ve been impressed with their professionalism and kindness.

Gonna get some books on cd. 35 round trips will get me through at least one or two.

No one knows what the future holds. Except for that one certainty. All this is an attempt to push the date of that certainty further away than doing nothing. I’m hopeful, cautiously optimistic.

Health, Reimagine. Reconstruct. Reenchant., Third Phase

Tough Place

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Beltane and the Recovery Moon

I’m in a tough place. Tired out. Psychically weary. Physically weary. Workouts stalled due to schedules. Writing non-existent except for this blog. Habit. Of very long standing. No hiking. Watching a lot of TV, dulling the mind, the heart. On purpose.

Of course, as we enter the ninth month after Kate’s bleed, with all that has entailed, and considering flu and pneumonia for February and March, it’s not a surprise. Add the I’m Back! from prostate cancer, the imaging difficulties, the appointment today, and I’m pushed over the line sweet Jesus.

Symptoms: staring blankly, weariness, heaviness in the soul, irritability, lack of motivation. I don’t know what to do with my life, I said to Kate yesterday. Not sure what I meant, though it felt true at the time. In 2015, during the diagnostic runup to the prostate surgery, I talked about losing all sense of the future. My mind just wouldn’t go there. Not the, oh, I’m in the moment sort of thing, but a symptom of possible lost hope. This is probably the same. Cancer eats away not only at the body but at time, too. At our sense of ourselves as ongoing.

I have novels to edit. Ancientrails, the printed edition, to organize and edit. Paintings to paint. Grandkids to see. Domestic chores to get done. Colorado to see with Kate. Yes. All true. But right now I don’t have a sense of urgency with them, they don’t call to me. Sit down. Pen in hand. Start whacking out paragraphs. Or, stand up. The moon and the sun, the lesser light and the greater light. What colors should I use? What shape? Where should they go on the painting?

Will pass. May last through my treatment, however long that takes.

Aging, Family, GeekWorld, Health, Third Phase

J-Tube at Work

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Beltane and the Recovery Moon

Kate’s still sleeping, taking in nutrients. The j-tube has some similarities to the tpn. It has a pump and a set of tubing to connect the pump to the j-tube port. No more bags though. No more syringes. No more batteries. No more heparin or saline flushes. No more pic line. The nutrient solution is called Jevity. I couldn’t figure it out, but Kate said, “Longevity.” Oh. I see.

The really big difference though is that the j-tube puts the nutrients into the digestive tract. This is safer, no more direct line to Kate’s heart for possible wee beasties, and also more sustainable over the long haul. With Sjogren’s dry mouth the j-tube might be permanent. Thanks, Dr. Ed.

April, 2018. Happy Camper

In other local technology news the Rav4 has reached an inflection point in our lives. The AC either has a leak under the dashboard or a faulty evaporator. $900 to remove the dashboard and diagnosis it. If, as they suspect, it’s the evaporator, another $1,900 for the part. With labor somewhere in the three thousand dollar range. It’s a 2011, eight years old next month. As a rough trade-in it’s worth about $5,800. Too much to spend.

So. A new, or newer, car. We’ll keep the Rav4 since it’s in good mechanical shape. With the exception of the AC obvi. Worth more to us than it is as a trade-in. I didn’t get the y-chromosome negotiating gene. I hate it. Buying a new/er car is, grrrr.

Meeting with a friend’s husband this morning in Evergreen at the Muddy Buck. He has prostate cancer, too. A mini-support group, I guess. Then, at 1 pm I’ll get diagnosis, prognosis, and treatment plan. All prostate cancer, all day.

Family, Health

Gone the TPN

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Beltane and the Recovery Moon

2014

The tpn is over. Kate’s pic line got pulled out yesterday afternoon before she left Adventist. Don’t know what we’ll do with the saline flushes, heparin blocks, batteries, gloves, kits for attaching the bag to the pump, the remaining bags.

The j-tube nutrients, called Jevity (I know, like continuation and continuators), arrived in a small box last night. Enough for a month. The tpn required three boxes each week, with three styrofoam boxes plus cooling gel packs. The j-tube is on Kate’s abdomen so she can handle the flushes and the feedings. I’m out of a job. And, I’m glad.

When I got to Adventist yesterday, Kate was not yet ready to go home. I spent 5 hours there. I’ve reached a saturation point with driving to hospitals, hanging out. I’m tired of it. The constant back and forth, the long drives. We’re in the 9th month now since Kate’s bleed. It’s been a lot and I’m showing the strain.

Not pretty, but true nonetheless. This will pass and I’ll get back in the groove. Yesterday though…

Aging, Cinema and Television, Family, Health, Reimagine. Reconstruct. Reenchant., Third Phase

St. Elsewhere

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Beltane and the Recovery Moon

Kate’s going to be in the hospital one more day. They want to be sure the j-tube is working, no leaks. A gastric function test today with contrast. Like making sure all the plumbing is in order after sealing the wall. Not sure what they’ll do if they find a leak.

Today it feels like I woke up in a Truman Show simulacrum, one focused on medicine, a Grey’s Anatomy in which Kate and I are a plot thread about medical issues affecting the geriatric demographic. Maybe I’ll drive out to Littleton Adventist this morning and someone there will tear a hole in the screen separating us from the cameras and crew.

Having Kate back in the hospital has flashed forward the bleed and its long aftermath, the second bleed, the pneumothorax. On the first day she’s gone my reaction is to be self-indulgent. Eat poorly and watch a lot of TV. Yesterday was hot dogs, ice cream and several sessions of Big Mouth, a Netflix cartoon about hormonal middle-schoolers. It’s surprisingly good, recommended by Ruth. Not sure why I have this reaction, marking her absence surely, but why self-indulgence?

Tom Crane’s guy.

I suppose those are denial strategies. Eat and forget. Watch and forget. Suppress. Repress. Good thing I have this bandage stripping habit. Wouldn’t want to get stuck. My inclination these days, these third phase days, is to be more forgiving of myself. As somebody said, if your compassion does not include yourself, you are not yet (something): fully compassionate, enlightened, realistic? Ah. Looked it up. It is incomplete.

Family, Health

Family

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Beltane and the Cancer Moon

Kate’s Crowns

The Cancer Moon is a sliver, headed toward a new moon. June 3rd will be the new moon, Kate’s surgery date. On June 7th I see Dr. Gilroy to discuss radiation therapy, probably get scheduled to start. By that time yet another Recovery Moon will be shining over Shadow Mountain. We had a healing moon last October after Kate’s bleed and a Recovery Moon in March following my flu/pneumonia.

A third recovery/healing moon makes sense to me. That lunar month will encompass Kate’s recovery from the j-tube placement and our getting used to this new method of getting nutrition for her. It will include much of my radiation. By the end of it we should both be in better places.

Rigel’s nose

Ruth came up yesterday. She pruned the Russian sage, flattened all the boxes for the trash (Chewy, Amazon, Option Care), and got Kate back into her sewing room. This morning she’s going to make pancakes, a cherry pie, and help me make chicken and leek pot pies.

We went to Sushi Win yesterday for lunch to celebrate my CT scan findings. Ruth had a Sushi platter. She ate it all. Dad says I have a teenage appetite. She does.

She’s a scholar, loving Mandarin and math. She’s an artist working in oils, photography, prints. She’s a cook and a good one. She loves animals, brushing Rigel and Kep each time she comes. Ruth has become a sweet, loving young woman. May it continue.