A plan

Lughnasa and the Chesed Moon

Tuesday gratefuls: Pet scans. New androgen deprivation drug. Kristy, a real sweetheart. Cancer. Shortness of breath. Cool air. Less smoky. BJ and Mary coming in today. Joe. Life. Death. Kate, always Kate. Subway. Liks.

Sparks of Joy and Awe: Pet Scans

Tarot: Queen of Swords


PET Scan

Quick one, more later. Saw Kristy, Dr. Eigner’s PA. At first I was put off. Big PSA rise and I still see just the PA? Boy was I wrong. Kind and clear, compassionate. Her presence was chesed. And, I needed it. Braided blond hair, pretty-as have been all of Eigner’s PAs-she knew her way.

Bottom line: I asked, Will this shorten my life span? No. Not if you’re compliant and keep coming to see us. Oh, I find life attractive. I’ll be compliant.

Advanced prostate cancer. That’s now me. Diagnosis. Remove prostate. Recur. New Plan. Radiate plus Lupron. Recur. This is the third iteration of the cancer. It’s initial appearance and two failed attempts to eliminate it.

Pretty sure I’m down to managing it as a chronic disease. At least this way it can’t recur.

The plan: ADT. Androgen Deprivation Therapy. Probably using a pill instead of shots. This will last for at least a year. In case the fancy name doesn’t tell you, this is chemical castration. In fact, they measure the efficacy of ADT drugs by how long it takes them to mimic actual castration. Me and the neighborhood sex offender.

The new drug is Orgovyx.

The plan: Pet scan. This is the axumin scan I did not get at the first recurrence. Why would they approve it this time? Because your PSA’s a lot higher. Oh. I see. This sends radioactive isotopes targeted to prostate cancer cells into my body. Then. It looks for them. Where they light up, there’s the cancer. I’ll know not only location, but also quantity.

Depending on the location of the cells, more radiation. I suppose they’ll try to cure it again, but, as I told Kristy, my trust level about a cure is pretty low.

Not excited about more ADT. Hot flashes. Fatigue. Impotence. Sarcopenia. Less excited about dying. So.

I’m a little off center today, but not too bad. I expect a call today about scheduling the pet scan and authorization for a no-cost prescription for the new pills. The pills, which I take daily, have three advantages. First, they drop the testosterone right away with no initial surge as the Lupron creates. Second, when stopped, the pill’s chemical clears the body in two weeks rather than 3-6 months. Third, and most important to me, it carries less cardio-vascular risk. Since I have vascular disease.

Better than yesterday. Me. At least there’s a plan, a way forward. Wish this wasn’t happening coincident with Kate’s birthday celebration of her life. But, it is. Going in deep, once for myself, once for her. Hard to have two plunges in a year, let alone a couple of days.

My mussar practice from the last MVP is, helpfully, on the character trait of equanimity. Here’s what I agreed to do this month: Name the context in which an emotion occurs. Name the emotion. Choose to experience it or not. To intensify it or not.

Something valuable here. I can say. Yes. Both cancer recurrence and a time that will revisit Kate’s death, bring grief to the surface. Feeling? Anxiety. Dislocation. Fear.

What do I choose? Calm. Courage, ometz lev, courage of the heart/mind. Grounding. Grief.

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