Surviving In This Very Moment…

My Personal Battle with Prostate Cancer … And Life!

Archive for the category “Cancer Survivor”

Simple Solutions to Complex Problems? I Think Not

Simple Solutions to Complex Problems? I Think Not

Simple Solutions to Complex Problems? I Think Not

I should be riddled with guilt because I haven’t posted a thing in the past nine days but I am not. My schedule has been absolutely crazy going in and out of doctors’ offices, geting poked, prodded and ultrasounded to see if there is a root cause for the high calcium levels I am experiencing. Coupled with a recent diagnosis of osteoporosis, my internest thinks I have some kind of parathyroid condition but both a nuclear medicine scan of the thyroid and recent blood tests seem to point elsewhere. The ENT specialist decided that I should have an ultrasound of the neck looking specifically at abnormal parathyroid activity. While in the ultrasound chamber the machine simply died and could not be brought back to life. This meant that I had to come back for a second round. It turns out that the main board burnt out and had to be replaced. The second time around everything went according to plan. I won’t know the results until next week but I am not going to worry about it but I sometimes wish there were simple solutions to the medical issues I face. The point is that everything is good considering I am a prostate cancer survivor!

I am going to a chiropractor this afternoon to see if he can rid me of the lower back pain and the pain in my neck and shoulders that medicine has not been able to treat. The chiropractor is well versed, I am told, in Chinese Medicine and acupuncture, techniques that brought significant relief after I was involved in a serious automobile accident about 20 years ago. I thought I would give this approach a try since Western medicine is not bringing me any relief at all! Seems like I have nothing to lose.

On a final note in this rather bland post, I am quite tired as I write this. I stayed up until the wee hours of the morning watching a great hockey game. The Chicago Blackhawks and the Boston Bruins faced off for game one of the Stanley Cup finals. Two evenly matched teams had at for nearly two full hockey games when the Blackhawks finally scored the winning goal at 12:08 of the third sudden death overtime period. If this is any indication of the type of series we have to look forward to then I will be most happy especially if the Blackhawks are victorious in the end. That being said, I am retiring for a nap because I only had 5 hours of sleep last night and I am wiped out.

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Weathering the Storm…Nine Months Later but Who is Counting

Weathering the Storm...Nine Months Later but Who is Counting

Weathering the Storm…Nine Months Later but Who is Counting

At six-o’clock in the morning on Sunday I am sitting in my hotel room in Kansas City, Missouri listening to the thunder as the tail end of a violent Spring storm passes by. Looking at the weather radar I can see another small cell approaching from the southwest. Last night the weatherman reported that there was a 60% probability that one would be exposed to a violent storm, possibly a tornado during the afternoon hours when I will be in Denver. Lucky me.

All this got me to thinking that I was and always have been lucky. Most recently, when I was diagnosed with aggressive prostate cancer in September of 2012. What could be lucky about hearing the words, “You have cancer,” you ask? At the time, I didn’t think it so lucky either but then, after all the testing, the poking and prodding, I learned that the tumors were likely (but not positively) encapsulated in my prostate and that surgery would be the most aggressive ‘cure.’ The decision to operate took place in October but, because of the swelling of the prostate due to the needle biopsy, surgery had to wait until late November. That thirty day run-up to surgery was a nervous time, a time in which I thought a lot about my own mortality.

As long time readers know, the surgery was successful, the tumors were, in fact, contained within the prostate; it became clear that life would go on. Of course, I was left with two significant side-effects of prostate surgery. I suffered significant incontinence requiring me to wear diapers for the next five months. As I write this today, I am confident that the incontinence will not be a problem much longer if at all.  This, of course, answered a significant question I had for many years, namely, “Just who would wear Depends for Men anyway?” The surgical procedure was said to be nerve sparing so that sexual functioning would not suffer. Oops, that side-effect remains intact. I think of this as a small price to pay for a long life expectancy; who knows, I’m told this is likely not permanent either.

Since the surgery, however, I have suffered two major setbacks. First, I had a significant urinary tract infection, one that was resistant to many antibiotics, requiring that a permanent line be attached to a vein in my arm for daily injections of some potent antibiotic. While this seemed to do the trick (the infection is gone) I was diagnosed with chronic kidney failure with a kidney function of under 20%. While the reason for this seems to baffle both my internist as well as a kidney specialist I am seeing, the last kidney function test showed a marked improvement in kidney function. The worst seems to be over. Lucky again.

Good, because on Wednesday I will arrive in Las Vegas to play a little poker. While I don’t think of poker as a game of chance, winning always involves a bit of luck as well as a great deal of skill. So, as I go to Las Vegas, I’ll wear the cloak of luck I seem to have been wearing for the past 70 years, one that has allowed me to weather most every storm I have encountered. 

No More Roman Numerals

No More Roman Numerals

No More Roman Numerals

I can’t imagine what I was thinking when I started the “Thinking in Jewish” series of posts by numbering each post with a Roman numeral. This numbering system is antiquated and cumbersome and I am, quite frankly, tired of the whole mess. So from this day forward I will number the “Thinking in Jewish” posts using Arabic numbering system which means that the next post will be labeled 32.

There is a question I want to answer for the readers of this blog. It comes up from time to time in the comments which makes it a worthy topic to blog about. It centers on what on earth my atheism and the posts in the series “Thinking in Jewish” has to do with my prostate cancer diagnosis and treatment. Along the same lines I have seen a strange undertone that seems to be asking what is an atheist like myself doing commenting on Jewish thinking in the first place.  So here goes…my best effort at talking about these issues as I blog away.

Begin at the beginning. When I heard the words no one ever wants to hear, the words that may indeed harken the beginning of the end of life, the words “YOU HAVE CANCER” it has a sobering effect on the way one chooses to look at the world. In my professional life I was a Professor of Language and Literacy at a Midwestern state university. My professional interests gravitated toward the study of the teaching of writing so that middle school and secondary school teachers could better teach their students the skill of writing without effort. Blogging, then, seemed like the most natural thing I could do to both help me focus on the fact that I now have a disease that may contribute to my demise. Kubler-Ross was wrong in my case. I grieved over the possibility that my life was coming to an end but I quickly accepted that as a fact that may or may not be true. My job now was to come to grips with how I intended to live the remaining years (or months whatever the case may be) of my life.

As an atheist, I rejected the idea that there is a creator God that is omnipotent, omniscient, and benevolent. My own observations of the world and my deepening understanding of Jewish religious texts, however, caused me not to reject my own Jewish roots. I am a Jew, I have a Jewish understanding of the world, of time and space, of ethics and morality. I simply don’t attribute any of this to a creator God. one that is angry, demanding and punishing. As a post-Shoah (or post Holocaust although Shoah is a better word choice) Jew, where 6 million of my nation perished at the hands of Germans in an unspeakably horrible genocide (perhaps religicide is a more apt descriptor) for no other reason than they were Jews in Europe, made the very concept of a benevolent and omniscient God improbable and the very idea than an omnipotent God would not put a stop to the horrors of the camps, gas-chambers and crematory ovens would make this God either a sadist or rather than omnipotent, simply impotent and unworthy of worship. The other possibility to consider is that there is no God to be omnipotent, omniscient or benevolent, a possibility I find more convincing than any that includes God or religion at the center of the a discourse.

While sick and waiting for testing to be completed to determine what course of treatment for my prostate cancer would be recommended, I decided that learning how to ‘think in Jewish’ would be a good way to think about the potential end of life. It was a clear choice. The Christian story makes absolutely no sense to me. The same can be said for the story of Islam although that one is easier to swallow perhaps because it was formed in the same region as the Jewish story while the Christian story, while originating in Palestine, is essentially a European take on the very idea of monotheism. That being said, I thought it best to stick with what I know and simply become better at understanding where and how the religion of my people developed. The story, especially when told in the light of the ultimate schism of Jewish and Christian thinking and the response of both to the Roman destruction of the Second Temple in Jerusalem in 70 CE, is fascinating. I do not intend to go into that schism here but the response of the triumphal Christians and the defeated Jews of the first three centuries CE paints a picture of quite different approaches to the self-same problem.

What I found as I studied and read more deeply was that the ethics of Judaism played a great role in the way I had been living my life for years. There was embedded in the literature constant reminders of obligations to care for the widow, the orphan and the stranger, for those less fortunate than we might be and there is always someone less fortunate than yourself no matter what your current situation might be. I don’t recall who said this but it is appropriate here. It goes something like this, “I cried out because I had no shoes until I saw a man who had no feet.” Sure I had cancer, but I still had hope and that hope lay in the hands of skilled physicians, men of science, who would do everything possible to make the remainder of my life one filled with the absolute joy of living. In the end, the men of science told me that surgery would cure my cancer and while there are some unpleasant side effects of the surgery, my life will not be disrupted to any great extent. I am now writing as a cancer survivor, one experiencing the unpleasant side effects and it is truly a small price to pay for many more years of life.

That being said, I decided to continue this blog because my personal struggle with ethics and evil in this world has become an important part of my life. Sure, it didn’t begin when I was diagnosed with cancer but that diagnosis brought it to the forefront of my being-in-the-world. That is why I continue to blog about my encounter with life in general and sometimes about health related issues that seems to arise as a result of my experience with cancer.

So no more Roman numerals and I’ll continue to make my thinking visible to me (and to you) on this blog.

Finally, Good News on the Medical Front

Finally, Good News on the Medical Front

Finally, Good News on the Medical Front

I finally have good news to report. I feel as though I have done nothing for the past four or five weeks but sit in doctors’ waiting rooms but now I have good news. My failing kidneys are no longer failing. The last blood work that measured kidney function showed numbers that were essentially normal. While still a bit below the norm, there is no statistical significance between my numbers and the norm so that makes me quite happy (not that I wasn’t happy before because being happy is really a choice) but happier would be the better term here. The down side of all this is that I can no longer take hard working anti-inflammatory drugs for my arthritic pain because they beat up my kidneys making them undesirable. Tylenol, which will only beat on my liver or narcotics like Norco are the only drug related choices. Since I won’t take the narcotics and Tylenol, while it provides some relief, is not really up to the task, I think I’ll look into alternative therapies and lose some weight to see if that doesn’t help reduce the pain I am experiencing. That being said, all is good. I am going out now to enjoy this beautiful day.

If You Meet the Buddha on the Road, Kill Him

If You Meet the Buddha on the Road, Kill Him

If You Meet the Buddha on the Road, Kill Him

There is a Zen saying that goes like this: If you meet the Buddha on the road, kill him. The foundation of this saying is to remind us that if someone seems to have all the answers to all the questions, they don’t have any answers at all. I was reminded of that saying last Monday night when I sat down for a traditional Passover Seder and the leader of the Seder presumed to know everything. It was rather tedious having to listen to his zealotry as he fumbled through a Haggadah different from the rest of us trying to find a place we could all agree on. It was tedious to listen to the polemical insistance that the story being repeated was an actual experience witnessed by millions of Jews in Egypt and at Sinai around 3200 years ago.

I must admit being a bit impatient with the leader, who was trying to equate my relationship with a Chabad Rabbi and his relationship with the Chabad. When I tried to explain to him that my interest was more or less academic and not religious or spiritual he was arrogant enough to tell me I was wrong and that no one goes to the Chabad unless they are interested in spiritual development. When he presumed to know my personal motivation I demonstrated my own impatience by telling him that the stories that survived to form Rabbinic Judaism are simply made-up, redacted and crafted by the redactor to create a theosophy matching the politics of the exile after the rise of Christianity and the defeat of Bar Kochba; that it is impossible to ignore the political reality and still understand the surviving mythology.

At that point I was told that he and I are exactly the same. We come from the same religious experience. In point of fact, nothing could be further from the truth. True, we are about the same age, we both have prostate cancer although mine is currently in full remission while his is, unfortunately, not, we both attend the Chabad (but not for the same reasons) but there the similarities end. I am an atheist, a Jewish atheist but an atheist nevertheless while he is conveniently religious (only when it suits him). I am curious about the form of argumentation used by the post-exilic sages because it is a fascinating academic exercise to understand the thought process as the core documents of Jewish thought were created but I do not accept these documents as anything other than an effort to explain that which is difficult to explain. He takes the documents at their face value asking no critical questions as to origin, political considerations or relationships between Jews and Gentiles as these documents were being created. I could go on about differences but I think I have made my point.

I generally find those people who presume to speak for others to be both tedious and arrogant. Perhaps the two cannot be separated in any meaningful way. In this particular case, I was also angered by the presumption that this man decided what my personal motives might be and how utterly wrong he was. His error was compounded by his failure to listen to any explanation of my motives that I offered. I soon became tired of the whole affair and began to respond to him with the following, “I can’t believe you swallow this made up BS hook, line and sinker!” For that I probably should ask for forgiveness but I probably won’t because I only see him on rare occasions any longer.

What I find is that I have far more questions than I have answers. I don’t presume to speak for anyone other than myself when I write. Sure I try to write persuasively but I don’t expect anyone to simply accept my arguments at face value. I write to construct tentative answers to difficult questions offering up my musings for comments and critique. After all, isn’t that how we learn to understand each other. Only when there is a single-minded zeal does the process of understanding get interrupted falling into ruins. So keep the conversations lively and if you meet the Buddha on the road…Kill him!

 

Infusions, Doctors and Life Generally

Infusions, Doctors and Life Generally

Infusions, Doctors and Life Generally

As I was sitting in the very comfortable reclining chair getting hooked up for my sixth infusion of antibiotics to deal with the  resistant echoli strain that has seen fit to invade my body, I was struck by the idea that since my cancer diagnosis, surgery, and recovery period, I have slowed down. Now slowing down is a good thing. It began when I took off my watch forcing me to be less concerned with time in general. While the act of refusal to recognize time as a constraint was difficult at first, it has become a blessing. To not feel the urgency of time makes the time I have more precious; something akin to a gift from myself to myself. At the same time, I have not lost my appetite for punctuality. This may seem a contradiction but I think it is not. When everything is run by the clock then punctuality is an obsession but when I take the time to just take in what is there, punctuality becomes an ethical act; an act of respect for the other whether the other is driven by the clock or not.

So sitting in that chair, talking to Cynthia, the nurse administering the antibiotic, I noticed all of the surroundings, the pictures on the wall, the clock with the broken second hand, the smell and taste of the antibiotic as it drips into my veins. In the moment of that half hour of dripping solutions I was at one with the universe.

Since taking off the watch six or so months ago the world seems to spin at a slower pace. Of course it isn’t the case but the fact that I take the time to notice things I didn’t have the time to notice before is a bonus that was totally unexpected. I hear the voices of doctors as they try to figure out what is going on with me and find the urgency of one doc countered by the patience of another as they look at the results of the data. One doc looks at a number and nearly panics while the other looking at the same numbers takes the approach of waiting to see how the whole picture develops before striking out with a treatment plan. I think that one should never treat a number, rather one should look at the whole picture and treat the cause of the abnormal data that emerges over time. Jumping in without all the facts is as dangerous as denial of the emerging data. While one cannot be absolutely certain when incomplete data is present, one cannot allow oneself to be driven by the presence of a single abnormal number either. That too is an insight I learned after taking off my watch and allowed myself the luxury of observation.

As an aside, I found it interesting that even with the PICC line inserted I had to be stuck to draw blood in my internist’s office. What a waste of a good PICC line. When in the infusion center blood was also drawn and the same blood numbers will be analyzed. Why twice? Could it be profits are involved?

 

PICC Lines and Emergency Rooms

PICC Lines and Emergency Rooms

PICC Lines and Emergency Rooms

What appeared to be a simple urinary tract infection, likely due to the fact that the prostatectomy left me with a bit of incontinence which continues with varying degrees of severity, turns out to be a highly resistent strain of echoli, one requiring a fourteen day course of iv infusion therapy with the one antibiotic to which I am not allergic. This meant that I spent the bulk of yesterday morning having a PICC line inserted in my left arm. When the PICC was inserted and the first round of antibiotic was administered, a blood draw was done right before the line was bandaged. I thought I was done but that would be too much to expect at this point. I was home for about an hour when I got an urgent call from the infectious disease doc overseeing the treatment of the echoli infection. “Hurry,” she said, “go to the ER immediately. Your potassium levels are alarmingly high and your kidney function numbers are way out of whack.”

And so it was that I wound up in the Emergency Room where I was treated with a drug to help reduce the potassium in my system and was administered fluids to drive my kidney function back to normal levels before I was discharged from the hospital just in time to see the Blackhawks lose for only the second time to their closest rival, the Anaheim Ducks.

I had the second dose of the antibiotic this morning. When I arrived at the office for my appointment the receptionist told me that my doc wanted to see me earlier than Friday when I was already scheduled to see her. By next Monday she will have the results of the ultrasound of my kidneys and bladder and we’ll see what the next step will be. Of course, the ER doc handed me a sheet describing End Stage Kidney Failure but told me it was just a precaution and that the problem I was suffering was likely due to the echoli infection I was already being treated for. ESRF looks a lot like the effects of the particular antibiotic I am being infused with and it should clear up as the treatment kills off the bacteria in my system.

Still, as a cancer survivor, it is a bit disconcerting to learn that I might be sicker than I ever imagined. I mean, seriously, beating one disease only to have a second potentially life threatening illness take its place is simply not what I had in mind. Of course, looking on the good side, if I do require kidney dialysis, at least I have a central line already installed in my arm, making the whole process easier to deal with.

By the Numbers

The most important number I saw yesterday was a PSA of less than 0.01, essentially no prostate cancer remaining six months post surgery. That was very good news but not unexpected. Everything else was normal or bordering on normal with a few slight adjustments. More to come later

 

Yes, A Week for Medical Concerns: Dealing with the Aftermath of Cancer and More

Yes, A Week for Medical Concerns: Dealing with the Aftermath of Cancer and More

Yes, A Week for Medical Concerns: Dealing with the Aftermath of Cancer and More

In the next ten days, starting today when I visit my internist and oncologist back to back, I begin a ten-day period of rather intense medical review. While I expect to find things right on schedule, one never knows. My internist drew blood last week in preparation for this morning’s visit. Leaving his office, right around the corner from Starbucks, I went to read and enjoy a cup of coffee. While sitting in Starbucks, I began to notice some significant back pain along with gripping groin pain. It took a few moments, but it soon became clear that I was passing a kidney stone. As if I didn’t have enough urological problems, I then noticed that I was running a fever of around 101 degrees. Yikes, now I am getting sick as well. Just what I needed. Since the symptoms weren’t getting any better, last Friday I went to my internist complaining of cloudy urine and this on again off again fever. He prescribed an antibiotic, one I had never taken before and said I should keep the Monday appointment as a follow-up as well as one in which we would address any number of issues. By Saturday, I couldn’t stay away from the bathroom and I had developed a bright red, blotchy rash all over my body. I stopped taking the antibiotic on Sunday. It is now Monday morning and I still have bowel trouble but at least it is not constant and urgent.

Soon after I post this I will be on my way to Starbucks once again in preparation for my trip to the internist’s office. As soon as I finish with him I must go to the oncologist for an infusion of iron as my system simply refuses to ingest iron from any source whatsoever. This means a bag of the dirtiest looking rust water (I know it is not but that is exactly what it looks like) will be introduced into my veins and allowed to course through my system adding iron to my blood stream.

Finally, I get to see the urologist who replaces the urologist who treated me for the past fifteen years. He took a new position and so I am left to see if I like his understudy or not. I am actually feeling a bit uncomfortable about this change but my old urologist swears that this new doc is even more affable than he is and that he would send his own brother to him which, I suppose, is a strong recommendation. Time will tell whether I like this new guy and whether he will become my urologist of choice or will I have to shop for someone else? Tick tock tick tock!

Other than that, not much is new on my medical front. The kidney stone pain has subsided which may only mean that the stone is not moving about or it could be that the stone has passed. My fever is gone but there again, on only two days of antibiotic it may return. I think I’ll suggest to my internest that he stick with antibiotics that we know I have absolutely no allergic response to and take it from there. I nervously await the PSA results of my blood test, he also tested for testosterone levels but I don’t know why. I think I’ll ask. May post later with some news about the test results. If not, I’ll surely post tomorrow.

To the Pain…

To the Pain...

To the Pain…

At the end of June, 2012, I had a total knee replacement performed on my left knee. For three months I was in so much pain, a pain that simply didn’t seem to be getting any better, that I regretted having undergone this surgery. I was shocked and, frankly, surprised that the pain was so intense. After all, I have two total hip replacements and a titanium back from a laminectomy to deal with a stenosis caused by my severe osteoarthritis. I expected recovery to mirror my prior orthopedic surgeries. Then, one day about three months after surgery, the pain simply disappeared; while I was left with some discomfort, it was getting better from my commitment to physical therapy. But my healthcare nightmare of 2012 was not quite over. In October I was diagnosed with prostate cancer and, because of the biopsy, the bone and CAT scans, it was decided that surgery was the most appropriate option. So in late November I underwent a radical prostatectomy. So far, this is nothing new for those following this blog. Here is where it gets a bit dicy. Because of the surgery and the post-operative restriction on lifting, I was unable to continue the exercise program that my PT laid out for me. Three weeks ago I was granted a lifting of all restrictions on lifting and exercise. Ten days later I was in my orthopedic surgeon’s office for my six month evaluation. I was complaining about a stiffness developing in my left knee. He suggested that I go to physical therapy just to make sure that I didn’t do any serious damage to the knee as I worked my way back into some kind of shape.

Yesterday was my first serious day in physical therapy and man do I hurt today. There isn’t a muscle in my lower body that is not feeling the effects of having been sedentary for the past two months. Things that I did with ease prior to the prostate surgery were not only difficult, they were painful as well. When I rolled out of bed this morning I could feel the pain everywhere. I have a whole regimin of exercises to do at home and I will not return to PT until Tuesday. With enough effort on my part, perhaps I will rejoin the ranks of the reasonably fit but right at this very moment that doesn’t seem like a reasonable outcome. What I’ll have to do is shelve my pessimism and visualize the end result as I go down to my basement to push myself harder but within the limits laid out by my PT.

Okay, I know this is a short post, but I am out of the house to meet with the orthopod about another issue, nothing I am terribly worried about, and then to see Zero Dark Thirty. Exercise will wait until I return.

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