Surviving In This Very Moment…

My Personal Battle with Prostate Cancer … And Life!

Archive for the tag “Surgery”

ProPep Surgical – da Vinci Prostatectomy | da Vinci Robotic Surgery | Nerve Monitoring Prostate Surgery

I found this interesting. I wish I had known about this technique so I could have discussed it with my surgeon prior to my prostatectomy. Being informed allows one to  advocate for oneself.

ProPep Surgical – da Vinci Prostatectomy | da Vinci Robotic Surgery | Nerve Monitoring Prostate Surgery.

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. 

Turning Tables: Waiting in Proximate Space

Turning Tables: Waiting in Proximate Space

Turning Tables: Waiting in Proximate Space

I am writing this while sitting in the waiting room of the Valley Ambulatory Surgery Center while my wife undergoes a surgical procedure on her right knee. What is unusual about this is that I am on the other end of the surgery, the person who waits. My own medical history contains many surgical procedures, almost all related to arthritis, where I was the patient and she was relegated to waiting for the results. This particular moment, therefore, is quite different for me and I can only imagine how it is for her.

Waiting, in this sense, is the core of the ethical in the sense that I am now making myself available as I await the call of the other, in this case, the call of my wife as she awakens from her drug induced slumber. Here I am, in proximate space, having made myself available, assuming the response-ability to be of service in her time of need.

As I wait for the call I am reduced to an observer, a singular point from which I wait. This reduction, however, does not make me into the same, into that which becomes normative. Waiting in proximate space is a unique, albeit, selfish space in which I have clear choices. On the one hand, I could dwell on what is taking so long, why isn’t this thing done, or, on the other hand, I can sit in this very moment letting the flow of time wash over me like a flowing river. I choose the latter. I choose to write rather than dwell on the negative aspects of time. Negativity helps no one, to the contrary, it freezes one in a cube of stress.

The very act of writing propels me to interiority, a space that is private yet made public by the very fact that I post this writing for the public to read. The interiority of writing is where I begin to see what I think, to build on an idea and to test its limits. It is the place where knowledge is constructed. It is the place of proximity, a productive waiting for the call of the other to pierce the fabric of the ethical, to tear apart the difference between the self and the other while preparing to bind the self to the other in service to the cry of the other. Writing prepares one for the existential experience of an ethical life.

So here I sit, waiting for the call, waiting for the surgeon to tell me what a grand job he did, waiting for the nurse to allow me to ease into the twilight of Susan’s recovery.

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.

Treating Disease and Not Risk Factors: A Holistic Approach

Treating Disease and Not Risk Factors: A Holistic Approach

Treating Disease and Not Risk Factors: A Holistic Approach

I spent the day yesterday with my wife as she went for a baseline heart assessment. She worries because her father and mother as well as her brother all had significant heart disease diagnosed in their late fifties. She is in her early sixties with some risk factors for heart disease so her goal was to establish a baseline as a way to measure changes in her risk for heart disease. That is all well and good. I am a firm believer in understanding risks and probabilities, I play poker after all. What I am most worried about is the desire of physicians, especially cardiologists in my experience, to treat risk factors in the absence of actual disease. When I was in graduate school we were encouraged to ask two questions as we began to investivate research reports. First, who funded the research; is there a funding agent that has a significant dog in the fight because if there is the results of the research are significantly less valuable than if the research was conducted objectively. Secondly, we were encouraged to ask just who actually benefits from the results of the research; understanding the relationship between beneficiaries of research and those upon whom the research is actually intended to benefit along with the divergency in ultimate beneficiaries is important in evaluating the results of the research itself.

Take Lipitor, as an example. According to Wikipedia, “Atorvastatin [Lipitor] was first synthesized in 1985 by Bruce Roth of Parke-Davis Warner-Lambert Company (now Pfizer). The best selling drug in pharmaceutical history, sales of Lipitor since it was approved in 1996 exceed US$125 billion, and the drug has topped the list of best-selling branded pharmaceuticals in the world for nearly a decade.When Pfizer’s patent on Lipitor expired on November 30, 2011,generic atorvastatin became available in the United States.” (emphasis added) While I am not looking at specific studies, I can imagine a reasonable scenario in which the vast majority of research done on Lipitor was funded by Pfizer or their predecessor company, studies that showed the benefits of Lipitor in preventing fatal heart disease. I immediately am skeptical of research that is funded by the company that benefits in terms of manufacture and sales when the drug goes on the market. In the case of Lipitor, the drug was the best selling pharmaceutical for over ten years; a patented drug the profits from which flowed into the coffers of Pfizer’s treasury. Clearly, Pfizer was a major beneficiary of the drug Lipitor.

The question of patient benefits are a bit more sketchy. Side effects from Lipitor (and other statin drugs) are many and some are even deadly. Again according to Wikipedia:

As stated earlier, myopathy with elevation of creatinine kinase (CK)] and rhabdomyolysis are the most serious side effects, although rare at <1%. Headache is the most common side effect, occurring in more than 10% of patients. Side effects that occur in 1–10% of patients taking atorvastatin include:

  • Weakness
  • Insomnia and dizziness
  • Chest pain and peripheral edema
  • Rash
  • Abdominal pain, constipation, diarrhea, dyspepsia, flatulence, nausea
  • Urinary tract infection
  • Arthralgia, myalgia, back pain, arthritis
  • Sinusitis, pharyngitis, bronchitis, rhinitis
  • Infection, flu-like syndrome, allergic reaction

Atorvastatin and other statins are associated with anecdotal reports of memory loss by consumers, which have been seen in clinical practice in a tiny percentage of users, particularly women. Evidence is conflicting with anecdotal reports contrasting with a well-established association of high cholesterol with dementia. However, it is known that cholesterol synthesis is necessary for normal neuron functioning. According to Pfizer, the manufacturer of Lipitor, clinical trials “do not establish a causal link between Lipitor and memory loss.”

Elevation of alaninetransaminase (ALT) and aspartate transaminase (AST) has been described in a few cases.

High-dose atorvastatin had also been associated with worsening glycemic control in the Pravastatin or Atorvastatin Evaluation and Infection Therapy – Thrombolysis In Myocardial Infarction 22 (PROVE-IT TIMI 22) substudy.

Side effects occur in up to 10 percent of all patients taking Lipitor, or now generic Atorvastatin; one in nine people will experience some side effect from this drug. What is even more interesting is the list of side effects does not include potential damage to one’s liver, neuropathy, or other conditions that may occur when using Lipitor. What is even more unsettling is that the drug is designed to treat “Secondary prevention in people with coronary heart disease and multiple risk factors for myocardial infarction, stroke, unstable angina, and revascularization.” The first part of this sentence shows a use for treating disease while the second half of the sentence specifically treats risk factors for, or the probability of being affected by, something that has not yet occurred. I wonder just how much profit Pfizer made from treating risk and not treating actual disease? My guess it that it amounted to over 75% of all profits earned from the sale of this drug.

Risk factors are just that, factors that may or may not contribute to an individual’s chances for developing a particular disease. With regular doctor’s visits, a solid program of reasonable weight control, exercise and a baseline from which to assess risk, clearly one need not spend untold thousands of dollars popping pills. A personal example, from the time that Prostate Specific Antigin (PSA) testing was available I had mine checked at least once a year. I had significant risks for prostate disease, especially prostate cancer so establishing a baseline that was particular to me, not to some generality of statistical risk, became a guide post for my own awareness of the changing risk factors. When my PSA suddenly spiked to 23 the time had come to actively pursue treatment options. Until that time, however, taking prevention pills was not a personal option. Treating risks is something like carrying an umbrella on a sunny day thinking that there is a potential for rain albeit an unlikely chance that rain will occur at all. When there are potentially deadly side effects in taking a drug aimed at prevention, when the drug is known to destroy one’s liver, the risks of taking the drug are perhaps greater than the risk of disease itself.

I am ranting here because my wife was prescribed Lipitor by a new cardiologist, had to undergo a stress-echo test in which her skin was sandpapered raw, and she was told that she could only eat chicken, fish, veggies, and fruit and she had to eat all this food without seasoning the food. Seriously? If it were me, I’d simply run the other way. I avoid doctors that prescribe medication on a first visit and surgeons who do not offer non-surgical treatment before they recommend surgery. I am disturbed by the practice of medicine that throws the patient under the bus in order to benefit pharmaceutical purveyors and themselves first and the patient second. I am not sure what she intends to do but I will do all within my power to encourage a second opinion, one from a cardiologist who doesn’t reach for the prescription pad first and alternatives second. For me it is a matter of medical ethics and holistic treatment of a patient and not a risk factor.

Showing Improvement

Showing Improvement

Showing Improvement

I am old enough to realize that every single new day, in fact every single moment of existential time, brings with it something new. New challenges abound while carefully balanced by new things for which to be grateful. Being-in-existential-time, experiencing first hand the lived-experience, is something to be savored, enjoyed and embraced. This all works when one looks outside of oneself, finds ways to serve, to engage with others in a face-to-face encounter. It does not work when, in the depths of emotional or physical pain one turns to the interiority of the self because all there seems to be is pain or loss that triggers the desire to turn inward. When in pain it is difficult to think of anything else. When I had my left knee replaced six months ago the pain was so severe that I wanted no part of any other human being including my closest family. I saw absolutely no hope for relief. Drugs like toradol provided some immediate relief but that relief lasted but a short period of time. Then, about 3 months post knee surgery, the pain simply disappeared; presto, it was gone. The prostate surgery four months post knee surgery brought a different kind of pain, one that settled into my upper torso, especially around the shoulders and chest. This came from the settling of the CO2 pumped into my guts during surgery. While it was happening I was beside myself but then it left me only it was two days not three months.

The point of this is simply that there is no pain so great as not to resolve itself over time. I am in the middle of such a resolution as I write this. The incontinence suffered as a side effect of the radical prostatectomy I had is beginning to diminish, so much so that I have changed from Depends for Men to Depends Pads for Men during the day. It feels so good to wear cotton underwear and not the rubber pants that are part of the Depends for Men. I feel like I can breathe once again, that the underwear doesn’t stick to my buttocks, feel cold, chafe or bind. The thing that prompted the change was the simple fact that I was using fewer Depends three weeks after the catheter was removed. Leakage is slowing, not stopped. But the simple fact is that things are improving, getting better day by day.

This is, of course, an important lesson to remember. No matter how difficult something may seem at the moment, there is always a bright side to the picture. That old saying, this too shall pass, is quite true so long as one is willing to do the work to extract oneself from the interior of the self. It all comes back to the idea embedded in Levinas’s fundamental ethical obligation, to be of service for the benefit of others, to think of others before you think of yourself, to be ready to answer the call of the other without reservation or expectation of reciprocation. It is this basic idea of getting outside of the self in order to be present in existential time, in the material world, that makes all the difference in living in the world or contained as a hermit within the self.

Being of service to others is a decision made without reservation. It is a decision that rips a tear in the fabric of interiority allowing the self to escape itself in order to live in the world. This tear in the fabric of one’s internal self, once made, becomes the guiding model for one’s lived-experience. This is not to say that the tear cannot be overlooked, especially in the time of great pain, physical or emotional, but once there it becomes the window that allows light to render the darkness moot. The tear in the fabric of interiority is permanent, it cannot be repaired. It remains open even in the darkest of moments, in the times of greatest difficulty. It provides a way back to the material world and the ability to be of service for others.

Back Home After The Doctors Visit

Back Home After The Doctors Visit

Back Home After The Doctors Visit

Making an appointment with one’s urologist on his last day in this office was more interesting than I had ever imagined. For the first time in my memory I was buzzed back to the examining room on time. The efficiency of the staff was at its best. I first was visited by a resident who laid the groundwork for the ultimate visit from my urologist. Blood was drawn, fluid samples left and then some genuine time spent talking about how normal my recovery was up to this very moment. Absolutely nothing unexpected, unheard of, abnormal, or even slightly out of the ordinary. Good news once again. I’ll wait for the PSA results which are expected to be significantly lower than they were before this whole cancer thing began, maybe even undetectable but who knows. More than likely, given the time frame of four-weeks since surgery, a number slightly under 2 can be expected. Four weeks from now, however, a PSA of around 0.1 would be more like expectations. We’ll see. For the moment, however, everything looks quite positive.

As Guy Clark (a Texas singer-songwriter) once wrote,

Nothing lasts forever
Say the old men in the shipyards
Turning trees into shrimp-boats
Hell, I guess they ought to know.

Clark’s words have often been of great comfort to me. Change is a constant; randomness in this world is the grease that lubricates the entire machine. Accept that and the very idea of turning trees into shrimp-boats is something one must not only expect but accept as a rule of living in this world.

In my mind the universe is a very large random number generator, run by probabilities, predictable to a fault but not to the detail of any single individual actor in the play. If something can happen, if something is possible, no matter how small the probability, it will happen. You can absolutely count on that. It may not happen to you but if it is within the realm of possibility it will happen to someone or something. One cannot live in fear of the possible. That is a waste of one’s time and effort and gets you absolutely nowhere other than, just perhaps, causing significant stress, a factor which could actually trigger the unwanted. No, the only rational place to be emotionally is to be in this very moment, a time in which we deposit traces of an existential life and think about our own potential future by creating goals, hopes, and dreams.

Wasting time on the what could be, the what might be, the otherwise than what is wanted, the worst possible outcome without accepting what could be, what might be, the otherwise that what we want, or the worst possible outcome opens the door to negative energy and outcomes to occur. By accepting the worst, the otherwise, the could be, the door is open for us to work positively toward a more positive outcome.

Let me give you an example. After a radical resection of the prostate, even with nerve saving techniques and the steadiest of surgical hands, it is quite likely that one will suffer from some form of urinary incontinence. I know this for an absolute fact. The truth is that it is possible for this condition to be permanent, the worst possible outcome I can think of; the otherwise of desired outcomes. That being said, if this were true in my case, that the worst outcome possible were to occur I would not allow that to interfere with my zest for living. I have accepted that possibility. It would be something I would simply have to get used to. But I am doing everything humanly possible to assure that this outcome doesn’t occur. I do pelvic floor exercises on a regular basis. I left the urology clinic with a new, quite difficult, pelvic floor exercise that I do twice a day, morning and evening. This combination is expected to produce results sometime in the next 11 months, yes 11 months; I have already experienced some positive signs from just doing the pelvic exercises regularly.

So there you have it, accept the worst, work toward the best; it is a combination guaranteed to provide one with a serenity beyond one’s wildest dreams.

Overlapping Circles of Community

The impossibility of approaching the other (autrui) without speaking to him signifies that here thought is inseparable from expression . . . consist[ing] in the intuition of sociality by a relation that is consequently irreducible to comprehension.
Emmanuel Levinas, Basic Philosophical Writings, p.7

Overlapping Circles of Community

As the new year approaches, less than two weeks away, I think it is important to reflect on the past year, the ups and downs, the natural fluctuation of the randomness of time, in order to digest the traces left behind that continue to affect me. As I age I find that life presents new, often unique, challenges that simply come with getting older. I also find that concurrent with those challenges is a desire to connect with friends and family through increased social contact. Additionally, while I have always been struck by nature, I find myself increasingly being in awe of the beauty and violence of the natural world. Both of these connections require one to approach the other (in the case of social contacts) and the Other (in the case of natural phenomenon) with a speaking, a conversation or perhaps as Levinas equates this use of language, with a (non-theistic) prayer (more like a polite but insistent asking or imploring) said without reservation or expectation.

Two major medical issues seemingly exploded, disrupting my life since May. The first of these required a total replacement of my left knee, a procedure from which I am still recovering. I am no stranger to orthopedic surgery having had two hips replaced and a L3-S1 laminectomy fusing my lower spine with titanium rods and screws but I had no idea how difficult it would be to recover from knee replacement surgery. After three and a half months of physical therapy I regained nearly full extension of the knee but I remain plagued with a stiffness that seems to haunt me during the day.

As if that were not enough, I was diagnosed in September with prostate cancer. Considering that the biopsy of the prostate found an aggressive strain (Gleason score of 4+4) and a spike in my PSA to 23 (a range from 21 to 26 over three samples) there was every reason to believe that the cancer was metastatic. This proved not to be the case on bone and CAT scans but the CAT scan was inconclusive because of the amount of metal surrounding my groin. In consultation with my urologist and internist and long talks with my wife, we decided to undergo a robotic radical prostatectomy, a procedure performed on November 28th, nearly one month ago. Once again I dodged a metastatic bullet when the biopsy of the prostate found the tumor completely contained within the organ and the lymph nodes free of disease. At this very moment I can look forward to many more disease free years.

As a result of the prostatectomy, I am left with two side-effects. I am currently required to wear diapers due to incontinence and I am unable to become aroused. I don’t know if these are permanent or temporary and I am not certain I want to undergo additional surgery to correct them. I meet with my urologist on the 27th of December and expect to have a frank discussion with him to see what he thinks. While he will be handing me off to a new urologist, one of his partners, as he moves to a new position out of town, I believe he will be more than straight forward with me about these two side effects.

So the point of retelling these two medical tales is simply this, for me, most of 2012 was consumed with medical issues. It was also met with family tragedy as my youngest cousin, Steven, passed away from multiple myeloma, a particularly virulent cancer that simply consumed his body but never his spirit. About a month before he died I was in Los Angeles to celebrate a 60th wedding anniversary of my wife’s closest friend’s parents. While there I had breakfast with Steven, my sister and several other cousins. Steven, I believe, knew the end was near but he never let on. We talked, laughed, shared stories of our younger days and, without knowing it, said our good-byes. A month later I was back in LA to attend his funeral.

When I let my family know that I was diagnosed with prostate cancer the outpouring of love and support was absolutely overwhelming. What I learned from my cousin Steven was to never ever give up on life, to live life on life’s terms, to experience every moment of existence as unique and filled with the joy of breath; there will be time enough for whatever the antithesis of celebration might be in the grave so there is no need to feel sorry for oneself for a life well lived.

None of my lived-experience of the past year comes close to my being able to comprehend the consequences of these events. There being no intentionality causing the events to occur (I see the universe we share as a gigantic random number generator where probability trumps intentionality) I find that I take great solace in the long and sometimes quite brief conversations I have had with those closest to me. I am learning to extend myself to others in powerful ways and even find myself making new friends along the way. I am buoyed by a fresh look at the natural world in which I exist and the awe inspiring power ranging from the smallest micro-organism to the power of a tiny river’s capacity to carve a Grand Canyon, to the ravages of a blizzard in winter. Taken together, these events, these conversations, my ability to see the absolute beauty in nature and to be awed by the universe itself make this life a life worth living.

In Every Sorrow There Is Profit

“In every sorrow there is profit” (Proverbs 14:23).

The weather forecast is...rain!How can a sorrow turn a profit? Let me relate this to my own sorrow, my battle with prostate cancer. The words, “You have cancer,” even when these words are somehow expected given the circumstances, are stunning. In my particular case, these words placed me in immediate confrontation with my own mortality. I certainly understood that life itself is a terminal condition; that one cannot expect immortality or at least a corporal immortality. I knew that I was going to die someday but suddenly the prospect seemed utterly possible.

The cancer was discovered through needle biopsy prompted by the fact that my PSA had a range of 21 to 26. The cancer biopsy found about 5% of three samples had a Gleason Score of 4+4, making the cancer itself quite aggressive. In consultation with my urologist, internist and my wife, I decided to follow the recommendation of the urologist opting for a robotic radical prostatectomy, a procedure that would provide me with the best chance for a “cure.” Since my bone scan was negative for metastasis and my CAT scan was mostly negative for metastasis (because I have a great deal of titanium shielding my pelvic area (two replaced hips and a laminectomy l-3 to s-1) the pelvic area being a question mark, the diagnosis of non-metastatic cancer was on hold until the biopsy of the lymph nodes surrounding the prostate. All that was hard to swallow especially when I had to wait a month for the prostate surgery to take place because the gland was swollen due to the needle biopsy procedure.

The instant one learns that one has a potentially fatal disease, prostate cancer is the second leading cause of death in men, the prospect of eternity becomes real. But what exactly does eternity mean? For me, the prospect of eternity means a reversal of the transition of exiting one infinity, a condition that is emergent at the very moment of birth to the transition of returning to that very infinity at the very moment of death.

This transition is one in which one moves from existential time, the lived-experience, to archival (remembered) time, the traces left behind for friends and family and possibly for others outside a direct connection to the self. The first time I heard the words spoken aloud, “You have cancer,” it was like a kick in the head. The last time I experienced such a sensation was when I heard the not unexpected words, “Your father is dead.” Everything stops, stands still, refuses reality. It is the first stage of any sorrow, that of denial. I found a quiet place to sit, to embrace the stillness, the silence that surrounded me. I wanted to be completely alone, to sink into myself allowing me to feel sorry for the loss or potential loss that is approaching. In very real terms, I found myself embraced by and embracing a deep sorrow. In poker terms, however, I had a few outs. Not all the cards were played and not all the possibilities were known.



I soon discovered the profit promised in the proverb that inspired this post. The strength I had working for me was the fact that I had some outs; that there was the possibility that the surgery would be curative so rather than facing immediate mortality, I would be safe, at least from this disease, for some time to come. This gave me the strength to rethink the ethics proposed by Emmanuel Levinas summarized by what Hillary Putnam called the fundamental ethical obligation: I am responsible for the welfare of the other without reservation or expectation of reciprocity! This fundamental obligation provides one with the ability to live in this very moment, the moment of existence, without projection and without memory in the sense that what is done is done and, without reservation, one cannot dwell on regret as a predominant emotion to the traces of the past.

The sorrow imposed by prostate cancer provided the opportunity to profit from the knowledge that Here I Am! responsible for the welfare of the other, the fundamental ethical obligation, as a call to live ethically in this very moment. Living in this very moment is both exciting and freeing. I can’t imagine living anywhere else.

With Apologies to Martin Luther King, Jr. — Free at Last!

Free At Last

Free At Last (photo credit: Roger Passman)

The first words I heard on the news this morning as I was getting ready to take a shower was that the area was seeing a bit of light rain and that it would last at least through rush hour and maybe beyond. “Oh no,” I thought, “this will make our drive into the city miserable!” There I go, projecting again. When will I ever learn? What really might make the drive miserable is traffic for whatever reason that traffic builds, be it time, weather or early holiday shoppers and I never even thought about other reasons.

This morning I had an appointment to remove the catheter that has been my constant companion since surgery last Wednesday. While mostly going unnoticed, there were times when the catheter was a royal pain, mostly when it came to doing the necessary upkeep to make the whole thing run smoothly. Then I had a day bag and a night bag, each one requiring a different skill set to manage. But this would all end this morning when the catheter would be ripped from my insides to bother me no longer.

Driving into the city was nothing like I imagined. There was no rain, only a bit of holiday traffic but it was still early. We left the house at 5:50 AM to make an 8:45 AM appointment. While I didn’t think it would take that long to drive into the city, I knew if we left much later our 1 hour drive could easily turn into 2 hours and then who knows. My mother taught me that if you aren’t at least ten minutes early for an appointment, you are definitely late. We arrived, dry, at 7:10 AM and sat down to a healthy hospital food breakfast. Yummy?

Being conscious of the time, we arrived at the urology clinic at 8:30 AM for my 8:45 AM appointment. Good, I was on time. Once checked in, I received a pager and a set of instructions for where to go when the pager went off. I expected rapid treatment because I booked the first appointment of the morning. So I sat patiently, waiting, waiting, waiting…until 9:30 AM when I went to the receptionist’s desk to ask if the pager was working or not. After many questions, the nice young lady behind the counter paged the nurse practitioner with whom I had the appointment. In a few moments a nurse appeared and led me to the procedure room. She was quite apologetic, perhaps because she was not the nurse practitioner with whom I scheduled the appointment, but she was efficient and pleasant; before long I was sans catheter. Oh happy days…

I came to the procedure armed with two pair of Depends for men. I expect to leak a bit as my body becomes used to working without help. There are exercises I am supposed to do and because they are so easily accomplished I do them frequently. I expect to not need these male diapers for too long but I am prepared for several days worth of leaking. I can always buy more if I miscalculated.

The whole point of this post is that progress is being made. Not only am I cancer free as of this very moment, I am also catheter free. We’ll see about erections and incontinence as time goes by.

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