On the same day, in a couple of weeks, my wife and I are seeing respective doctors to check in on our cancers. March twenty-second.
I don't think of myself as someone whose self-definition normally includes reference to a medical problem, especially one so iconically extreme.
Tuesday, March 8, 2011
Saturday, February 19, 2011
My Prostate Cancer Treatment Plan
My urologist recommended my recently diagnosed prostate cancer be treated within the next four months. As far as he could tell from his digital exam, it had not yet escaped the gland, and my PSA was relatively low, but the biopsy showed it was moderately aggressive, though not advanced.
My father had prostate cancer and opted for radiation. It messed him up and bowel problems resulted, making the rest of his life pretty hellish. Even if I could get past Dad's experience, it doesn't seem like a good choice. For one thing, if radiation didn't work, the only further option would be hormone treatment, and that just doesn't sound good. Plus, I can't get over the fact that you don't get visual feedback on how effective the treatment has been.
After surgery, you know pretty clearly how clean you are, and radiation is then an option to kill any worrisome outliers that couldn't be surgically removed.
I'm planning on having a robotic laparoscopic prostatectomy, which has been described as the new "gold standard" for treating prostate cancer.
Having it done laparoscopically means much smaller incisions and faster recovery time. The robotic part of the surgery is desirable because it allows for extremely precise excisions.
Since this is a relatively new procedure, it's especially important to have an experienced surgeon, and I'll have someone who's performed several thousand of these surgeries. I read 25 reviews from those he has treated, and they all gave him 5 out of 5 stars, across the board (except for one patient who gave him a 4, for punctuality). He's the guy the doctors go to to be treated, and he both opted for, and was satisfied with, this type treatment for his own recently diagnosed prostate cancer.
The surgery couldn't be scheduled until early May, which my urologist says will be OK, but I'm on the waiting list for moving into a cancellation.
Sloan-Kettering has a nomogram--a predictive model that takes into account different variables--that tells me I have a darned good probability of not only surviving this but living for a good many years yet, most likely succumbing to something other than these damned spots.
At this point, the main thing that scares me is having, for a week, that damned catheter. I've got an idea what's involved, but I can't quite bear yet to fully look into it.
My father had prostate cancer and opted for radiation. It messed him up and bowel problems resulted, making the rest of his life pretty hellish. Even if I could get past Dad's experience, it doesn't seem like a good choice. For one thing, if radiation didn't work, the only further option would be hormone treatment, and that just doesn't sound good. Plus, I can't get over the fact that you don't get visual feedback on how effective the treatment has been.
After surgery, you know pretty clearly how clean you are, and radiation is then an option to kill any worrisome outliers that couldn't be surgically removed.
I'm planning on having a robotic laparoscopic prostatectomy, which has been described as the new "gold standard" for treating prostate cancer.
Having it done laparoscopically means much smaller incisions and faster recovery time. The robotic part of the surgery is desirable because it allows for extremely precise excisions.
Since this is a relatively new procedure, it's especially important to have an experienced surgeon, and I'll have someone who's performed several thousand of these surgeries. I read 25 reviews from those he has treated, and they all gave him 5 out of 5 stars, across the board (except for one patient who gave him a 4, for punctuality). He's the guy the doctors go to to be treated, and he both opted for, and was satisfied with, this type treatment for his own recently diagnosed prostate cancer.
The surgery couldn't be scheduled until early May, which my urologist says will be OK, but I'm on the waiting list for moving into a cancellation.
Sloan-Kettering has a nomogram--a predictive model that takes into account different variables--that tells me I have a darned good probability of not only surviving this but living for a good many years yet, most likely succumbing to something other than these damned spots.
At this point, the main thing that scares me is having, for a week, that damned catheter. I've got an idea what's involved, but I can't quite bear yet to fully look into it.
Wednesday, February 2, 2011
Oops
"You have prostate cancer," the urologist just told me by phone. Biopsy, et cetera: seven on the Gleason scale of six to ten.
"Oh, shit," is my first reaction, and then, "Well, I can get through this."
And I can, although I was surprised by the diagnosis. When my doctor first told me in December that my PSA, although not exceptionally high, had been consistently creeping up over the past two years, making an appointment with the urologist was more a way of assuaging his and BFF's concern than any alarm on my part.
So...we'll see what this brings, but I'm not too worried. Yet.
Friday, December 17, 2010
Orphans
Three days ago, on Tuesday, an hour before the phone call, I had finished a day of teaching and was writing lesson plans for today, when my wife and I were planning to arrive in Puerto Vallarta right about now.
It was my sister on the phone calling to tell me that she was with our mom at the hospital, and that it was time for me to come.
I left the next morning to cross the country so that I could be with Mom at what, that same evening, became her death bed.
Tomorrow is the first of two memorial services we will hold. It will be at the retirement home where Mom has spent the past 4 years living on a unit along with others who have memory problems.
My sister, from whose house in Virginia I am writing this, has been a weekly companion and caregiver for Mom during this time.
Our plans are fragile flags claiming country we hope to inhabit. The earth can shift in a second, changing boundaries, rivers, lives.
Sunday, December 5, 2010
Downstream Bohemia Redux
We are looking forward to our upcoming visit to Yelapa, a small Mexican fishing village on Banderas Bay, accessible by boat from Puerto Vallarta. Ana Rosa, our landlady, has graciously invited us to share Christmas dinner with her family. We will be combining our vacation there with a trip to Guanajuato capital.
This is a re-post written after last winter's idyll.
As a schoolteacher, I get a two-week vacation every December. In lieu of a raise in these hard financial times, BFF was given extra time off. That allowed us to spend over a week in a tropical paradise—a small fishing village in Mexico to which the only reasonable access is a 45 minute boat ride. Heaven.
As a consequence of its isolation, there are no roads, and hence no cars in the village. Virtually all the heavy lifting is done by human, and occasionally mule, power. We were fortunate enough to have rented a casita overlooking the town pier, where most of the people and goods are offloaded from the small boats, called pangas, that arrive two or three each hour.
Upon arrival, crates of beer, produce, dry goods, plastic pipe, you name it, are unloaded and moved by a small team of men with wheelbarrows. They work industriously for 15, 20 minutes, or so after every boatload, fanning out through the labyrinth of uphill alleys and paths to the ferreteria, the several tiendas, or wherever anyone has a delivery. Then they come back with their wheelbarrows to the benches near the pier to sit, talk, laugh and rest until it’s time to do it all over again.
As a person who has spent most of his working life in manual labor, I appreciate both the effort and the satisfaction these laborers must feel with the rhythm of their day. But, I have to admit, more than that I appreciate simply being able to watch their muscular and good-natured ebb and flow.
One fellow in particular attracted my attention. He was older, and
he worked more often than the others. Roundly built and dressed a little more shabbily, he wore a sweat-stained baseball cap over his thatch of black hair. He was good-natured, and greeted me with a friendly, “Hola, amigo,” whenever we passed. He was also tireless, humping load after over-loaded load up the winding cobblestones, back and forth, until all the goods had been moved. My name for him was “El hombre mas fuerte del pueblo.”
Over the course of several days, looking out over the pier from our balcony, I produced a not-very accomplished sketch of this gentleman. I then got it into my head to give him the sketch, as a sign of friendship and appreciation for his labor. Our last hours in Yelapa, I hunted “El Hombre” down. He seemed a little taken aback, but smiled and shook my hand. Leaving him, looking back, I saw that he had carefully folded the picture and put it into his pocket.
About half an hour later, as BFF and I sat nervously with our bags waiting for the possibility of a panga back home, “El Hombre Mas Fuerte” reappeared. The two of us endured smiles, awkward attempts to converse, and even more awkward moments of silence as we tried to think of how to converse, until it became clear that he had assumed the role of our protector and handler, assuring that we would make our boat safely without having to worry or lift a finger. On parting, we shook hands--the solidarity shake. “Gracias amigo, hasta el ano proximo.”
I look forward to seeing "El Hombre" [whose name I now know as Cipriano] again this year. I flatter myself to think he might still have, somewhere, that poor sketch I gave to him. What he gave to me is an enduring memory of friendliness that transcends borders.
This is a re-post written after last winter's idyll.
As a schoolteacher, I get a two-week vacation every December. In lieu of a raise in these hard financial times, BFF was given extra time off. That allowed us to spend over a week in a tropical paradise—a small fishing village in Mexico to which the only reasonable access is a 45 minute boat ride. Heaven.
As a consequence of its isolation, there are no roads, and hence no cars in the village. Virtually all the heavy lifting is done by human, and occasionally mule, power. We were fortunate enough to have rented a casita overlooking the town pier, where most of the people and goods are offloaded from the small boats, called pangas, that arrive two or three each hour.Upon arrival, crates of beer, produce, dry goods, plastic pipe, you name it, are unloaded and moved by a small team of men with wheelbarrows. They work industriously for 15, 20 minutes, or so after every boatload, fanning out through the labyrinth of uphill alleys and paths to the ferreteria, the several tiendas, or wherever anyone has a delivery. Then they come back with their wheelbarrows to the benches near the pier to sit, talk, laugh and rest until it’s time to do it all over again.
As a person who has spent most of his working life in manual labor, I appreciate both the effort and the satisfaction these laborers must feel with the rhythm of their day. But, I have to admit, more than that I appreciate simply being able to watch their muscular and good-natured ebb and flow.
One fellow in particular attracted my attention. He was older, and
he worked more often than the others. Roundly built and dressed a little more shabbily, he wore a sweat-stained baseball cap over his thatch of black hair. He was good-natured, and greeted me with a friendly, “Hola, amigo,” whenever we passed. He was also tireless, humping load after over-loaded load up the winding cobblestones, back and forth, until all the goods had been moved. My name for him was “El hombre mas fuerte del pueblo.”Over the course of several days, looking out over the pier from our balcony, I produced a not-very accomplished sketch of this gentleman. I then got it into my head to give him the sketch, as a sign of friendship and appreciation for his labor. Our last hours in Yelapa, I hunted “El Hombre” down. He seemed a little taken aback, but smiled and shook my hand. Leaving him, looking back, I saw that he had carefully folded the picture and put it into his pocket.
About half an hour later, as BFF and I sat nervously with our bags waiting for the possibility of a panga back home, “El Hombre Mas Fuerte” reappeared. The two of us endured smiles, awkward attempts to converse, and even more awkward moments of silence as we tried to think of how to converse, until it became clear that he had assumed the role of our protector and handler, assuring that we would make our boat safely without having to worry or lift a finger. On parting, we shook hands--the solidarity shake. “Gracias amigo, hasta el ano proximo.”
I look forward to seeing "El Hombre" [whose name I now know as Cipriano] again this year. I flatter myself to think he might still have, somewhere, that poor sketch I gave to him. What he gave to me is an enduring memory of friendliness that transcends borders.
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