Wednesday, May 11, 2005

A Subtle Shift


Photo of Ilona and the author on Easter Sunday. Posted by Hello

Today means boundless and inexhaustible eternity. Periods of months and years and of time in general are ideas of men, who calculate by number; but the true name of eternity is Today.

---Philo

Example moves the world more than doctrine.

---Henry Miller

In Buddhism there is no place to apply effort. Everything in it is normal---
you put on clothes to keep warm and eat food to stop hunger---
that's all.

---Yuan-S'ou

A year and a week ago I underwent major surgery for removal of a prostate gland that had been determined to be a bit cancerous. I wrote about it and talked openly. Cancer is as terrifying to people of our civilization as just about anything we think of. I learned in the waiting rooms, however, that it makes brothers and sisters of us in treatment, as men and women struggle with their own varieties. The silence in those rooms is broken with great relief when we start talking together. I thought writing and letting people know what happens to me might serve some purpose---at least for research because so much effort is going into finding a cure...or even a cause.

But lately I guess I've gotten silent too, and occasionally I'm reminded of that, when a faraway friend or relative writes, "What the heck is going on with your health?" I haven't meant to be secretive, but there are some contributing factors. For one thing, I was raised not to talk about ailments. My parents didn't tell us much about theirs, and when they felt it was time to cash in their chips and go, that's what they did. As a kid, I got the impression that what chiefly marked the elderly was they always were talking about hospitals and stuff being taken out of them...and the long convalescence. LBJ showed us his scar. So despite my resolve to let you know, I may have slipped back into my more natural reserve about some things.

Furthermore, I sense there is a bit of a stigma about getting sick this way. People do NOT want always to ask me how I am...with that sympathetic tone. But if they don't ask me, then they might worry I'll think they don't care. So sometimes I feel they avoid me altogether. Easier. And I may sense their sensitivity and try to help them out by avoiding them too. Then I think maybe I've changed into someone more resentful and bitter...and that's why people don't smile in my direction so much. That's a dangerous downward spiral always available. Perhaps I slip into it sometimes.

And then have come intervening personal matters that really don't have anything to do with cancer...although, once you've got it, as terminal or survivor, everything seems to have to do with it. There was the Presidential Election, and I believe it was the second stolen one in a row. Obviously I went ballistic with my conviction, and wrote about it as long as I could hear so much as a peep of protest in the media or on the Internet. More recently our daughter suffered an injury in gym class that required reconstructive surgery. It's cost Ilona a lot of time from school, her grades have gone down---although in the old days a kid would have been extended extra help and time to catch up---and we have needed to care for her. (Her last visit to the surgeon and physical therapist will be today...so her life is returning to normal.)

But mostly I think I have been experiencing a shifting of my life's gears. Having never had a serious illness before or been in a hospital for anything, I'm new to this kind of dropout. I remember kids used to get something, like rheumatic fever or a touch of polio, and just sort of disappear for a year or two. The rest of us would operate like the herd animals we were, and move on without giving our ailing comrades a second thought. Only a few were curious about the kind of change in life and time the situation requires. Time changes remarkably when you're always waiting for the next test result.

Three months after my operation, very slight prostate cell activity still was located in my bloodstream. We held a vague hope it might be residue from the surgery. Nope, a couple months later it still was there...but it was about the same amount. It was so small that even the latest microscopic technology wouldn't be able to find it. Two more months, however, and there was a bit more going on. Something had been left behind, and we needed to try to eradicate it. Radiation was selected as the therapy. We... Well, since stuff is left up to the patient to decide now (to avoid those lawsuits) I have to say "we." THEY consulted the statistics and told me that most often, when this occurs, the bladder is the next place the cancer goes. More tests and another bone scan ruled out activity elsewhere...so a section of the bladder is where the radiation was aimed.

I got 37 radiation treatments, every weekday. Those treatments concluded a month ago. Mostly I had no side effects. Others report burning and pain, particularly toward the conclusion of the series, as tissue become increasingly sensitive. The amount and location of the radiation remains the same...I think, or at least in my case. Everyone is different, and because of that and the incredible technology and staff required, it is very expensive. It cost more than the surgery. People who work in this kind of radiology have a very special challenge in their career, but I found we really seemed to like each other...and I think that must have helped in my process.

But now, we wait again. I'm going to see my regular doctor next week, just for the couple-times-a-year checkup, but I asked her to write an order for a PSA in the blood test because I want to know what's going on. My radiologist cautions it's too soon for an accurate readout, and he's not seeing me again until October! My urologist and surgeon has ordered a blood test and appointment in July. We're looking for 0% activity 3 or 4 blood tests in a row. If that happens, I'm out of the woods...for now anyway...or for that type...or something.

Uncertainty steps in where always there has been a complacency taken for granted. Well, I'm 65...and most of my life development has been right on schedule---although usually I'm the last to know just what is happening. I suppose that could be a disastrous history, if enough hadn't worked out pretty well and I weren't so content (despite the grousing around that I do) and I didn't find life's progress so wonderfully amusing. So I guess I haven't kept up with writing about the cancer because everything has gotten so gradual...and all we seem to do is wait. When would be a good time for essays about this to conclude? Hmmm, I may have started a series here with only one inevitable ending. At this point, the uncertainty and anxiety are tough, and I admit it. I sincerely hope I'm not too much trouble for other folks to be around. I think that fear may be what really causes age to kick in. Thanks for reading.

2 comments:

jazzolog said...

Responses I've received here, at other sites, and by email have prompted me to write a short essay this morning. One of the emails was from the school nurse in our district who asked that I write something for her health newsletter. Here's what I came up with~~~

The computer and Internet certainly have changed the Carlson family life over the past 5 years. They've changed the way we deal with sickness and health too. When I was diagnosed with prostate cancer on my 64th birthday last year, I quickly Googled the condition and bookmarked a few good sites. It's not that I believe in treating myself rather than staying inside the medical mainstream, but there are a couple of good reasons for hitting the Net.

One is that the days of doctors telling you and your family just what you're going to have to do seem to be over. Maybe it's because of malpractice suits or they know we're going to do our own research, but now you're presented with options and statistics and then you decide. Never mind the physician went to school and training for a dozen years to learn how to do this stuff, overnight you may have to become an expert.

When I met my radiologist several months ago, he tossed so many choices and statistics at me that briefly I was blinded by his science. I said, "Doctor, this is like playing roulette at Las Vegas." He gave me a sort of wicked smile and replied, "Only there's no jackpot." That was my first taste of radiology humor, but I got used to it.

Cancer looms increasingly at the end of life's road for Americans. We still hope for a death from "old age" or a sudden lightning bolt of some kind, but we know personally more and more people who are battling cancer. I decided to be open about my diagnosis and I'm glad I made that choice. Others prefer to be more private, but I have welcomed the support of friends, colleagues, and folks I've met on the Internet...because I wrote about it there too. Not everyone wants to know about things so personal, and I always need to remind myself of that fact.

Skin cancer remains the most common kind of cancer in the United States, but we guys need to know prostate cancer is number 2. One in 6 men get it currently, and the number's increasing. Every year over 232,090 men are diagnosed with prostate cancer, and about 30,350 die. In the UK only 1 in 20 men is diagnosed with prostate cancer. Why is that?

We don't know what causes it, and if your family physician sees a flag on your PSA blood test and sends you to a urologist, neither of them probably is going to try to tell you. Maybe there is something about the American lifestyle that is creating more of it here than in the UK. Or perhaps Brits just don't want to know about it. (Those men also tend to wait and watch more than we do, rather than head right away for surgery, radiation or chemo.)

There are many good websites about prostate cancer, and I recommend ustoo.com and for links to really good research networkforgood.org. I welcome any personal email and you may write to jazzolog@peoplepc.com.

Anonymous said...

Well done on a nice blog jazzolog. I was looking for information on prostate cancer symptoms and came across your post A Suble Shift - not precisely what I was looking for related to prostate cancer symptoms but an interesting read all the same!