And Now a Word From My Oncologist

This letter recently arrived in the US Mail.  Considering all of the radiation side effects I've had since the seed implant procedure on 2/29 I wonder if I'll receive another letter when the radiation declines by the first half life.

Achy-Brachytherapy

My cancer now has a 2nd glowing sole print on its ass.  I reported to the hospital bright and early and allowed them to sedate me and then to somehow implant radioactivity on the cancerous areas of my prostate gland.  I say somehow because I encouraged them to use enough anesthesia to bomb me back to the stone age.  I wasn't aware of what they did or how they did it.

Next stop: the O/R where cancer gets the 2nd of a radioactive 1,2 punch

But when they were done I sure knew.  While I was off pounding cold ones with Fred and Barney I had a Foley catheter installed.  Modesty prevents me from relating exactly what that is, where they stuck it or what it looked like when properly installed so click on the link (SFW) and all will be revealed.  When I woke up I was in pain all over.  My throat hurt because they had stuck some kind of breathing apparatus down in there.  My insides hurt where my new radioactive seeds, the ones that I'll take to my grave, now live.  My wiener hurt and my bladder was screaming that I had to pee like it was filled with jellied fire.

Not knowing where I was and not quite conscious I think that I tried to get up with the intention of finding a men's room.  But I still had tubes in me and wired sensors on me, some of which I'm told that I ripped out.  Oh, and the Foley catheter was still properly plumbed.  My struggle is what the nurse told me caused the big blood stain on the bed.   The nurse warned me that when he removed Mr. Foley's catheter it would be painful and boy was he ever right.  I screamed from the intense burning pain in a very personal place where I had never felt pain before.  They sent me home wearing a maxi-pad.

When I got home I motored around my house under my own power.  I'm uncomfortable and when I urinate it burns like I'm peeing Drano but the doctors said that I should feel better in a few days.  I'm carrying enough internal radiation to arouse the TSA or ICE from their slumber but I have a card attesting to my nuclear non-proliferation status to show them at the airport or the Canadian border.  My post-op instructions say to not allow little children to sit on my lap due to radiation and to take it easy for a few weeks.

My urologist says that if the scan I'm to receive shortly shows the seeds taking root in the right place I'm good to go, to move to our new home and to live out the rest of my days happily ever after.

Graduation From External Radiation

Although I'm still left with the side effects of 5 weeks of radiation Godzilla is safely back in his cage.  Soon I will get internal radiation and then hopefully be on my way to beating cancer and selling our house.

Leap Year

Leap year comes once but every 4 years and every 4 years I do a double take when I look at a calendar and see February 29th.  I've did a double take after I found out that my next step in prostate cancer treatment, seeding the prostate gland with little bits of a radioactive substance, was scheduled for the morning of February 29th.  

So imagine my surprise when I received an email from the builder of our new house in Arizona saying that they'd like us to come on down for the closing on our house to trade a large sum of cash for title and keys on February 29th. What are the odds?  

By the time you read this I'll be move in ready!

The builder broke ground the day I received my cancer diagnosis.  So in the race to see whether I'd beat cancer first or have to cough up money for a house I can't move into until I beat cancer is over, the house won. Needless to say I can't hand over money in Arizona while I'm sedated and having an invasive medical procedure performed on me in Seattle so my wife called the builder and sweet talked them into a no cost extension, because moving into a new house is a really big deal but becoming cancer free is job #1 prime directive now.  Only after recovery can I seriously think about job #2: paying for the new house, moving to the new house and selling the old house.  New house closing date is now March 15, the oncologist says I should be roadworthy by then.

I'm in the home stretch of daily radiation treatments and can't wait to hit the 5 week finish line.  The most annoying radiation side effect so far has been on my bladder.  Driven crazy by radiation it's in perpetual freakout mode, always alerting me that it's full and ready to burst. "I gotta go!!!!!", Right NOW!  There are no half measures, no stalling, no putting it off for the next rest area on the freeway.  It's always seems like a matter of desperation.  I sometimes awake every hour during the night to stumble to the bathroom and pee and man, is that annoying.  My oncologist says that this should diminish when the daily radiation stops, only to pick up again in March when radiation will be permanently installed in the prostate gland itself.  It should permanently diminish as the radiation half life decays the radiation away, kills the cancer and the seeds become inert.  Those inert seeds will go to the grave with me.

So how is this seed installation done?  What happens after the radioactive seeds are implanted?  If you're curious click here and read,

WHAT TO EXPECT FROM A SEED IMPLANT: THE FIRST TWELVE MONTHS

I received that in the US mail and it was most likely written by my oncologist as his name is first on the masthead. 

I had been under the impression that they would place these radioactive seeds in my prostate gland through my back door just as the urologist previously biopsied it but this isn't so. 

Following anesthesia, thin needles containing radioactive seeds are precisely placed under ultrasound guidance through the skin between the scrotum and rectum and into the prostate.

Yow!  That sounds like a frightening thing to let strangers do in a very tender place.  Anesthesia isn't what I thought it would be either:

The first choice is a spinal anesthetic where a thin needle is inserted in the lower back and a Novocaine-like medication is injected. With spinal anesthesia, patients are temporarily numb from the waist down and will not feel any of the needles being placed. In addition to the spinal anesthetic, patients commonly receive a sedative intravenously so that they are more relaxed and often sleep through the procedure. The spinal anesthesia is the most frequent choice of patients and the one that we usually recommend whenever possible. 

The second choice is a light general anesthetic so the patient is completely “out.” This works well but patients are often groggy for some time after the procedure. The anesthesiologist will review the details including both pros and cons of these two approaches. Sometimes the type of anesthetic is determined by the patient’s overall medical condition; other times it is a choice for the patient to make.

Make mine choice #2, light general anesthetic. I don't want to experience the lower half of my body turn numb while I watch people insert things into me.  I know that this work needs to be done, wake me when it's over.

Radiation Treatment for Prostate Cancer

I'm into my second week of 5 weeks of daily radiation treatments for prostate cancer.  Each morning I take the bus to the Polyclinic on Pill Hill, change into pajama bottoms, lay down and position myself into a plastic cast of my calves and feet and present myself to huge round device above me that looks like something out of a planetarium.

Technicians come in to verify my identity by asking for my birthday.  Then they pull my pajama bottoms down around my hips so they can find my little freckle tattoos in order to align me properly and hopefully avoid irradiating of any innocent bystander organs.

Once alignment is complete the technicians leave the room, close the door and the process begins.  I feel nothing and hear little.  Other than an occasional click there's no sensation of any kind.  When there's music it's been jazz or country.  After 10 or 15 minutes a technician comes in and we exchange pleasantries and it's over until the next time.  See you tomorrow!  I change back into my street clothes, leave the hospital and get back on the bus. 

That's it?  Beating cancer can't be that easy.  And it's not.  I've been warned that side effects are coming, specifically weakness.  And there might be some skin burning.  And other more invasive and unpleasant procedures will come after my 5 week course of radiation is complete and my diseased parts have been properly prepped.

One side effect that I am experiencing is an unusual flatulence.  It doesn't seem to matter what I eat.  It starts in the afternoon and continues for most of the night while I sleep, a sort of bubbly and near constant, sometimes painful production of gas.  Radiation is administered 5 days a week so when the flatulence faded over the long holiday weekend I suspected the radiation.

During my 5 weeks of radiation I get 5 minutes a week to talk to my oncologist so I asked him if the flatulence and radiation were related.  He smiled weakly,  nodded affirmatively and added, "there's going to be some mucus too".  Oh goody, gas and liquids.  "Will I get any warning or will it just happen?".  He smiled again.  "You'll get a warning".

It's not much of a warning though.  I'm starting to find the whole radiation experience to be just a bit creepy.  It's a treatment that I can't hear, see or feel yet I'm starting to experience the side effects.  The radiation has inflamed my bladder so I urinate frequently.  When I go anywhere my first task is to seek out and note all bathrooms.  I can't sleep more than 2 or 3 hours without having to get up to pee.  I'm looking forward to a period when I can recover from my treatment and prepare myself for the next much more invasive phase.

Cancer Coming Attractions

I'm starting to realize that emotionally for me cancer appears to have stages. The first one was the I'm gonna die stage. It started with the moment of my diagnosis, lasted for 2 weeks and was marked by emotional instability, no sleep and the desire to "get my affairs in order". It was an awful time when I didn't want to do anything or see anybody.  There was going to be no further retirement, no new house, no future, no nothing. Cancer and death tinged my every thought.

I'm in the 2nd stage now, acceptance. I have doctors and a plan so I have some confidence that I'm in good hands. Things could be much worse, at least I don't have a gruesome big league cancer like glioblastoma multiforme, or GBM. In this 2nd stage not much has happened. I got a hormone shot and I took some pills and got a mildly invasive back door ultrasound but other than that I've resumed my normal retired life and haven't thought about cancer much. But I sense a gathering treatment storm, I now have so many upcoming medical appointments that I've had to use Google Calendar to track them all.

The 3rd active, invasive and radioactive stage is about to get underway. Soon I'm going in for the internal implantation of gold markers. I was told that it's just like a prostate biopsy (!) except with no snapping sounds (the peeling of the prostate is accompanied by snapping sounds as the harvesting instrument does its back door deeds). That means an experience as close to prison rape as I'd like to get, urinating blood and other jarring side effects. Perhaps carrying the gold markers will be something new to explain to airport security screeners if I get x-rayed by the TSA, assuming that I get through all of this and live to fly again.

Soon after I report to the downtown radiation/oncology center for something that on the phone sounded like a simple consultation session. Then an envelope arrived in the mail containing a flyer with an ominous heading that read, 

PLANNING APPOINTMENT FOR RADIATION TREATMENT 

An excerpt: "A bean bag mold of your hips will be used to position you in the same way each day. A few tiny, pin point tattoos will be placed on your skin. These tattoos will assist in positioning throughout your daily treatments".  My first tattoos!

The flyer goes on to instruct me about my sit down bathroom habits (they want daily and on schedule production), what to eat to get the desired solid and gas levels, when to pee and how much pee to leave inside for them. "We would like your bladder to be partially full for your CT and each day when you are treated. Please, urinate 30 minutes before your CT and then each day before your treatment time to empty your bladder. Then drink 8 ounces of water or non caffeinated fluid and do not urinate until after your CT or Tx". I don't even know what a Tx is but for all I know I'll be getting one (or more) daily starting before New Year's Day.  Radiation treatments will be daily and last for 5 weeks so hello again daily commute, bring out those lead lined King County Metro buses.

The power of radiation

After all of this will come the 4th stage, one so invasive that anesthesia will be required and when I awake I'll leave sore and with even more radiation. The anesthesia is a good thing, please bomb me back to the stone age if the hands of strangers and their medical tools must enter me there.

Now men have their own unique and manly exam room stirrups

After that the healing can begin and if everything goes according to plan an old home can be sold and a new home purchased and I'll be able to gratefully add cancer survivor to my list of life accomplishments.