Notes from the Cafe Fiasco

MLTD - 6/26 - Options (Take 1)

Kevin R. Loughlin, MD is a very nice man and undoubtedly a fine surgeon, but he certainly knows how to ruin a guy's summer.

I met with him today to go over treatment options for My Life Threatening Disease (MLTD) and this is what he came up with in order of recommendation: 1) Surgery - go in and take out the bad stuff; 2) Brachytherapy - put radioactive seeds in the prostate to burn the bad stuff out; 3) External Radiation - get the bad stuff zapped five days a week for seven weeks straight. Approximate chances of side effects on each of these: Urinary Incontinence - small chance, Impotence - 50/50. Not being a gambling sort (at least with my health), I can't say that I like these odds all that much.

The one good thing that he said is that I have some time to make up my mind - I should be doing something by September and that means that I can explore some other less invasive options of the more Woo-Hoo variety over the summer (I got something to lose?). He also said that even this timeline is more a case of dealing with this hanging over one's head than biology (and it's good that he said this since it confirms my impression that, though he's a surgeon, he does understand that there's a mental element to all this).

We still don't really know exactly how advanced the cancer is in terms of tumor formation, so I'll again have the priviledge of having a probe stuck up my butt (this time for an MRI) in the near future so we can get more info in this area (pun intended). For the moment, we're assuming that the cancer is Stage 1.

So, it looks like it might be a summer of intensive chi kung and chinese herbs (which may be good for you, but taste just awful). Maybe I'll finally learn the whole Yang Short Tai Chi Form. If I did, at least that would be one good thing that could come out of all this.

One thing that also hopefully will come out of all this is an improvement in Kevin Loughlin's sense of humor. About three-quarters of the way through the session, I, with a straight face, asked him whether this was just all a cruel joke and he stumbled around for a minute trying to come up with a good answer. Then he noticed that I had a big smile on my face and I let him off the hook by telling him that that the question was a joke. Looks like Kev and I are going to get to know one another over the summer (even if he did ruin it for me).

MLTD - 6/25 - Research

Normally, when given a large problem, the first thing that I'll do is hit the books. The ability to do research on a problem is one of my strengths and also a way to feel like I'm in control of the situation is to do as much research as possible about it. For some reason, this time I haven't been doing this this time around. I don't know why.

It could be just garden variety fear of the "I don't want to know" type - though there doesn't seem too much denial going on here (after all, you folks are reading about this little problem that I have because I posted it on the Internet). Or maybe I know that this is going to be ugly and I'm just trying to give myself a break. This is just another thing that I don't know about this situation.

Anyway, it's time to step up. I've got the first meeting with the Doc tomorrow and I have to be able to discuss options intellegently - even if I don't take any of them - so it's time to "engage" (as Jean Luc Picard might say). But it makes me nervous. The more that I get into the literature, it's clear that in my case we might go anywhere from just watching the cancer for a while to full scale heroic surgery. And even if the treatments go well, there's dealing with recovery and the very real potential "side effects" of impotence or incontinence. In fact, the more research that I do, the more the "side effects" of the treatments look more like the potential "long-term effects" of the treatment.

Maybe the fact that I haven't done the research up to this point, is simply the recognition that no amount of thinking is going to get me out of this one. Even the most throughly understood and best choices may have very bad consequences. Not great news for someone who's lived the life of the mind all these years, but the truth, none the less.

MLTD - 6/22 - Reason to Believe

It's over a week since the phone call and I'm still having a problem with altering the belief system to incorporate the fact that I'm going to have to go through all of this - whatever all of this is, which still isn't clear to me.

I'm sure that a large part of this is that fact that I don't feel badly. The usual allergy symptoms are there, as they have been for the past 57 years during June, but beyond this, and the fact that I don't feel particularly "energetic," things are pretty normal - the dishes in the kitchen are stlll crying to be done, there will be much too much to read and understand over the course of this day, and my lovely old cat is conked out on the floor over by the window in the middle of his morning nap. This is a typical summer day for Marshall T. Spriggs.

Except, of course, for the small angel or demon sitting on my left shoulder that quietly whispers in my ear that I should be paying attention to what I'm doing because now there may be a positive limit on the number of times that this is all going to happen.

Besides this nagging, there has been little reason to believe that any of this is actually happening to me and there's a positive resistance to accepting the fact. I have to believe what the Doc said over the phone last week, but I don't want to.

My Life Threatening Disease

Things have been pretty boring lately. The job(s) have been relatively under control. I've been slogging along in the usual many and various arts. The Bush Administration has been the world's largest excuse to take Prosaic for a long time now. A state like this usually means that things are about to get really, really weird and this time is no exception.

On Thursday, I got the call from the doctor that told me that I have cancer -- a small amount of cancer in the left core of the prostate, giving me the honor of joining the 17% of American males that will have to cope with the disease at some time in their lives.

All of a sudden, things weren't boring anymore.

There were people to talk to, things to read, plans to discard, plans to make, and the occasional creepy, crawly feeling that I'm getting to understand accompanies the news that you have a Genuine Life Threatening Disease -- better known as fear.

And, of course, there is also an opportunity to write. Not that I can actually help doing this, since writing is how I explain my life to myself and there looks like there's going to be quite a bit of 'splainin' to do in the next few months. Such information is what I'm all about (as any of you have been reading any of this stuff over the past 12 years know) and you probably also know that I don't have much in the way of ethics in terms of what I publish about my life. I calls 'em as I sees 'em -- as embarrassing or strange as they might be.

On the other hand, I grew up listening to my elders participate in the favorite indoor sport of the working class -- comparing the illnesses that they and their family had fallen victim to (and they were copious). It was a genuine drag to hear about everyone's heart attacks, bad backs, and cancer. Especially cancer since, in the 1950's and 1960's, if you contracted cancer you were dead, even if you were walking around for a while.

Though this no longer automatically the case, the stuff is still serious since it can kill you before something else does. Prime grist for the writing mill -- just the stuff that people like me love (and would love even more if it didn't threaten to kill us). But how to write about this without putting you, my dear readership, in the same position as I was growing up? After all, 1) you've got enough problems, and 2) your email mailbox is already crammed with offers for new mortgages, penny stocks, and riches from Nigeria. As strange as it may seem, you may not want to hear about my description of my biopsy (no matter how much you like office supply analogies).

I think that the answer is that I will keep the Notes from the Cafe Fiasco email list relatively free of this topic and I will move all "news" of the progress or regress of My Life Threatening Disease (MLTD) to this blog. The postings will be under the category of "MLTD." This means that you, dear readership, will have to go look to see how I'm doing if you're interested, so it's your fault if you don't like what you find and not mine. Most of all, I'm not invading your privacy with my story ("How the Gland Turns"?) -- however it turns out. Of course, the one change in the list is that long (or permanent) periods between issues of NCF no longer mean that I'm just not getting any writing done.

The world of cancer blogs is actually quite exciting. I've got some real competition here - people who are really sick and can really write (best one so far by Leroy Sievers: http://www.npr.org/blogs/mycancer/index.html). Fortunately, these people either get better (and get out of the cancer blog racket) or die (and get out of the cancer blog racket). I intend to do the same.

Next week I have my first talk with the Doc about treatment options and a whole new world of toxicity. As usual, I'll post next when I have something to say.

At least I'm not bored anymore.

MLTD - 6/20 - Battlefield

Got through the biopsy two weeks ago, the "news" late last week, informing those who should hear from me directly, and the "general announcement" through the email list. Now I'm just finishing up responding to those nice enough to send notes back.

I'm already tired (mentally, not physically) and I can now see that getting through this is going to be at least as much a problem of spirit as it is a physical problem. And this is just the beginning. I know that my life will change in response to this crisis and I'd really like to be in at least partial control of how this happens but, today, for the first time, I'm wondering if I can do this. It already seems that cancer is a part-time job, that is until it becomes a full-time job later on.

Or maybe it's just a bad day.

Cutting Edge

According to the chart accompanying the front page story on housing affordability in the Boston Globe on Monday, housing in the Boston area became unaffordable in approximately 1999. Now, that's cutting edge journalism guys.