A look back at Autumn

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November 15, 2016

Since my last post much has happened. My PSA has done a roller-coaster set of readings. Down to about 30 and most recently (Nov 1) up to 37.  Part of the decline to 30 from earlier 45 was that I got chemo and a Lupron shot at the same time. Lupron helped some, which means that some of the cancer in me is still susceptible to hormone therapy but obviously quite a bit is not.

The round of chemo has kept my PSA down so I have continued past the originally scheduled 6 sessions. I now have had 8 and will have the ninth on November 28. It is not clear that there will be a 10th but I expect that there will be.

This round has been hard on my stomach and lower GI. I have had stomach discomfort, diarrhea, and some constipation. These side effects are draining. They take the oomph out of me.  Usually they occur about days 7-12 of the cycle. I work hard to maintain some exercise, trying to get in 2 miles walking a number of times a week. I am skipping it today in order to write this.

I found myself buoyed up when the PSA dropped from 45 to 30. I know not to count on that drop as an indication that further drops are coming, but it was a relief. I had spent much of the autumn working on end of life things and that task is also draining. But we have most of that set now, my end of life celebration, our money, the house, clarity with the kids and immediate family, cars, house repairs, yard changes both completed and ordered from the landscaper in case I am not here in the spring. I have felt less down these past few weeks and that is a fun feeling, sort of like the feeling I used to have about how good it felt not to have a migraine.

During these weeks I get rock climbing when I can, no longer once a week but still every other week.  And as I have said in these pages many times, I can’t let this condition turn me to, well, a pity party. We have a grand Thanksgiving weekend coming up, visits from old friends, from family and a meal on Thursday at one of Minneapolis’ finest restaurants, Mannys, in has now become a tradition. I keep up with my German, though right now it feels like I am at one of those plateaus that I would like to rise up from, but that is not happening quickly. Our Christmas plan is to spend December 23-30 with all the family in a villa in South Padre Island. What a kick that will be. We have never done that before at Christmas. I am really looking forward to that. 

The work with spirituality has also plateaued. I have read some fine books and have a new perception of religion in general though I am still working on the meaning not just of spirituality but of living spiritually. One of the touchstones of such living is connection, which I am finding hard to define and realize. It is easy to define connection but what does it mean to be connected to others and other things? The answers of course can be worked out rationally and easily but the emotional (or realized) meaning of those answers is much harder for me to achieve. I have enjoyed meditation which I began about 2 months ago. In the short term it is pretty amazing in its ability to effect calmness. I like that. But I am not sure of the long term goal of meditation. Is it supposed to lead to the traditional mystical experience? To the dissolution of the ego? Are there plateaus in the practice? I am certainly a beginner and I have no answers to these questions.

Oh, the photography. What a joy. I have completed my 366 project. I certainly received many supportive comments and I have posted all 381 photos in an album on Facebook. I have also written an essay about what I learned from the project and probably will post it on this site in the near future. I loved the awareness and sense of harmony with the seasons that the project caused. Preparations continue for the show I will have with a local painter who is rendering a number of my photos. I think that show will open in the mid winter. My photo group is a great source of satisfaction. I love the discussions of each other’s photos. I am amazed and delighted with what we see in each other’s work. Our work is available on Flickr as Red Cedar Photographers if you would like to look.

Photography is a kind of meditative practice. The practitioner must be aware of and focused on the image, which is akin to breath. I have a ways to go with this thread of thought, but I enjoy it and will get there.

Enough for now. Thank you for reading.

     

2015 A Roller Coaster Year

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2015 was a roller coaster year for me and my cancer. In July 2014 my PSA began a slow rise that eventually crested at 330 in September 2015. During that time I switched from a urologist to an oncologist who prescribed me through the preferred sequence of drugs.  All of them temporarily reduced my PSA, then failed as the PSA returned at a higher level.  The last two cost $9000 a month. Thanks for insurance. Now I am on chemotherapy which I started in October 2015. The chemo is docetaxel (Taxotere), the “gold standard,” as a doctor at Mayo in Rochester, Minnesota characterized it to me.

During the year my wife and I had to work hard to deal with the fluctuations of the PSA. We learned to be dubious about the first reduction in PSA caused by any medication. More on this aspect of our life in another post. Suspecting that the regular failure of medications would lead to chemo and the restrictions it causes, I chose to use the spring and summer to travel. My brothers and I drove the length of the Mississippi River in May, my wife, two daughters, oldest granddaughter and I visited Denmark in July and we spent August in Seattle with our son and his family.

During these trips I noticed a pressure in my groin often extending down the right side of my penis and another pressure in my right thigh that dulled my sensitivity to touch.  Two different doctors were unsure of the causes of these discomforts though I know have a theory that I will explain later. We returned from Seattle in early September. By mid-September the events that led to me being on chemo began.

One evening, September 18, I had a violent vomiting episode and three days later another. As it happened I saw my oncologist a few days after these episodes and he ordered a CT scan.  That scan revealed that I had “innumerable” small tumors along my peritoneal wall and a large amount of liquid, called Ascites, in my peritoneal cavity. No action was taken at the time but for the next week I was extremely uncomfortable with constipation, stomach pain, lack of appetite. Finally the oncologist recommended that I have the ascites drained. That event happened on October 1. They drained 5.5 liters of ascites. The next morning I weighed 12 pounds less, 184. I continued to lose weight down to 173, though have since regained poundage up to 180 which is where I would like to stay. I began chemo on October 8, a Thursday and have continued it every three weeks since.  I had my fifth this week and have probably about three more. The end date is not clear. I will discuss chemo in the next post.

When the ascites was cleared and the tumors in the peritoneal wall identified, the oncologist suggested that I should have doctors at Mayo in Rochester look at them to determine whether anything should or could be done. So we went twice to the Mayo Clinic a very impressive campus connected by both skyways and a pedestrian subway.  While the campus was pretty neat, the surrounding neighborhood was not. I wonder if it is difficult to keep doctors in the area.  The first time was an entire day of appointments with various technicians to get blood and pictures of all my insides, finished by a long meeting with one of the top prostate cancer doctors. He said that having prostate cancer on the peritoneal wall was very unusual. He wondered whether it was actually cancer of one of the other organs within the peritoneal cavity. He scheduled a biopsy for the area which occurred the next week. I have detailed this visit in in an earlier post.

That biopsy proved that the tumors were prostate cancer and he assured me that the chemo treatment I was receiving was exactly the correct thing to do (which occasioned one of my nephews to wish that someone said that of something he was doing). As the PSA has gone down, I have wondered whether the tumors and the ascites buildup they caused were the cause of a number of the discomforts I had before the ascites was drained (the peritoneal wall secretes ascites which lubricates all the organs in the cavity and also absorbs it so that the amount in the cavity remains constant. The tumors blocked the absorption, hence the large puddle of it that collected in me. One friend was glad to hear that the ascites was gone. She though I was developing quite a pot, which I was, and she was glad to hear it was gone. Cancer gives strange gifts.) One aside. As the ascites grew so did the PSA number. However, the issue that initially caused me to be referred to the oncologist, a tumor on my iliac crest, had not grown at all during the year and a half that it has been present and no other tumors have developed in the bones, the usual place for prostate cancer to metastasize. Who knows?  I am just grateful.

With the ascites gone, the numbness in my thigh and the pressure in the groin have gone. In addition the blood in my urine has disappeared and with management from Miralax I have my constipation under control.