The Weight Of The Wait

I was an OK student in school. Mostly B's and C's and a few A's. It felt good when I got the occasional A. It was usually in courses that I actually liked, like political science and art. I was terrible in math, biology and Spanish. I may have gotten a couple of D's in those, but overall I was an average student, I guess.

I had to wait about 5 days for my biopsy report. I've heard that with cancer, you really must get a handle on the waiting part. Tests, appointments, scans, drawn blood, more lab work..you get the picture. As the days went by, I got more anxious of course, but I soon realized that if my particular health group has good news to give, they don't mind sending it in an e-mail. If it's bad news, the doctor will call you at home. Seems right to me, but as each day passed without an e-mail, I was really starting to tweak out a bit. Valium helped to a degree, but by the fifth day not much could settle me down.

As I mentioned earlier, my first name is George, and that is how my doctors know me. But the message on my answering machine is for Gil. I found out later that this was the cause for some of the delay - the doctor thought he was getting a wrong number! After this happened yet again, I wised-up, (remember, I was only an average student), and changed my message to "George, also known as Gil") A real AKA for little ol' me! Word.

The call finally came early one evening, and I could tell it wasn't gonna be good news - I even sort of expected it, but I was not prepared to deal with my final test score, and I scored big, baby! 100%. Of the 12 samples they took, all 12 had cancer in them. I made an A+.

Damn!

I scribbled a few notes on a piece of paper as the Doc was telling me this, and of the different options available in dealing with it. They aren't very good notes, and my mind was vaguely somewhere else at that point. It was like I was watching a movie and suddenly a continuous low bass note was playing in the background. Message heard, loud and clear, Doc...but let's continue this conversation any other time except for right now.

So there I was, at home alone with Dexter. Stacey was just about leaving her work and was car-pooling, so I thought there was no need to call her - she'd be home soon enough. I sat on the couch and cried. I suppose just about everyone who hears this sort of news does the same thing, so I just let it come out. Suddenly I noticed Dexter was at my side, not attacking my head or being bad in any way. He was just sitting with me. He knew, too. Good cat!

OK...this is getting too sad, and I've flayed enough of my inner soul than I'm comfortable with. I'll wrap this section up just by saying that I'm the luckiest man on this planet to have the most amazing support from a perfect wife, family, friends and cat (somewhat...we'll see...). When I get weepy, feeling upset that I'm putting these people through this, these people love me enough to smack me upside the head and tell me - "this is what we're here for!". I think I'm finally getting it.

Damn!...The surgery date (July 7) is time-warping it's way towards me and there's so much...funny shit I've got to write about...I hope I can cover it all, and I'll certainly try before the surgery. For instance:

1. Hilarious hi-jinks of an intern injecting me with some kind of radioactive shit!
2. Bone scan...ambiguity!
3. Late pelvic scan results = an insane questionnaire from my primary care physician!
4. Becoming a member of "The Cancer Cult"!
5. My CD - I Am Atomic Man! was disturbingly prophetic. A robot will help cure me!
6. Potential "Accidental Clown-Leg"!
7. And most unsettling of all: MY SURGEON LOOKS LIKE GUI FROM GAME THEORY!!!!

Great.

Emotional Wreckskew

The day of the biopsy was probably the first inkling of how I discovered how I would be dealing with all of this. I have a very...delicate yet volatile emotional constitution to begin with and I was wondering how all of the stress and depression would manifest itself. That day I had two responses.

I'm a big believer in bringing levity to grave situations. It's how I deal with stuff. If I can lighten the air just a bit, it really helps me to relax. I discovered this 20 years ago when I suffered a lacerated cornea due to a random street mugging.

Once the ambulance delivered me to SF General, I noticed that the excitement level by the doctors that were attending to me was pretty darn high. Specialists were brought in and it just seemed that the whole hospital was looking at my eyeball with grim determination. It was unsettling!

It got to a point where I just couldn't handle all those furrowed brows. So I said "Stop for a second!". They stopped. I said - "Am I going to die from this?"
They answered "No". I then asked "Is my other eye OK?" They said "Yes". Then I asked them to please lighten up just a tad - they were freaking me out. I know they were just doing their jobs, but the moment I saw a few of those brows loosen up just a hair, I felt more comfortable.

Well, during the prostate biopsy, I have mentioned that I was joking around with the hot babe nurse. She was a good audience, and to some degree, so was the doctor. While I can't think of many things that are as serious as a biopsy looking for cancer in one's body parts, it can just get to be too much!

Once the work was done, the nurse took me back into the waiting room where Stacey was. As I walked towards my wife, the nurse said "He did great! I've been doing this for 5 years and I have never had a better patient for this procedure than Mr. Ray!"

And then something very strange happened - tears filled my eyes. For reasons I'm not completely sure of yet, I thought that was the absolute sweetest and most touching thing in the world for that nurse to say. Maybe it's as simple as me wanting my caretakers to really...care about me. I just don't know.

The second set of tears came about 10 minutes later as we were in the car driving home. I looked at Stacey and told her that this felt like the journey has now officially begun. I didn't need the biopsy results. I knew I had cancer and I was overcome with sorrow that I would be putting my loved ones through all of this. And this is something a little bit of levity cannot lighten up.

Until I found a safe-word!

It didn't take long for me to come up with some sort of ridiculous way to express how fucked up all of this is. When it gets rough for me, most of the time some pressure can be relieved by me shouting out a very specific set of curse words! No need to share them here, but they are indeed some very bad words...

And they make us smile.

Ahh....Maui....

God, I wish the biopsy was as dramatic as Alien's mouth ripping through my rectal wall, tearing out chunks of my poor prostate as Howlin' Wolf belted out Back Door Man into my ears...but it wasn't like that at all. Really.



After my second PSA test result came back high, my doctor told me I would now be seeing an Urologist. As it turned out, he is actually the head of the department of this medical group's Northern California district. Hmmm..my eyebrow raised a bit wondering if there was any particular reason why I would be referred to the department head but ultimately decided it certainly couldn't hurt!

A few days later I got a phone call from the Urologist telling me that the numbers (here we go again..) tell him that I need to get a biopsy. At that point I think my brain took me on a nice little visual vacation to Maui, and I remained calm, even when he told me the procedure would be relatively quick, a bit..uncomfortable (I've discovered that doctors use that description often), and that it involves needles in the rectum.

Come again, doc?

Fortunately, I already had a pretty good idea as to what I would be going through because a co-worker went through all of this about 4 years ago. But it does involve two things that can make men mighty uncomfortable: penetration up the butt, and the added excitement of introducing needles into the mix!

I know a lot of men that just absolutely cannot even talk about a simple prostate exam. The thought of a doctor's finger going in there can make a lot of guys very uptight, and in some cases, even...angry. Maybe it's because I've had a lot of exams of this nature, but it just doesn't bother me one bit. I've had women doctors do this, and of course men doctors. I guess the embarrassment factor ramps up a teeny bit with a woman doctor, but it's really no big deal.

Maybe it's as simple as the fact that I'm an artist, a rock musician, and I absolutely adored David Bowie and Alice Cooper! I'm culturally hip (in a 70's way!), and penetration down there should be not only tolerated, but..celebrated! Yes! Super sensitive progressive bi-sexual acceptance! I'm down with that!

;-)

That sounds full of shit, and by no means am I relating medical procedures in the butt to an act of sexuality (though I've seen pictures...), but honestly, the men I've seen turn the whitest with just a mention of a prostate exam are generally not involved in the arts in any way. Such philistines!

And then there's the thought of needles. Needles can make any type of person wig out, but I'm fine with those, too. (while I like a few of the Velvet Underground's songs, I don't think there's a cultural discovery to make here...)

Of course I did no further research on the procedure, I just went and did it. Stacey came along for support, and while I don't remember me being too freaked out about it, I just wanted her to be there once the deed was done.

The nurse lead me into the room and I immediately started to joke a bit with her. "Gosh! I'm so excited! I can't wait!" She said "Really?" I said "Just kidding." At that point the all important levity factor was in place, and as long as I can just bring a smile out of a lab worker, nurse (hot or not) or a doctor, I find that this puts me at ease and hopefully the folks doing the work at ease.

This is exactly what happened, as I laid on my side, butt exposed. Of course, as I have discovered over the years, there is a 90% chance that the doctor's aide or nurse will be female, young, pretty and hot. Never fails.

Digital exam - been there, done that. Bring it on, Doc. About 1 minute.

Ultrasound tube goes in - this is a camera not nearly as big as a sigmoidoscopy tube -we'll say 2 fingers wide. This is so the doctor can get an image of the prostate which is surprisingly not very far in. I believe this stayed in during the whole time. No big deal at all.

After he's checked out the image (which I could've seen had I wished, but since I am in fact me, I opted out of looking at the screen. I do this at any procedure that shows an image of my insides. I just don't want to see. If there's something abnormal, I'll freak out. If it's fine, I can then imagine what it would look like if it wasn't fine.

Next came the 4 (!) injections of a Novocaine - type medicine that is to help numb the areas that the biopsy will take place. (note: for those of you that do not know where the prostate gland is situated, it's on the outside of the rectal wall, surrounded by a lot of very important stuff that's extremely difficult to get to). He mentioned that it's just like getting Novocaine at the dentist. (uh...not really, doc!) He said I will mainly feel pressure, possibly feel that I need to pee (but not to worry - there's plenty of pads under me), and a little sting. And guess what? That is exactly what it was like. I told him at that point he was good. He responded by agreeing, and that he's done hundreds of these. Suddenly I was at ease with this doctor and we actually carried on a conversation during the scariest part, the biopsy itself.

I purposely avoided seeing what the biopsy instrument looked like, and frankly, I still don't know, so nothing to report here. During the procedure, I didn't notice any sensation of anything else being in me aside from the ultrasound tube. Using the image on the monitor, he took 12 samples, by needles, from 12 specific locations on the gland. This is called mapping. Each...sample felt like a bit of pressure, a small sting, and a click that sounded a bit like of a small staple gun. It went rather quickly, but after the 3rd one I said "Only 9 more to go, Doc?" He responded with "Are you counting?" "You bet, Doc" At that point he started to talk about the sound quality of vinyl vs Cds, and before I knew it he said "Ok, last one." He's good, alright. Really good.

I then was told to sit up slowly, some men feel faint after the procedure (wimps). I sat up feeling fine and took a deep breath of air and exhaled slowly. He asked if I was ok, and I told him that I was just relaxing for the first time in about 2 weeks!

Total time on the table: 10 minutes. I've had way worse times just getting my teeth cleaned!

One of the weirder preparations for this procedure was to "arrive with a full bladder". WTF? Turns out that right after the biopsy, he had me pee into a cup to make sure I wasn't bleeding, though I should expect "some discoloration" over the next few days.

Another thing to expect following a prostate biopsy is probably the most mind-blowing thing so far...Now, this does make me squeamish and I find no need for details, but 12 puncture wounds in a prostate gland result in blood getting in the prostate gland.

I'll let your own imagination fill in the blanks as to how one goes about getting that blood out of the prostate gland.

Ah....I bet Maui is beautiful this time of year...

Hysterical, Historical, Hysteria!

There are 2 things that I would like to discuss at this point. First, I have a colorful history of a psychotic fear of cancer. During the 80's and through much of the 90's, I must have spent thousands of dollars going to see multitudes of doctors over any type of abnormality I could find in or on my body. Why is there a lump on the right side and not one on the left? (I was a real stickler for physiological symmetry..) What is that sharp stinging pain in my side that never gets worse, but never goes away? Why am I peeing so much? Why have the glands in my neck felt swollen for a year and a half? Why am I running to the book store and pouring over medical books, desperately trying to diagnose what is wrong with me? (I REALLY think that is a terrible idea for people like me. If you can see a picture of it, you can now see a picture of it inside your own body...not good!)

This lead to some pretty unhappy moments that ran it's course through two marriages. It also, (fortunately), lead me to some very extensive psychotherapy with a great psychologist, and it also helped me find the best doctor on this planet for handling me. Both are women, (both retired now), but these people really stuck with me and were not afraid to bitch-slap me in my weakest and whiniest moments. Tough love was the prescription, and they were not afraid to dole it out.

I found out a lot about myself, and I don't think cancer itself is what I feared. I believe most of my agony was rooted in fear of separation, and stuff like that. This is stating it all very simply, but it's really about as far I want to go with it here.

But, man - all those doctors were bound to have given me some great quotes over the years!

"Mr. Ray - those are nice, rubbery testicles!"

"George.." (most of my doctors called me by my first name, I never thought that I would need to get on a nickname basis with them!)..."if you were having the symptoms of pancreatic cancer, there wouldn't be much we could do for you, anyway."

And my favorite: "George...I'm not God or anything, but I don't think you have cancer."

The second thing I'm a bit obsessed with is medical irony. Hate it. It can manifest itself in my thoughts on a daily basis. Weird...he was a vegetarian, who would have thought colon cancer would have done him in? He seems so energetic and funny, who would have thought he suffered from depression? He had such beautiful blue eyes, too bad he's missing most of the iris in his left one due to a street mugging!

And while I'm sure smoking and drinking may indeed contribute to prostate cancer (I assume - I also have a phobia about learning about things that are going wrong in my body!), I find it ironic that prostate cancer is the one I got.

But the ultimate irony (as pointed out by one of my sibs) is this: I have dreaded cancer all of my adult life and I have finally gotten it.

But it's one that ain't gonna kill me.

PSA Squared

PSA - prostate-specific antigen
PSA - public service announcement

Here's how this whole predicament started for me. Unfortunately, all of this is about stuff that many people (including myself) find embarrassing and uncomfortable to talk about because it's about down there, but hell - I'm 52 years old and I should just get over it. Jesus! We're all adults here...

Anyway, once it was confirmed that I had prostate cancer, and after I told my wife and siblings, I told a few of my friends and workmates personally. I was surprised as to how hard that was to do. It's a heavy thing to lay on someone, but the concern and love I got back was very comforting. There are 2 Hispanic girls at work that speak very little English, but they are both hard workers (and extremely cute and tiny!), but we have never really hung out together - just worked. When I told them what was going on, they both started crying and hugged me tightly. Of course that got me crying, and one of them looked up into my face and said in broken English: "I love you, Gilberto". Stunned, I asked her if she still loved me, even when I get mad and kick warehouse carts across the aisle? She said: "I love you all of the time, Gilberto." That could be the most memorable and touching words I could have ever imagined. I love them, too. Stuff like that is already making this whole deal a hell of a lot easier to deal with.

But I digress from the Public Service Announcement part of this post...

On a couple of occasions, guy friends, around my age and after wishing me well, immediately wanted to know: "Jesus Christ! What are the symptoms? What should I be looking for?"

Well, in my case, look for....less.

About a year ago, I started to notice that....Hmmm...let's say...uh...that the factory was up and running...but for some reason...shipping..seems to be getting... less and less.....product...out of the shipping doors...

God, that is so lame...it's just medical stuff - lemme try again: Ummm - less..you know..stuff came out of my..you know what...when I...did that.

Screw it. Less semen.

There - I said it. Tougher than I thought. But I think you get the idea. It was a gradual drop-off, and I just figured that age was taking it's toll on me. After all, my jowls, my ears, my saggy monkey butt have all succumbed to gravity's pull. I'm just not the teenage stud that I used to be. (I should also note that over the past few months I have lost about 10 lbs. - my weight fluctuates all the time, and I thought that the ultra-stress of the last year probably contributed to it and it probably did. I have no idea if this is the result of prostate cancer).

After about 5 months of this, I told myself that I was about due for a physical anyway, I'll just let the doctor know what's going on. Next thing I knew, it was a year later and the problem was getting worse. No other symptoms at all. Just by chance, I got a letter from my medical group informing me that it was time for an annual blood test and physical, so I went and had my blood work done and made an appointment for a physical with my doctor.

I had the lab work done about a week before my physical was scheduled. In this area my medical group is very efficient - within 24 hours they e-mailed me the test results, but I was perplexed by the fact that there were not many..categories on the report. The usual suspects were there - cholesterol (controlled and fine), blood sugar levels (actually better since I cut back on my cola addiction) and a couple of things that I didn't know what they were. But there were 2 important omissions. I'm always worried about my liver due to my past history of extreme Tylenol intake, evil cholesterol drugs and the fact that I love my beer. Nada. There was also no obvious PSA numbers. Christ, what kind of lab is this? This is lame!

The next day, on a Saturday, I got call from my doctor. Weird! I couldn't get to the phone in time to pick-up, but he left a doozy of a message: "your PSA levels are in the gray area. They should be between 0 - 4, but yours is 6.2. False positives are pretty common, but I'd like you to get re-tested in about 4 weeks. We can talk about this at your physical later this week."

And that was that. Here we go.

The Predicament

From Webster's New World Dictionary:
Predicament 1. a condition or situation, now specif. one that is difficult, unpleasant, embarrassing, or, sometimes, comical

For the past several weeks I have had a serious debate going on in my mind on whether or not I should write about this, but today my brain and my heart said in a very emphatic way - "Yes".

A little over 3 weeks ago I was diagnosed with prostate cancer, but I'm going to be fine, folks. I really am! But I will have surgery to remove the ol' boy (thanks for the memories pal, and all the damn trouble you've gotten me into!). My doctors, my wife, my family and most importantly, myself, all agree that I will have a good outcome. I believe us and amazingly, the math (!) adds up to a full recovery. (more about the math, later...)

This will not be a Gil Has Cancer Diary. To me, that just seems too creepy. But some of the stuff I've been through is just flat-out too good and too crazy to not write about! And who knows - maybe some helpful info will be provided to help guide some of my male readers about this predicament. Yep - we're getting older, boys!