Saturday, October 20, 2018

The Dark Days

In my ongoing story, this is a chapter where the hero is beaten up and the villain appears to be winning.  It makes for great drama as the hero gets to seek revenge in a future chapter.  But suffice to say that my wish for a short story with a happy ending won't come true.  So sit down, grab a box of tissues, and keep reading.

Thursday morning was my CT scan.  This was a rather straightforward procedure and the only challenge here was the barium sulfate prep drink.  The instructions said "may cause loose stools in some patients".  What they don't tell you is it may cause explosive movements in other patients, like me.  Luckily that didn't last long and we were soon back home where I went upstairs to take a nap, then the phone rang.

It was my urologist's office, wanting to know if I could come in for the prostate biopsy at 7:30 tomorrow (Friday) morning.  It was only after getting off the phone that it occurred to me that there might be a connection between the scan results and moving the biopsy earlier.

Let me say, the biopsy was an experience unlike anything I've ever had.  First, they shove a piece of ultrasound equipment up my rear, and then proceed to inject Novocaine, and then insert a needle into the prostate to withdraw a sample 12 times.  This does quite a bit of damage to rather sensitive tissues, the consequences of which I'll get to near the end.

So after the biopsy, the doctor spoke to me and my wife about the CT scan results.  They weren't good, but they did explain some of the pains I've been developing.  Metastases.  Advanced cancer.  The biopsy results won't be in for about a week, but the working diagnosis is an aggressive form of prostate cancer.

This is not unexpected given the high PSA result that started the week, but it's still devastating news to hear.  We both cried.  Then we went out to lunch with one of Dawne's friends that happens to be a survivor of multiple cancers.  We talked a lot about cancer and maintaining a positive attitude and actually laughed quite a bit.

In the evening, we called my sister and mom and told them the news.  Breaking the news to mom is the single most gut-wrenching thing I've done in my life.  Dawne had to do most of the talking, as I could barely hold myself together.  Just writing this paragraph was difficult, and used up a fair share of tissues.

Back to the disease itself.  "Prostate cancer" is actually an umbrella term that covers multiple forms of cancer that can attack the prostate.  Unfortunately the younger you are, the more likely you are to get one of the aggressive forms, and that seems to be what's happening with me.

Prostate cancer also depends on testosterone to grow, which might explain why in the general case it's more aggressive in young men who have naturally higher testosterone.  It also means that it's sometimes possible to manage the advanced form of the disease by blocking the body's production of testosterone, and I've already been given an injection of Eligard that is intended to do just that.  Unfortunately it will take a few weeks before we know if it begins to work.  In the meantime, there will be more tests and a meeting with an oncologist.

As for me, I'm in pretty rough shape at the moment.  My pain levels are currently pretty bad, as I had been managing them with ibuprofen but that promotes bleeding so I can't take it again until everything down there heals from the biopsy.  Tylenol helps some, but not as much.  Mostly I'm feeling beat up from tests, emotional stress, and the resulting sleep deprivation.  Right now my focus is on resting and recovering over the weekend when not writing a blog post.  It's a depressing part of the story, and things will probably continue to get worse for the next week or two.  But it's also a setup for the epic hero (that would be me) to come fighting back in a future chapter.  After all, how can you tell a good story without a good antagonist?

Several lighter observations:

The "biopsy site" was bleeding for a good while yesterday, and I still had gas from the barium sulfate drink.  Combine the two and there were several episodes of farting blood.  My solution was to put a panty liner in my underwear.  Practical and effective if not very macho.  It's all part of the absurd adventure I'm on.

After a digital rectal exam and the biopsy in back to back weeks, I'm planning to get a tattoo on my butt that reads "Exit Only".

Side effects of Eligard include hot flashes and possible breast growth.  I'm worried I may have to turn in my man card shortly.

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