* * *
The draft went into exquisite detail about medical technology and what it can and can’t do with regards to assessing the state of cancer. There was a beautiful long narrative about the journey of radioactive tracer from the veins, to the bones, and finally through the kidney and into the bladder. You should have seen my new bone scan, with it’s bright bladder full of tracer that outshined even the brightest of tumors. Of course, those tumors may now in fact be dead or dormant and what is showing up on the scan could be bone healing.
There was a very funny passage about how dormant cancer is just like dead cancer, except that dormant cancer could wake up at any time. Treatment continues to keep the cancer dormant with the hope that it will die peacefully in its sleep. There were comparisons made between me and supervillains that keep their foes alive so that they might have a slow painful death. I had re-watched “Austin Powers” several times to get every nuance about what Scotty Evil said about the expediency of immediately shooting your adversary, but sadly that quote is now lost.
So while there’s very little evidence for any active cancer, treatment is ongoing to keep it away. This cancer thing is taking longer than I expected.
* * *
I went to great lengths to discuss the numerous intricacies of being on disability leave from work. How I’ve had huge improvements in the last couple weeks as my recovery from chemo picks up speed. For months I’ve had the idea in the back of my head that this summer would be a good time to get back to the office. There’s still a few hurdles to overcome, but at the moment it’s a good possibility.
In one of my more inspired sections, I had plotted my return to work as if it was an engineering project. Unfortunately all my Gannt charts and Scrum stories were lost with the draft. Gantt charts aren’t normally part of Scrum, but I had combined parts of waterfall and agile methodologies into a new process that would have revolutionized software development.
In any event, there is an extra incentive to get back to the office before October. To continue on disability leave past then would require applying for social security disability. Apparently they would want specific explanations as to why I am unable to work, and honestly, I think it’s counterproductive to my recovery to focus on my limitations. If I applied today, it would likely be written as a series of haikus.
Cancer causes more paperwork than I expected.
* * *
The lost draft was 600 pages long, if you’re curious. Shorter than any Game of Thrones novel. I like to keep things concise.
* * *
I do still have the graph from my Garmin showing how much I’ve run in each month for the past year. Shockingly, the shape very closely follows how I’ve felt for the past year. I just might be crazy enough to use running mileage as a metric for my recovery.
Note the fall in mileage starting in August until my diagnosis in October. At the time I thought it was an overuse injury, but in retrospect it was actually symptoms of advancing cancer. While it may seem that I'm running a lot, it's not even half of what I used to do while working full time. Any running just gets a lot more publicity now because of the cancer and chemotherapy things.
* * *
My cell phone rang just now and it was the pharmacy calling to let me know my abiraterone acetate is in. This is a second line hormonal agent that will drive the cancer into a deeper state of dormancy, and hopefully cause even more to die in their sleep. I hope it gives them nightmares too.
True story: Years ago I dabbled in teaching myself to play the guitar without much success. Recently I’ve started that up again. I wrote a song about my treatment. Each verse covered a different drug, from leuprolide to docetaxel to abiraterone acetate, and then the chorus lamented that they all had the same side effects of joint pain and fatigue. The bridge leading into the guitar solo mentioned some other pharmaceuticals that can help offset the side effects.
The reader might want to ask themselves if “true story” applies to the entire paragraph above, or just the first sentence or two.
This should be the last medication change for a very long time, finally. My return to work has taken so long because just as I start to feel ready to return, the next treatment is on the horizon and I don’t know how it will affect me. I’m hopeful this one will be a non-event.
This cancer thing involves more drugs than I expected.
* * *
What wasn’t in the lost draft was the tale of my root canal gone bad. I had dental pain early last year that resulted in a root canal. Unfortunately the endodontist who did it missed one of the canals, so it’s since gotten re-infected. I find the timing suspicious as it seems to have happened when my immune system was compromised due to chemo.
I’ve gone from pain and digestive issues due to chemo to dental pain and digestive issues due to antibiotics. This cancer thing has more twists and turns and ups and downs than I expected.
* * *
The best way to offset fatigue from all those cancer drugs, counterintuitively, is exercise. My original draft included detailed descriptions of some very aerobic celebratory dances that can be done when you receive good news such as finding out that the promising but rather expensive cancer drug will be covered by your health insurance, even though your oncologist is prescribing it sooner than usual.
I’ve been trying to continue my explorations of the Midstate Trail, but all the recent rains have left the trail muddy and wet. I did get out to the section that goes up and over Wachusett mountain recently. It’s the steepest and rockiest terrain I’ve tried to cross since diagnosis, and while I was pleased to have the dexterity and endurance needed, it was causing havoc with my sciatic nerve. Discretion being the better part of valor, I turned around short of the summit so that I’d be able to get back down the mountain and drive home without excessive discomfort.
At one point, the trail was so muddy it could have used a bridge over the mud and puddles to get to a bridge over the stream.
This rainy weather is taking longer than I expected. Bonus photo:
I was pretty tired and grumpy after my hike. While exercise helps with fatigue, it’s neither miraculous nor instant. However, I’m only a little over a month past the end of chemo, and most of the improvement I’ve seen has been all in the last two weeks.
If it weren’t for the addition of yet another drug to my regimen, I’d be quite optimistic about getting back most of my old energy in the not too distant future. Another drug is another unknown so we’ll just have to wait and see.
* * *
The part of the lost draft that I miss the most was the ending. It was very thankful of my employer, my coworkers and managers, and how supportive they’ve been. Having great medical and disability coverage has removed any worry about cancer causing financial problems. This cancer thing is more expensive than I expected.
Having time away from work has also allowed me to focus on fighting and recovering from the battles. Scientific studies have shown that the best way to fight prostate cancer is to hit it as hard as possible as soon as possible. The downside is that there are a lot of treatment side effects to deal with. The upside, hopefully, is better control of the disease and better quality of life later on.
My simplistic way of looking at the situation is that I had a lot of cancer in my bones which was causing rapidly increasing amounts of pain last October. Aggressive treatment is the best way to get it out of the bones and get rid of the source of the pain. However, cancer dying in your bones isn’t any less painful than cancer living in your bones. Once it’s dead or gone dormant, then the bones and nerves can begin healing. I had a noticeable reduction in pain last November, just before chemo, but it’s only been in the past few weeks that I’ve had another significant reduction in pain and improvement in my ability to do things.
To put it in terms of running, not long ago I was struggling to walk (with occasional bits of running thrown in) more than 3 miles, and as often as not exercise would bring the chemo side effects to the forefront. Most days I’d only have a few good hours to do things, and those hours were usually taken up with medical appointments.
Suddenly I’m running (with regular walk breaks) 5 miles and chemo side effects are being replaced with a runner’s high. I’m good for over half a day, though can’t regularly handle being busy for most the day (see my Wachusett failure and its grumpy aftermath, above). If I weren’t adding another drug, I’d fully expect to be up to 8+ miles and ready to work full time in a month or so.
I’m having a great response to treatment, and all signs point to eventually achieving a lasting remission. This might even include going off all treatment entirely some day. Being off treatment with no signs of disease is only slightly more likely than winning the lottery, but it does happen and so far I’m liking my odds. It makes dealing with the aggressive treatment much easier.
This cancer thing makes a better story than I expected.
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