A Neutered Dog

October is cancer awareness month in the US. And the company I work for put out this announcement.

10/3/11: October is Cancer Awareness Month
The numbers can be staggering. Experts estimate that approximately 7.6 million people worldwide will die from cancer this year. In the United States, it is predicted that there will be more than 570,000 cancer deaths in 2011, and more than 1.5 million new cancer cases diagnosed.

And it had me wondering about their use of the word staggering. Of course 7.6 million is a huge number of deaths so I wanted to get perspective about the numbers. Looking at the World Population Clock at census.gov and recalling my early math education I ran some numbers and this is what i got:

Deaths:

(7.6 million / World Population) * 100 which is less than 1/10 of 1 percent per year

(570,000 / US Population) * 100 This one in almost 2/10 of 1 percent. Spin doctors can make that “double the world’s cancer death rate”

New diagnosis in the US:

Sounds simple right? Sit, stand, squat or whatever position works for you then just relax and … viola!

Well ND would not be writing here if this were always true. For most men who have a radical prostatectomy incontinence is very common the first weeks or months after surgery. Then we strengthen of pelvic floor muscles by learning to do our Kegel exercises. We are now dry and life goes on.

For me this was mostly true, at least for the 11 or so months after my robotic prostate surgery. Except that two months after the surgery I started External Beam Radiation of my lower abdomen. I took 68 Grey’s in 38 EBRT treatments, given daily, 5 days per week. Now unlike some cancers that the radiation beam is targeted at a tumor and the bombardment begins, I no longer had a tumor. So what I received was what PA described as “carpet bombing”. The radiation oncologist was trying to destroy and lingering cancer cells in the area that was around my former prostate gland.

So this is where a lot of my urinary system problems began, because not only does EBRT destroy cancer cells it also destroys healthy tissue. For me this was my bladder, which now partially occupied the space once taken up by my prostate gland. Geez, I really miss that thing… but there’s more about that another time.

Back to my now radiation damaged bladder and urethra:

Two days before Thanksgiving, just about twelve months after my prostatectomy, I went into urinary retention. At about 2 AM I woke up like many men to go relieve myself but there was a problem. I could not get a urine flow no matter how I tried. As it was already becoming uncomfortable I woke my wife with the news that I needed to get to a ER… STAT! No ambulance but a really rapid trip would be best, dear.

Now having a full bladder and no way of emptying it without the assistance of ER personnel can quickly become one of the most painful experiences you can have. Cutting to the chase I’ll skip the time waiting in an ER at 2 AM on a Saturday morning and just say that once the ER nurse was able to get a Foley catheter the relief I felt has got to one of the best feelings I’ve ever had.

Now most people will begin to feel urges to urinate at around 200-250 ml in their bladder. When someone says “…I gotta go REALLY bad” might be in the 300-400 ml range. That Saturday morning I filled the bag to 1000 ml !!!

Finally making my way back here I was torn. I knew I needed to start writing again, but look at the time gap… over two years! So what do I do?

Do I just jump back in like the two years plus never happened?

Do I delete everthing back to the beginning and start over?

Nope. I figure it is best to admit to my being bad and try to catch-up.

Now two years is way to long to catch-up in one posting so I will stretch this out over several posting. And I’ll do this not by starting where I left off but I’ll begin now and work my way backwards until I get close to filling my two year absence.

I’m so tired of being shutdown, being told that how I feel about having cancer is not fair to others who have cancer.
Let me explain. I write here about some of the darker sides of prostate cancer and it’s treatment…. As I see it. This is my blog, this is my thoughts and opinions. As we quickly approach another Pink Day on Mother’s day I again start hearing the sound bites and other commercials.
Cancer is not pretty, it takes much more from many others. Am I the only one who feels that cancer sucks?
Why is it that when a Pink cancer survivor is interviewed that they seem to have reached some higher level of self-actualization? And they credit their cancer for that.
Is there no one who hates cancer as I do and talk about the ugly stuff that comes with it? Do they not talk about the bad side of cancer?

That is a common statement for most of us. ‘Has it been a year already?’ or ‘It’s only been a year’
In one case we are happier then the other, surprised that… my oh my time has flown by. In the second instance we’re not putting time between us and last year’s event fast enough
Cancer patients see both
It was one year ago, yesterday actually, that I had my first of 38 sessions of external beam radiation. The week prior I had gone in for my first visit with my radiation oncologist. He told me that I’d be getting 68 Grays of radiation over the 38 treatments. They would be 5 days a week and I was expected to make every appointment. If I missed any I would be extending the length of the course of radiation
I was also fitted with a leg mold that would help in positioning myself on the radiation machine. I was also given three new tattoos that would be used to align me with several lasers. One tattoo was on each hip and the third tattoo was about an inch above the base of my penis. Pretty cool that I could say that I now have five tattoos, huh?
And so it began…
Oh and by the way, just what is a Gray and what does it mean to get 38 of them?
38 Grays or one course of radiation is equal to:

About mid-January I made another appointment with my doctor for more help with the incontinence. We discussed how things had been going and I told him about how in addition to the leaking that I felt I was not emptying my bladder. So to check he did used a sonogram and it turns out that I was retaining what he described as about a ‘coke can’ of urine. Well there was only one thing to do, I would have to self-catheter… Yikes!
Like I’m gonna shove a rubber hose up my penis… By myself?!?! NOT
I left the doc’s office figuring that would be one of the last things I’d be doing. Was I wrong. In the past when I’ve been cysto’d in the office I found myself in the ER hours later with a stricture. A complete blockage that prevents urine flow. Not much is as painful as having a very full bladder and getting more full by the minute. Well it wasn’t a few days later and I was having to catheter myself. The pain level was pretty high but it’s amazing that despite the pain there was a huge relief as my bladder emptied.
The last few weeks have been a combination of leaking and filling pads contrasted with having to catheter myself.
It’s a crazy frustrating time right now.

Incontinence continues… It sucks.
Activity makes it worse, walking a lot or lifting. I recently moved an old television down to the basement and as I lifted it the faucet opened full blast. That filled a pad. It becomes embarrassing while on a Christmas Eve day trip to the grocery store. Just going to pick up a few of those last minute things on the list for the Christmas dinner or parties, I’ve had the same leaking, just a bit slower. The uncontrollable leaking being so bad that it fills my men’s pad and leaks through my pants…. while in the store! Luckily it’s winter here and my coat was long enough to hide my pants and spare me any public embarrassment.
Things like this are small but that they are just seeming to continue and it all takes an emotional toll. After the grocery store incident I came home, changed and then just broke down.

Having an RP (radical prostatectomy for those in the know) leads to incontinence problems, we all know that. Many time all can be well but often a man will have ongoing problems. I’m one of them.

Maybe it had to do with my cancer being locally advanced and the surgeon had to cut further into tissue and organs to get to clear margins? Surgery will leave scar tissue and this is where the problem comes up. I came off the post-RP catheter and within a month or so I was pretty dry. By early July the incontinence was back so on the next trip to my doc he did a cysto. That’s a fun exam … NOT. First off the nurse tries to numb my penis with a lanacaine flush then I’m given nitrous-oxcide. The doc enters the room and inserts the flexible cystoscopy… yeow! Once it is in the discomfort subsides. What the doc looks for is scar tissue and he can stretch the opening in the urethra. Unfortunately the stretching can cause some swelling and a stricture.

I’ve had two strictures and two trips to the ER unable to pee. Few things could hurt more then the pain of a full bladder and no ability to empty it!!!

That should be with a question mark of course, because I’m no doctor and I didn’t stay at a Holiday Inn Express. This is my disclaimer
Within a fews days, maybe weeks, after my last Lupron shot it struck me that I am no longer having hot flashes. Why? (see previous disclaimer) I do not know why, but I have an idea. It may be that the latest shot finished off my brain’s calling for the productions of testosterone. I’m past my chemically induced menopause. Don’t get me wrong, I do not miss the throwing off of the blankett in the middle of the night. Nor do I miss sitting at my desk with my daily 9 o’clock hour sweat-fest. The hair on my chest is gone, even that male hair that runs from our belly-button to our groin. My leg and arm hair has become so fine it’s difficult to see. But the good part of all this is that I shave my face once a week!

And then I see this. Madden NFL 09 PINK!!