3 Month Update

Well several people asked me to update this blog and I kept promising to do so. But before I do, here's something that helped put it in perspective. The subtext for this is an email that's been circulating and some woman named Sue entered her brother's email for a radio contest for "worst job ever" and with this entry she won:
Hi Sue,
Just another note from your bottom-dwelling brother. Last week I had a bad day at the office. Before I can tell you what happened to me, I first must bore you with a few technicalities of my job. As you know, my office lies at the bottom of the sea. I wear a suit to the office. It's a wetsuit.
This time of year the water is quite cool. So here's what we do to keep warm: We have a diesel-powered industrial water heater. This $20,000 piece of equipment sucks the water out of the sea. It heats it to a delightful temp. It then pumps it down to the diver through a garden hose which is taped to the air hose. Now this sounds like a damn good plan, doesn't it? I've used it several times with no complaints.
When I get to the bottom and start working, what I do is take the hose and stuff it down the back of my neck and flood my whole suit with warm water. It's like working in a Jacuzzi. Everything was going well until my ass started to itch. So, of course, I scratched it. This only made things worse. Within a few seconds my itchy ass started to burn. I pulled the hose out from my back, but the damage was done.
In agony I realized what had happened. The hot-water machine had sucked up a jellyfish and pumped it into my suit. This is even worse than poison ivy under a cast. I had put that hose down my back, but I don't have any hair on my back, so the jellyfish couldn't get stuck to my back. My ass crack was not as fortunate.
When I scratched what I thought was an itch, I was actually grinding the jellyfish into my ass. I informed the dive supervisor of my dilemma over the communications system. His instructions were unclear due to the fact that he and 5 other divers were laughing hysterically.
Needless to say I aborted the dive. I was instructed to make 3 hellish in-water decompression stops totaling 35 minutes before I could reach the surface for my chamber dry decompression. I got to the surface wearing nothing but my brass helmet. My suit and gear were tied to the bell. When I got on board, the medic, with tears of laughter streaming down his face, handed me a tube of cream and told me to coat my ass when I got in the chamber. The cream put the fire out, but I couldn't shit for two days because my asshole was swollen shut.
We've since modified the equipment to filter out most sea creatures.
Anyway, the next time you have a bad day at the office, think of me. Think about how much worse your day would be if you were to squash a jellyfish on your ass. I hope you have no bad days at the office. But if you do, I hope this will make it more tolerable.
Original source: forwarded email in August 1999
Sound too bad to be true? Yep, an urban legend:
"You're absolutely right to classify this story as an urban legend. First off, if a commercial diver was working in cold water at depths requiring A 35-minute decompression time, he'd certainly use a drysuit which does not allow water to touch the skin. Second, the expense and pressures involved in pumping heated water down to the diver at such a depth would both be ridiculous. Third, the jellyfish would've been pulverized from the pump and the stew of stinging cells would have affected all sites of contact (i.e. all over the fellow's back), not just at one spot. Fourth, if the diver spent 35 minutes in safety stops and still had to spend time in a decompression chamber, he would have to have been incredibly deep and using mixed gases, which contraindicates hardhat diving. In short, it's a crock. Amusing, but a crock nonetheless."
Ok so how am I doing? My butt hurts. It hurts to sit. What do I do? Sit and talk to people all day. It's not as bad as that diver guy but certainly for a lot longer. Apparently I'm in the minority (but who knows?) of men who wound up with long-lasting pain after the surgery. Got up to about a 7 on a 10 point scale. Surgeons told me this and that, should go away any day, well, we've never seen it last this long, well never past 6 months, well we might have to "go back in there again." Don't think so.
So thanks to my old buddy and physical therapist Kathy White with backup from another friend Sara, I was told Donna Edwards at Mountain Spirit Physical Therapy was an expert in pelvic pain. Got a referral (no longer needed under the new open access law that says you can go straight to a physical therapist without a doctor's order) and went and have session #4 tomorrow. She's a wonderful woman. Fortunately another good friend Tracy gave me a "heads up" (hahaha) about what to expect and loaned me her TENS unit. The following paragraph is PG-13 and may be Too Much Info but I have a twisted sense of humor anyway. I'll clean it up.
So by now I've pretty much lost whatever modesty I had. Half of Knoxville has seen my bottom. One of the lovely things of prostatectomy is a persistent dribbling incontinence and I wound up getting a yeast infection from being wet all the time. Yes I am truly being "womanized" and so I call up my dermatologist after I can't clear it up (Desitin didn't work) and the helpful woman asked why I needed an appointment and I said "jock itch." She made an appointment. The same lady whom I guess is close to retirement age asked in person why I was there and must not have written it down the first time and I repeated "jock itch." So I see my dermatologist and in the middle of pulling my pants down and showing him my crotch and full frontal nudity, said matronly woman knocked on the door and came right on in. I just laughed. Now 50.1% of Knoxville has seen my bottom. So anyway that was a week or two before I saw the physical therapist and sign about 80 pages of forms and recalled reading in one page that pelvic floor therapy can be awfully uncomfortable and private and just to make sure there's no hanky-panky that the patient won't be alone. So in the middle of my first session the secretary (I am certain she has no LPN, RN or other medical initials after her name) comes in and stands in the corner. What does pelvic floor therapy entail? Well let's just say a glove and KY jelly are absolutely necessary. At this point I'm laughing. Up to 50.3% of Knoxville now can pick me out of a lineup of flashers. THEN at the conclusion (why not the beginning?) of the session I'm handed a form to sign that it's ok with me NOT to have a witness. In "hindsight" (hahaha) I guess I should have refused and made her secretary sit in each time and made some grunting noises or like that asshole Florida student cried just after he said, "Don't Taze me, bro!"
Ok, so now you know. Good news is I think it's getting better, strung together 2 days with no significant pain, can sit longer, and am cautiously optimistic about getting paroled from this pain jail. I talked to a guy who had his robotic surgery at Vanderbilt and had pain for 8 months and his surgeon's response was "well that happens sometimes."
The moral of the story is it really helps to be your own advocate and have good friends and resources. And as I tell my closest friends, "pray for my sorry butt." Thanks. I'm still able to find some things funny. Hope you do, too.

Bye-bye catheter hello pads

They say the second best moment in a man's life is when he buys his boat and the best is when he sells it. I still have my ski boat (haven't got it out yet). I've had worst and best moments lately but first place this week goes to having my catheter out. There was some foreshadowing going on when the nurse on Monday told me to start taking shallow rapid breaths and I thought I was back in Lamaze training when she whipped it out on the second breath. As usual you get the vaguest idea of what'll happen next - "you'll be able to get your continence back over the next 4-6 weeks." What's the slope of the curve, y'all? For me it's been surprisingly fast, just 4 days later and it's pretty good! I do feel like an honorary woman, going from labor and delivery of a catheter (didn't take the baby home) to now having periods. Bear in mind I had 2 brothers and no sisters and was spared the sex talk with my daughter and step-daughter and somehow I didn't know the difference between absorbant, superabsorbant, light, heavy pads. Is a 3 pad day a light day or a heavy day? Being sure to wear dark clothes in case of a leak. So I experience Lamaze breathing, periods and now post-menopausal stress incontinence. I always knew I laughed a lot but never felt it in my pants. So I tell people not to tell me jokes, squeeze before I sneeze and am more serious. Well, a little. Wednesday was a washout (literally) due to nurse Jamie's presence, starting with her telling how she set off the burglar alarm and it went downhill from there. How she posed her first deceased patient as a nurse who "graduated fifteen minutes ago" sitting up all pretty in the bed. "How was I to know how fast rigor mortis sets up" and her supervisor yelling, "Who's the M-F who did this?" She had to lay on top of the old lady for the funeral home to get her coffin-ready. All day long Jamie stories and I'm wetting my pants. I gave up by 10am. It was worth it. Don't even get me started on diapers. But I'm alive and having that damn catheter out after 2 weeks has started a new round of gratitude.
It's funny how everyone I talk to who has survived cancer has come out with a new attitude. The tribal shaman or medicine man/woman in many cases survived a life-threatening illness, connected him or her with Spirit in way that those who haven't been through that ordeal wouldn't understand. I get it.

The most bizarre moment and I wasn't even there...

Several of you have written or told me they enjoyed the funny anecdotes interspersed in my writings. I have a story to be told of my surgery but it’s not funny, even to my warped sense of humor. This is for my brother Don, who dislikes funerals and thinks the open casket variety is especially primitive. Turns out to be good for something in an unexpected way.
So the hospital named after the mother of Jesus did a great job in surgical care with my fantastic urologist Paul Hatcher, M.D. Nursing care seemed to be either fabulous or not-so-fabulous. The care received pre-op and in recovery was excellent, one of the nurses knew me from a mutual friend and had another good news story about prostate cancer survival in her family. Here’s the bad news. Someone (volunteer, nurse, coordinator, wasn’t clear) told my family I’d been moved to the Oncology floor and wrote down a room number and to go up and see me. As my wife Judy said it was a good thing she wrote it down so the family couldn’t be accused of misunderstanding her. So Judy is walking into that room with Jeremy and Hayley literally on her heels (and her friend Evans behind them) when they are confronted with an obviously dead person in a bed. Judy put her arm out to stop them but it was too late. She said later the person looked quite jaundiced and they couldn’t really tell if it was a woman or man but didn’t stick around long enough to figure this out. Judy went straight to the nurse’s station, asked (demanded) to speak with the nursing supervisor. She told her what happened, showed her the piece of paper and issued her demands: a different and larger room, across from the nurse’s station and an investigation into their procedures so this wouldn’t happen again. These 4 people decided to withhold this info from me until after I got home; they worried I’d see it as an omen. When the secret emerged, I expressed my concerns to them about how bad that must have been when Hayley said, “Oh I’ve seen dead people before when they open the caskets at funerals.” So her great aunt and grandmother (once again) helped even in death. The law of unintended consequences, or in this case – benefit. Jeremy laughed it off but correctly pointing out, “At least it wasn’t you in that bed!”
The evening agency (temp) nurse promised me I had Demerol or hydrocodone pill ordered for pain. Still trying to shake off the anesthesia and morphine haze, I didn’t want Demerol/phenergan and asked for hydrocodone. Thirty minutes later I called them and they said it wasn’t ordered but they’d called my doctor for an order, which I got ten minutes later. Despite having recited my medication list at least five times, I was never offered my stomach med Protonix (not a real big deal) nor my maintenance asthma inhaler Advair which would have resulted in almost a guaranteed asthma attack. Fortunately I followed the rules I recommend to anyone going to a hospital – be prepared and take your own meds with you. I managed to sneak two Tylenol tabs and my Advair inhaler and managed just fine. God help you if you go into a hospital on a psychiatric medication – they will typically omit it, reduce the dose, tell you that you don’t need it or shame you. Take those with you, too. The night nurse apologized for giving me a suppository, rather than saying something like “this is going to help you.” The day nurses were fabulous and one was another LMU instructor who knew Lisa Pullen who works with me. I think that got me better care, Lisa!

Staples out but 6 days and counting...

Well I got my staples out. The waiting room was filled with grumpy old people and some woman across from me was quite vociferous (he ran 90 minutes behind). When I got in the nurse asked me how I was and from her body language she was braced for another complaint. When I said, "Great!" she heaved a big sigh, I laughed and told her the waiting room needed to be sprayed with Prozac. She said, "yeah, they take it out on us." I thought of giving some advice like telling people how far behind you're running but figured if you could run a prostatectomy through remote control, surely you could reason that out. Then the same nurse took out my staples which stung. She asked how she was doing and I said fine. She told me it was her first time. "Really?" I asked. "No, just kidding," she said. First humor in a pretty long time on the medical scene (wait until my next post and you'll see how grim it got).


Dr. Hatcher went over my path report. More info for those readers with prostates: my biopsies which were in 4 quadrants only showed cancer on one side/lobe but the pathology report on the removed gland showed cancer on both sides/lobes, involving 20% of the prostate. Gleason score still 3/4 but tumor stage went to 2C. Just shows how lucky I was. Still am ok, no PSA followup until October.


I tried to get him to remove my catheter but no such luck. He asked if I wanted to do it myself and I thought of the brokerage commercial where the surgeon tells the guy with the steak knife to make an incision between the 3rd and 4th abdominal muscles and asked, "Shouldn't you be doing that?" So I go back in 6 days to have this dadgum thing removed. My step-daughter Christy (an RN) offered to do it. Said I could cover up. I told her if something (unlikely) went wrong like dragging some alien spider out or a turtle clamped down on the end of the catheter, I'd rather be in the doc's office. She seemed not to take too much offense. More later...


Lane

Cured !!!!!!!!!!!!

Cured. What a fabulous word. My new favorite verb. Dr. Mounger, Dr. Hatcher's partner who set up the robotic surgery for him and assisted came to do rounds this morning and said I'd go home around 2pm today. He said it would take about a week for the pathology report. Dr. Hatcher told Judy after the surgery that everything looked clean, took a few nodes for biopsy, didn't see any obvious cancer spread. Then just before discharge Dr. Mounger called the hospital room at St. Mary's and told Judy that the pathology report was in (maybe some special treatment for a doctor?) and there was no cancer in the nodes or outside the capsule and that my cancer is cured. Surreal. I am in shock. I'll write more later. Love and thanks to all those who care about me and prayed for me. It worked! I have taken one pain pill yesterday, none today. Hard to believe I've had major surgery.
Lane

The antidote to helplessness

I am reading Martin Seligman’s excellent book “Learned Optimism.” He pioneered the theory of learned helpnessness and depression. Simply put if whatever you do doesn’t work, you learn how to be helpless and give up. In an experiment with 3 groups of dogs, he made a sound followed by a shock. In the first group the dog could press a button with his nose and wouldn’t get shocked. In the 2nd group (helpless) they were “yoked” to the first group but nothing they did would prevent a shock. The 3rd control group had no shock. They they put them in a room with a low wall and ran the experiment. The first group was exposed to the noise and they jumped over the wall to keep from getting shocked. The control group jumped over the wall. The “helpless” group gave up and 85% of the dogs wouldn’t jump over the wall and just sat there and got shocked. Think of poverty, living in a dictatorship, being abused, being imprisoned as examples of chronically being unable to affect your environment. But what about the 15% of the “helpless” group who jumped the wall and those people who prosper in the face of adversity? They’re the optimists. They are the ones inoculated against getting depressed. His other point which I wrote earlier about is that the other significant factor in depression is rumination. He pointed out that women have more depression than men because they think about their problems. Seligman says if a person loses his/her job, the woman thinks about what she did wrong. The man is much more likely to take action and even if it’s “bad” action like arguing with their wife, gambling, violence or some other acting out (or healthy action like I did home repairs) they are avoiding the depression-inducing rumination. So I spent the morning flying my radio-controlled helicopter and watching TV with my son Jeremy and friend Terry. Note that this is not denial, which is the substitution of a wish-fulfilling fantasy for reality. I know my diagnosis and what’s in store tomorrow. I just am not going to dwell on it.

The Reluctant Fraternity

Thanks to Donny Pember for getting me in touch with his friend Mike. Mike had the da Vinci robotic surgery in February and told me how relatively easy it was, got his catheter out early in 8 days and went dancing at a wedding on day 9 which sounds good to me. He gave me lots of encouragement and nitty gritty details, said that I'd joined the group of men known as the Reluctant Fraternity. If only I could dance but I'd be willing to learn in exchange for losing the catheter early.
Connections are what nourishes us. I have read many a patient a chapter in that old best-seller Everything I Need to Know I Learned in Kindergarten by Robert Fulgum. It concerns a child hiding in a pile of leaves under his window while playing hide-and-go-seek and the others are giving up on him. He considers setting fire to the pile but just decides to yell, "Get found, kid!" He describes the grownup version, cites a physician who got cancer, decided to tell no one including his wife and family until the end. Some people said he was courageous but his family was privately very angry with him, felt betrayed. I am not advocating hiding. Tell someone. Tell a lot of someones. It comes back many-fold.

13 Days
I promised to make another post prior to surgery. Thirteen days and counting, morale still high. Not much news to report, did my drive-by orientation at St. Mary's. Another cute nurse story - the screening RN told me we're neighbors in Louisville. She lives on Buck drive off Topside. I told her that used to be THE PLACE at Christmas in Louisville, almost every house for 3 blocks heavily decorated with lights and yard stuff for the season. She said it was her first house they bought and asked the realtor, "Is it common for houses to have so many outdoor outlets?" Guess they wondered what the heck the previous owner was doing electrically (in so many places) outside. Group topiary? Precision drill teams for weedeaters? Sad to say that this kilowatt-blowing pasttime has passed its time and few people put up lights anymore. Oh well, we still have the helicopter on Topside. Again, thanks for the prayers, support and positive thinking. Lane

Gone to Graceland

I'm in Memphis with two wonder pharmaceutical reps whose names are withheld to protect the innocent. We have time between talks and swing by Graceland. We don't have time to take the tour but I hear it's the gawdiest place on Earth. One of the ladies tells me she knew someone who was the plumber at Graceland who was called out to remove the toilet The King expired upon. I asked if it was for sentimental reasons but she said it was looking for forensic evidence. Let your imagination run on that a while. The other rep tells me Monday at lunch her neighbor's car hasn't moved in a month and they haven't heard from him and she's worried. Then I see her at suppertime and she tells me, "Good news, my neighbor is alive." It takes a second to recount the context. Memphis is a scary place so missing folks suggest foul play. Anyway I hear some good blues down on Beale Street, amazing for a Monday night and all in all a great 2 day distraction. Will write again before and after surgery June 25th. Continued thanks for all the support, prayers and blessings. Lane

More good news/The Trend is your Friend

Summary: no bladder cancer, just "atypical cells" and surgery scheduled June 25. Had my followup visit with Dr. Hatcher. The nurse calls me and Judy in after a half hour wait, gives me the specimen cup. I tell her they're obsessed with urine around there. We get parked in a temporary then move to another room. Dr. Hatcher is buzzing around. We wait an hour, can you guess what my imagination is saying? He finally walks in and says good news, no bladder cancer, just atypical cells, they (pathology report) really aren't sure what it is. Could have had it for years, we'll just watch it. I tell him that's pretty dadgum vague. I guess his office will be my 3rd home and he compares it to an abnormal Pap smear. He says only a third of bladder cancers are associated with cigarette smoking. I quit 30 years ago for nothing. Judy says it's all due to drinking Sweet 'N Low but he says there's no evidence associating bladder cancer with saccharine. She says "yeah, right" and rolls up her sleeves. When Judy is peeved she rolls up her sleeves like she's gonna bust your head open on the schoolyard. Talk about telegraphing your punches!
Anyway he says they're booking surgery with the robot in June, research shows no difference in outcomes when spread with a 2 month window so a week here or there won't make a difference so I schedule after a planned family vacation to Texas to see relatives. He says there's no difference between Ft. Sanders and St. Mary's. I vote Ft. Sanders but the nurse says they do them on Mondays at St. Mary's and Thursdays at Ft. Sanders. She tells me the machine is newer at St. Mary's so I opt there since it's 4 days earlier and newer. I'm told it's a 23 hour admission so I go in Monday morning at 5:30 and I guess that means they kick me out at 4:30am Tuesday. Guess we'll have to call the police for an escort for Judy to go out to her car (rough neighborhood there) or get a few big guys to come and sit with us. Just some more preop, make an appointment with the anesthesiologist and take 1-2 weeks off. I'm betting on back to work July 5th.
Thanks to all those who're reading this, sent me emails and called and wished me well. I haven't shed one tear up until this second and now I'm moist in the lacrimal glands because I have never felt so loved in my life and I thank you. Lane

Interim good news - labwork - alk phos (looking for bone metastases) and liver enzymes (liver metastases) are both normal. Hopefully I'm on a trend.

Bladder biopsy/punch my ticket

Summary: Bladder biopsy done this morning, some good news. I went at 6am today to UT Hospital for a biopsy under general. As usual the staff is nice but interesting. The young woman (she looked 17) in admissions pushed the automatic door open to walk me to the cashier to pay may deductible (it's a business). Told her she looked strong enough to open the door. She said she didn't like to touch door handles. Must be fun to have OCD and work in a hospital. Perhaps she could be a telephone operator and avoid unclean appliances. Nurses were great. My male nurse was being shadowed by a nursing student and before wheeling me back to surgery turned to Judy and asked, "Don't you want to give him some sugar?" Thank God I'm in Dixie. We all laughed when he said he probably shouldn't use that line because he pulled it one time and the lady sitting by the gurney said she was the preacher's wife, not the patient's wife. I'd have still wanted some sugar but hey, that's just me.
I did get one or two pieces of good news. My chest x-ray was normal (no metastatic lesions apparent), EKG normal and my CBC, electrolytes and kidney functions normal. I noted they didn't do an alk phos to see if had bone mets and needed a bone scan as promised. I'll just do it myself on Monday. Helps to be a doctor.
Anyway Dr. Hatcher came out afterwards and told Judy he hadn't seen anything like my bladder in years, thought it might be something called plasmacytosis which is simply treated with antihistamines. Had some discomfort, suggested they give me a urinary analgesic pyridium and they thought that was a good idea. Gotta advocate for yourself.
I'm not sure how many punch biopsies they did in the bladder but between the prostate and the bladder if I had a ticket like Smoothie King or Pilot Coffee Club I could get a free supersize drink by now. I don't know what would be appropriate. Maybe $25 off my next test or surgery or an upgrade to steak instead of chicken.
My follow up appointment is Thursday, May 24th, will know more then and will keep this updated. Thanks for all the comments and emails and prayers. Thanks to my good buddy Diana Nelson, a fantastic public speaker, for loaning me the 4 CD set of Prarie Home Companion annual Joke Shows. I loved the one about the drag queen who went to the Catholic church. He told the priest, "Honey I love your gown and hat but did you know your purse is on fire?"
Lane

Stop the weirdness

Summary: the cystoscopy went easy but the urologist doesn't know what he's seeing down there.
I have slipped through the wrinkle in time, fallen down the rabbit hole, been abducted by aliens or knocked into another dimension. I am being innoculated by rare and unforeseen events to the point that it is getting tougher to surprise me. For me to move past the numb stage will require some ordinariness.
I ran into a friend in the urologist's office who fortunately got better news than me. The nurse calls out "Mr. Cook" and I stand up but so does an elderly gentleman and she acutely spots him as the correct one. Later another nurse comes out and asks for Mr. Cook. I verify they mean Lane Cook. I met with Dr. Bruce Woodworth, the third urologist in the practice of three. They are all getting to know my bottom. He tells me there's a possibility of a middle lobe of the prostate growing into the bladder and they want to make sure if I have or don't have one. Miraculously I don't. I told him I just thought he was looking around the neighborhood. I dreaded the cystoscopy (tube run up the penis to the bladder). As was the case with the biopsy, the numbing gel was fine, had no pain. I once had a dentist do something in my mouth and say, "oh, shit." That was my last visit with her. So Dr. Woodworth says something like, "that's interesting." He says 1/3 of my bladder wall is red, doesn't look like cancer. He asks if I've ever had radiation treatment. I tell him never (must have been one of my alien abduction trips, I can't recall which one). And no I don't put laptops on my lap - they get too hot. He says it doesn't look like cancer, could be a telangiectasia (like those spider veins on the noses of old drunks) or plasmacystosis, hasn't seen this in over two years. "We need to biopsy these," he said. "Go right ahead, you're there," I say. He tells me that requires general anesthesia so I am given to conclude it must be quite painful. He asks again if I've had radiation. My memory is so-so but that's something you normally recall. So I'm going to have a detour. Before I make it out the door I find out he and Dr. Hatcher, my main urologist, are booking robotic surgery now in June (so much for my wish to get it over with soon) AND that UT Hospital decided to buy something other than the da vinci robotic surgery machine(probably something I'll use in the future with my luck) so I have to go to Ft. Sanders or St. Mary's hospitals. I plan on having my wife and step-daughter Christy (an RN) there to keep them from killing me off.
I go to do my preop bloodwork, EKG and chest x-ray. The pharmacy tech shows me her stuffed pigs that sing songs and laugh. Unreal. The anesthesiology resident witnesses to me and invites me to his prayer meetings in a hotel, tell me hundreds of thousands of people have been healed by prayer. And yes, they are charismatic. He asks me how I feel. He's a really nice guy. I should call him back and tell him to get out of anesthesia and into psychiatry. I also thank him and tell him he better be careful who he says those things to (religious) or some disgruntled person will turn him in. He acknowledges that. They get my blood, do my EKG, say I'm ready to go home. I remind them I have to have a chest x-ray. Oh yes, take this down the hall. The waiting room is packed. I sit on the floor and Judy sits in a love seat next to a young woman who starts coughing and tells the receptionist she's really sick. She looks like she has the flu. We turn away from her. They come out, stare at me and say, "his buttons are ok" and walk back in. I have no clue what that means. Then the tech comes out in a moment and comes and gets me. He tells me to lean against the plate. "What about my shirt" I ask and he says that's ok, my buttons are fine and won't show up. With my luck, the radiologist will diagnose me with 3 or 4 small button-sized tumors in the midline of my chest. I've just had a snake up my hooter so I tell him I'll take my shirt off. He doesn't care one way or another and snaps my picture. He never looks at my brand new orange arm band to verify that I am indeed Lane Cook.
So Friday morning at 5:30 May 18th I have the mystery lesions biopsied. Stay tuned. Probably asbestos fibers.

The Bad News

Friday, May 11, 2007 - I get a call from Dr. Hatcher. He tells me I have moderately fast growing prostate cancer. I'm numb with the news. I call my wife Judy and she asks if I'm joking. I assure her I am not and that Dr. Hatcher will meet us at 6pm this evening. I drive home in a hypnotic state, unemotional.
We hug a lot and make plans to go. I've pretty much decided to go with a radical prostatectomy. We watch a couple of videos on the da vinci robotic surgery:
http://www.intuitivesurgical.com/products/da_vinci_video_overview.aspx
http://www.sharpmedialibrary.com/documentary_2005/Robert_and_Rita_HIGH.wmv
I've heard bad things about radiation, burns to the rectum, how salvage surgery afterwards is not easy nor effective.
We go and meet Dr. Hatcher. I'm reassured by his reputation, his Duke University and Massachussett's General Hospital residencies. Dr. Mounger says he is a fine surgeon. So do several others.
He tells me I have a Gleason score 7 (the lower the better) and stage 1B. Good news-it's only on one side. Bad news-looks like it's growing into the left nerve supply so it will likely have to come out. So much for nerve-sparing surgery. I have to have a chest x-ray and lab studies (alk phos, CBC) to rule out metastasis but no bone or PET scans for now. We discuss lots of numbers, percentages. He seems to focus more on incontinence and ED than death rates, assures me if we get it all I am essentially cured. I ask how many he's done - he's done over 2,000 radical prostatectomies, over 100 of the robotic ones. I ask him if it was him would he go to Vanderbilt or Hopkins. He says maybe a year ago but not now, they have the same outcomes. He said he saw two men in followup this week: the man who had the radical had taken 4-5 hydrocodone and the man with the robotic surgery had taken no pain pills at all. I have to spend the night in the hospital, there 2-3 days, home for 1-2 weeks with a foley catheter in, have to have a cystoscope (the news just keeps getting better and better). Says I'll be 99% in two weeks. Unfortunately supplemental testosterone is never again an option.
Fortunately Judy is a great support, has always stood by me and this is no exception.
We tell the kids. My son is scared, "I've already lost one parent to cancer." His mother was way too optimistic for her metastatic breast cancer so my attempts to reassure him fall on deaf ears.
My daughter asks if they gave me a certain number of years to live and I said no and mention total cure if they get it all. My aunt who is 90 cries and cannot speak. My brother tells me to hang in there and take supplements. Lots of support from friends, office staff. Diana offers to come back early from vacation and I tell her no, I'll need her later. "May you live in interesting times" is the old Chinese curse.
More later. Lane

The leadup

April, 2007. I want to know why I'm tired a lot, want to take a nap in the evenings. I get my testosterone checked and it's in the toilet. It was borderline a year ago, now it's time to do something. I go in for my annual DRE and PSA prostate exams. My physician, Danny Cox says ok to start the testosterone gel. Five days later he calls and says he doesn't like my PSA and Free PSA, wants me to see Paul Hatcher, urologist. I actually argue but am a good patient and go. A year ago my PSA was 2.4. It came back 2.7 but repeat showed 2.4. I schedule an appointment. Before my appointment I check my PSA again. 2.7. I'm still optimistic.
May, 2007. I see Dr. Hatcher. He tells me he can feel a ridge on my prostate which Dr. Cox didn't feel. He recommends a biopsy. I hear scary things (pain) about this but also reassurance.
May 9, 2007. I see Dr. Hatcher's partner Dr. Jay Mounger. Funny guy, older, quit doing most surgery, just does biopsies. He uses a local anesthetic and grouses and tells jokes. "If it hurts, you don't have enough Novacaine!" he says. The next day I see two fellows who've had biopsies by other docs in the last year with no anesthetic. How cruel.