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Sunday, November 23, 2014

Fringeville #129, November 23 2014

...the corpuscles look like little chicken wings...
(Please note in the post below I am talking only from my own experience as someone whose prostate was surgically removed as primary therapy for my cancer. When I talk about PSA levels, etc. it is from my perspective as a surgical patient. Radiation therapy is a whole 'nuther bag. After radiation therapy, PSA may take a long, long time to drop to its lowest level. The prostate wasn't removed and there may still be some healthy prostate cells cranking out PSA. Whether surgery, radiation or some other therapy is the best choice for a patient is something that has to be decided on a case-by-case basis. There is no one-size fits all for prostate cancer. What worked for you may not be the best choice for me, and vice versa)

This past week I had to have blood drawn for my 6-month PSA check. With the surgical removal of my prostate, what the blood test should confirm is that my PSA (Prostate-specific antigen) levels are undetectable. Because we yanked the lil' sumbitch.

I have this test every 3 months post surgery. The first was in August. Last week was the second. And I've noticed a little something about myself when it is time for these tests. I dread them. And from what I've read, most guys in my shoes dread them as well.

I am not a needle-phobe (though my sister Mitty is...she was a legendary needle-phobe back in the day). It's relatively painless, and the most difficult part of it is getting to the testing center in Hazleton. I can't have it done at a regular lab because it is an ultra-sensitive test. They are looking for incredibly small levels of PSA, and they really shouldn't find them (because as mentioned above, we yanked the lil' sumbitch).

The dread is that the test will find measurable PSA.

How is that possible?

Let's say a couple of those bad boy prostate cells took a pleasure cruise up the river lymph, or otherwise got out of the box before the prostate was removed. Those little peckerwoods will multiply. And they will produce PSA. Therein lies the dread. Because as anyone with prostate cancer knows, you are cured until you're not. In the case of folks like me, who had the prostate removed, the longer you go without a return of detectable PSA the more likely you were cured. If it becomes detectable, well the later that happens and the rate at which the PSA level doubles guides the approach to treatment. If it starts showing up a decade from now, and rises slowly, that's not a horrible scenario. At that point, I'm much more likely to choke to death on a chicken wing than to die of prostate cancer.

But if those PSA levels return early and rise quickly, that's when a fellow starts to feel like a milk carton with an expiration date.

And so fellows like me ...who had the lil' sumbitch yanked ...go about our lives and push our cancer to the back of our minds. Until it is time for the test. And the intervening time from test to results is when we drum our fingers as we drink our morning coffee and wonder what we'll do if we lose the PSA lottery so soon after surgery.

And I still hate the term for the unwanted return of PSA. They call it 'biochemical failure', which somehow sounds like it's our fault.

Doc: "You've got biochemical failure, Mr. Hooter."
Patient: "But I stayed up all night studying for the blood test!"
Doc: "Yeah, well your PSA tells a different story. Slacker."

The dread motivates someone like me to some sort of action. In my case, I took a look at where I was in life and made some changes over the past few weeks:

  • Because I'm hopefully cured, I've taken on a second full time job because staring at piles of bills doesn't make them go away.
  • Because I may not be cured (unlikely but possible) I have adopted a 5-year horizon view of my life. If I become a milk carton, that's what I'm looking at as time remaining to get things done. This is just my own level of neurosis picking that span of time. Five years  is chunk of time that I can work with.
  • I have begun backing away from things that take me away from my family.
  • I have begun letting go of making all the big decisions around Jimboville.

And that segues me into the next piece of this blog...

* * *

...ignore the ugly blob and campaign stuff. Focus on the car.
See that beautiful red Buick behind that butt-ugly guy in the white shirt? That's Bess. I love Bess. Bess has been the HQ for two political campaigns. In the summer, when the air conditioning is on, it even has an indoor pool in front of the passenger seat. I used to call it "Lake Laureen" because when Laureen Cummings ran for Congress in 2010, that was her seat and she had to strategically place her feet where they wouldn't be submerged in those dog days of summer. Congressional candidate's feet shouldn't squish when they walk.

For the past couple of years, Bess has been my daughter's car. Bess has picked up some bumps and bruises, and if you lock all of her doors you can't open any of them. You have to break in. She's also become steadily more expensive to maintain.

With the impending addition of my second job, I realized we were facing a major dilemma in Jimboville: A 5-3-2 crisis. Five jobs requiring vehicles. Three people for said jobs. Two old vehicles to carry the burden.

I realized this wasn't going to work, and as I went into this past week facing the dreaded PSA test I decided to guide my daughter Courtney through her first car purchase. Before I got sick, her role in the whole process would have been to sit quietly and listen while I worked everything out with the dealership's sales and financial folks. I would have cosigned the loan, and she would have a dependable vehicle. But she wouldn't have learned a damned thing because I'd have done the whole shebang, and I'd have been her safety net financially.

But the worm has turned.

I knew that while unlikely, there was a possibility I might not be around when she buys her next car. So I did two things which are very, very difficult for me. First, when the salesman asked if I was helping on the loan, I said no. And that hurt. A lot. The second thing I did was shut up for 95% of the entire process. I watched her work with the salesman and then with the finance officer. If there had been any red flags during those sessions, I'd have stopped things dead in their tracks. I wouldn't sit there and let my daughter get taken advantage of. But I had faith in the dealership, was impressed with the salesman, and appreciated the way the finance officer took his time carefully explaining each piece of paperwork. He knew it was her first car purchase, and he wants her back next time. (A big shout out to Ken Pollock Nissan. Job well done. And if  you're looking for a car, ask for Keith Onyshczak.)

In the end, my daughter got a great vehicle. And I learned just how well she can handle herself. And oddly, that was bittersweet, because on the one hand I am enormously proud of her, but on the other hand she really doesn't need me any longer. Like her brother, James, she is smart and self-sufficient. Though she hasn't actually left the nest (and if she sticks with my plan of not dating till she's 40 she'll be here a while) she can make her way in the world.

So the two big takeaways are:

1) My wife and I have raised two fully functional and self-sufficient adults.
2) I have Bess back. Come summer, in the hot and steamy dog days, you'll find me cruising down the highway with the only mobile lake in Northeastern Pennsylvania.

* * *
...time to eat yet? I just made a Hack Sandwich.

Lastly, I watched the NCAA sanctions in full bloom as my Lions came up flat usual ...on offense and the D just ran out of gas. I'm not hitting the panic button. The Lions only had their mouths smashed once this year. 4 of 5 losses (including the holdup-by-zebras against the Buckeyes) were by a handful of points each. Any kind of consistency on offense and ...don't laugh ...we're a one-loss team and Coach Franklin is a miracle worker. But the reality is that we don't have the horses, thanks to the NCAA.

I will be in State College for the Michigan State game next week with my brother. I really don't know what to expect. They are a very, very young team and this will be an emotional game. The best we can manage, including a bowl win, is an 8-5 record.  But quite honestly 6-7 is a very distinct possibility. The NCAA wanted to damage the program. Mission accomplished.

But 2015 comes quickly and with it the ability to rebuild to full strength.  I'm already thinking about the Blue-White game and a belly full of Five Guys grub next spring.

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