Yikes more surgery; Maybe retirement is now an option

I don’t know if the well-worn and often misused word irony is appropriate but something has to be in a dictionary to explain what happened today.

Look at this way: At 7:30 a.m. I finished up with the physical therapy that was linked to my Oct. 10 neck surgery.

Some 90 minutes later I was visiting with Dr. Steven Combs, a kindly orthopedic surgeon who knows a thing or two about knees, shoulders, that kind of stuff.

We each know that this visit was coming when first chatted a few months back.

Sooner or later I’d tackle him and make him say “uncle” by including me on his surgical to-do list.

I will say this, however, it was very refreshing to see Dr. Combs peel out of his pocket a well-worn pocket paper calendar instead of harnessing a cold-blooded electronic thingamajig.

Consulting his calendar Combs searched the openings in January.

"January 16,” he said as I followed his lead and explored the calendar found on my cell phone.

So January 16 it is, with the “it” being a total replacement of my left knee. That way I’ll have a matched set, the right one becoming artificial several years back by a former partner of Combs.

That step was easy enough. Actually, maybe not so easy.

The debate I had with myself and with several other doctors was either to replace the left knee or else have a neurosurgeon open up my lower back, chip away at the bony material clamping a no-longer-helpful titanium rod and reinstalling another one. For the third time, I hasten to add.

And as challenging and major a surgery a total knee replacement is, all of the doctors I had a pow-wow with said the lumbar rod replacement would/will be a heck of a lot more complicated, difficult and chock-full or greater risks.

So, I asked Combs, just what’s going to go on when I’m splayed atop a gurney at Lake Health’s Willoughby branch.

Don’t mind me but if you are of the squeamish sort you might want to skip this part and scroll to the story’s end.

I’ll have what Dr. Combs called a “mobile bearing” implant.

He’ll slice open a several-inch chunk of my left leg, slightly above and slightly below, the knee, and on the left side too.

Oh, yes, one other thing. I won’t feel a thing. Dr. Combs said I’ll probably be given something called a femoral artery something-or-another.

There are fewer post-op complications with that kind of knock-out procedure, Combs said.

Who am I to argue, so I said it was fine by me as long as I wasn’t awake.

After the soft tissue is rolled over and the femur, knee and tibia are exposed Combs will go to work installing the artificial construct.

This 1 1/2 to 2-hour process will require him and his team to drill a small hole into the stump of both the tibia and the femur bones.

He - and they, his team - will take the hinged artificial construct which is made from chrome-cobalt, insert the femoral half into its designated bone and the tibial tray into its respective stump.

Sandwiched between them will go a spacer made from ultra-high-density plastic.

Ditto for the patella button, a fancy name for what will become the knee cap.

Combs will then suture the wound and I’m set to go; going meaning that I’ll be wheeled to a surgical unit room for the next two to three days.

After that I’ll be wheeled to a rehabilitation room for the next seven to 10 days, Combs said.

Oh, almost forgot. With this sort of procedure they will have me up and walking (if walking is really the correct word) that evening with the aid of a personally detested walker.

Rehab won’t be much better. I swear after the first knee surgery I gathered that the only people Lake

Health hires for that sort of work are unemployed iron workers who enjoy nothing more than wrestling heavy objects and acting surprised when you cry out “that hurts!” to which they only diabolically laugh.

Once I’m home and for the next several days my wife will have to give me antibiotic injections, each to my stomach area.

She has experience so I’m not worried a bit. In fact, with the first knee replacement Bev did a better and less painful job than had the official needle-dealers.

Combs said I’ll be at home for four to six weeks, recovering under the ever vigilant eye of Bev and an occasional visiting nurse.

That will take me up to early March, I calculated.

“Perfect,” I thought. “I won’t miss all of the late-winter steelheading fishing season.”

I didn’t mention that part to Dr. Combs, of course, though I suspected he knew I was up to something when he said “no ice fishing.”

Yeah, yeah, so long as I can hobble alongside a creek before the steelhead vacate the rivers and before the male turkeys start gobbling I’ll be fine.

If it weren’t for that darn nasty lower back, of course.

And on a somewhat related topic. After I returned to work this morning I spoke with our human resources person who handed me some required long-term medical disability forms to complete.

I also requested details on what is needed to file retirement papers.

Now don’t get too excited. As I told Tricia Ambrose, our paper’s top editorial section gun, the way I figure it I’m only at Defcon Two, maybe Defcon Three. Tops.

It’s worth considering, this retirement thing, I figured.

As Tricia said - and she has been by far the best boss I’ve had - maybe Bev and I ought to enjoy a few years of at least moderately good health.

Makes sense. I’ll keep you posted.

Just don’t break out the champagne and party hats just yet.

The left knee may be a done deal but not my retirement.

- Jeffrey L. Frischkorn
JFrischkorn@News-Herald.com
Twiter: @Fieldkorn

I'll tell you what important event happened Tuesday, and it wasn't an election

So we are all waking up this morning with the same president, the same House and the same Senate.

 I get that.

 I also understand that our nation is deeply divided, perhaps not seen in a way since the Civil War 125 years ago. 

Check, got that one, too. 

In effect - for both sides who so keenly hated the other side - what happened Tuesday was nothing more than a Pyrrhic victory, for each party, which is why I never bothered to watch even one minute of the returns.

I had medicine to take, stuff that knocked me out so I could avoid the pain that was knocking me silly.

But we all woke up this morning, didn't we?

The sun still rose, didn't it?

My wife still kissed me good-bye and say - as Bev always does - "have a wonderful day," and mean it with all of her heart.

When I opened the door to my house in the very heavily developed city of Mentor-on-the-Lake wasn't there a doe not 20 feet away looking at me, and wasn't that a dandy and absolutely stunning thing to see?

And while many folk were voting yesterday afternoon I was visiting with my urologist to go over tests to see if the radioactive pellets inserted into my prostate were where they should be in order to kill off the cancer residing there. 

We then talked about things like incontinence, impotence, radiation-induced fatigue, the super-charged price for "male-enhancement" drugs, that it will be at least two more months before we know if the cancer is dead.

Oh, and in the waiting room were several other men - some older and some younger than me - with the same hang-dog look of fear and pain on their faces. Each knowing that their very lives were now in someone else's hands.

So I walked out of the urologist's office keenly disappointed, hoping for more but getting less than expected, let alone, hoped for.

We had an election and some of my candidates won but most of them did not

 I get that as well.

Stopping to think about it, after tens - hundreds - of millions of dollars being spent on a tragically negative and divisive campaign by ALL parties we have not budged politically from where we were 24 hours ago.

To think, all that just to maintain the status quo.

So please, don't try to tell me what truly happened yesterday at the polls was the day's most important event.

It wasn't.

Not by a very long shot.

 - Jeffrey L. Frischkorn

JFrischkorn@News-Herald.com

Twitter: @Fieldkorn

Boy, that went well. Maybe even too well.

I suppose that I should feel guilty somehow, but I don't, thank you.

On Monday I paid my dues and respect at Lake Hospital Systems' Lake West Hospital (us old timers still call it "West End Hospital").

For the entire summer I knew this trip was necessary if I ever was to lick the two cancerous tumors that were growing inside my prostate.

During that time I had lows and highs in emotions, the level depending upon how much anxiety was bubbling just beneath the surface. A few times it even began to boil over and spill onto my wife, Bev.

Pity because I never meant to hurt anyone, especially my wife of 40-plus years.

So I sucked it up and did my best to live a normal summer life. Even if that life was overflowing with other pressing health issues.

None, though, took on the significance  of dealing with cancer.

Yes, I know all about the huge survival rate if prostate cancer is caught early on, and mine was unearthed before the tumors could be felt as bumps during a doctor's physical examination.

Visiting first with an urologist, than with a radiological oncologist and finally with both at the time of Monday's procedure, the best cure option was to have what is called a "brachytherapy."

This is where specialized physicians inject hollowed-out, rice grain-sized titanium pellets called seeds into a man's cancerous prostate gland.

I would also like to note here that the pellets contain radioactive isotopes. While the radiation don't actually kill the cancer cells it does shake, rattle and roll their DNA in such a way that the bad little guys cannot reproduce.

When the urologist and the oncologist got done with me they had installed 70 strategically placed radioactive pellets.

The whole thing from when I entered the hospital at 8:15 a.m. until I left took just five hours.

Five hours out of my schedule isn't much when you consider that the procedure will give me a lifetime of enjoying my family, friends and the outdoors.

As far as the procedure itself, well, even the anesthesiologist called it boring.

Boring is fine by me, I told the assembled hospital staff as they readied me for the trip to the O.R.

Don't ask me what was going through my mind during my short journey aboard a hospital gurney.

Anesthesiologist and fellow Bible Community Church member John Hagopian  made sure of that by squirting some happy juice into the I.V. tube connected to my left wrist.

I was asleep before we rounded the first corner of the pre-op room.

Yet this is the part where I'm sort of feeling guilty for not feeling guilty.

Back in the recovery room an hour or so later and about the only thing I didn't request was something for the pain. That is because there was no pain.

Yeah, you read correctly: No pain. None. Zip. Naught. And anything else you kind find in a thesaurus, for that matter.

Even after Bev piloted me back home, helped me up the few steps and into the house, I felt comfortable, you know, down there.

Frequently exchanging a warmed-up ice packs for a freezer-chilled one I would press the intended pain- relief package up against where the seed-shooting needles had clipped skin and tissue.

This effort was strictly precautionary. The reason being: There was no pain down there. Nor anywhere else.

And though I was given a script for some pretty potent pain-killing synthetic-morphine substitute only one of the paperwork's capsules was swallowed. Just one, for crying out loud.

It was all truly amazing stuff, actually. Everything I read, every man who has had this procedure, everything just oozed to expect some level of discomfort.

But it never came, for which I am grateful beyond words.

Yes, my body is still in over-drive, trying to adapt to what's happened. There's some burning when I do have to urinate, and the urge to do so has increased markedly.

And there are times when that tap on the bladder comes a little to late.

Each of those things will eventually ease up, likely to nothingness, the doctors have said from Day One.

I can live with all that, I figure, especially considering the alternative.

Even so, not having something pain-wise to complain about leaves me stalled for comment.

I guess then all I can say is "thank you, Lord" and enjoy a day free of pain down there, all the while knowing that the odds are heavily stacked in favor of me verses the dreaded C-word.

The last thing I want now is to also take a guilt trip.

- Jeffrey L. Frischkorn
JFrischkorn@News-Herald.com
Twitter: @Fieldkorn

Time to ride, cancer posse

Well, the horse is all saddled up and we're burning daylight.

 After four very long months of seeing specialists, undergoing tests, having a biopsy taken from my prostate while still awake and then having several lymph nodes removed from my bladder, and a full scan of my entire skeleton, at 8:15 Monday morning I'll walk into Lake Hospital System's Lake West Hospital (sorry, but us Lake County old timers still say "West End").

There I'll  have what's left of my prostate poked with about 70 rice-grain-size hollowed-out titanium pellets (or "sees") that are filled with radioactive material (I believe Iodine-125, and imported no less).

The brachytheraphy - as it's called - will take roughly 60 to 90 minutes. In five years the process has a 96- to 98-percent survival rate.

Of course it's a life-altering procedure with a host of potential nasty side-effects.

But those are the unknowns.

What IS known is that without the treatment - and had I not been so paranoid about getting screened for prostate cancer every year since I turned 50 some 12 years ago the chances from eventually dying of these disease would have been almost certain. Or so says the doctors, and I'm not one to disagree.

 So for a few seconds during each old-man check-up I  allowed for the physical exam as well as the drawing of blood for the PSA test.

No regrets, only what might-have-been had I not insisted on the exam/test.

Come Monday afternoon I'll find myself on a strange new trail but I feel a sense of confidence, too.

I'll let you know how things go.

For now, I'm going home to enjoy a fancy meal of boiled lobster and a sweet potato topped off with brown sugar, maple syrup and a small dollop of butter.

I figure I deserve it, especially since on Sunday all I'll be allowed to have are liquids with no sugar or creamer to sweeten my coffee. Now that's punishment enough.

- Jeffrey L. Frischkorn
JFrischkorn@News-Herald.com
Twitter: @Fieldkorn

Sex and the not-so-single prostate cancer patient

At a meeting no one wanted to attend about a subject no one wanted to comfortably listen to, psychiatrist Stephen Levine spoke frankly anyway.

And that was a good thing. At least for roughly 20 men, most of whom were accompanied by their wives.

A psychiatrist who has long specialized in sexual issues, Levine candidly laid out to the assembled group the long and short of sexuality following treatment for prostate cancer.

He made his remarks during a recent Thursday evening prostate support group meeting held at Lake Health/University Hospital’s Seidman Cancer Center in Mentor.

Not only was the meeting free but so were the sweet treats and coffee. Reason enough, I figured, to sit in on the topic and even chip in my two cents worth since I’m due for treatment for prostate cancer Sept. 24.

Frank to the point of being blunt, Lavine’s also manage to treat a rather grim subject as humanely as possible.

Which makes sense. That is because to men the matter of prostate cancer, its treatment and subsequent impact on their sexuality weighs heavily on the mind.

Sometimes even to the point of obsession. And frequently enough that  some men don’t seek either medical treatment early on, let alone mental health assistance once treatment has arrested the cancer.

“Until about 1992, the issue was referred to as ‘impotence,’ but that’s not a very nice term and is demeaning to men,’” Lavine said at the program’s jump start. “Now it’s called ‘erectile dysfunction, or ED,’ though you have the same term problem.”

Instead, suggests Lavine, the medical profession ought to use the term “penile unreliability.”

“It’s a big deal to lose your potency,” Lavine said.

Oh, yeah it is, as the heads of most every attendee nodded in agreement.

Not in so much a literal way, of course, but in such a manner where the wife can feel she’s being denied her own sexuality by either the fear, the anger, the frustration, the disappointment on the part of a non- or low-performing husband.

A big part of the bigger mental health picture, says Lavine, is that men are much less inclined to seek professional help following prostate cancer treatment and its sexual aftermath than are women following breast cancer reconstruction.

Fully 90 percent of the women who’ve undergone breast cancer treatment seek mental health support within one year. For men, it’s much, much less, Lavine says.

“Prostate cancer is a physiological problem,” Lavine says. “‘Cancer has come and found me.’”

Lavine then laid out the various alternatives that men can employ to assist them in having at least a modest level of sexual pleasure via a maintained erection following some form of prostate cancer treatment.

That’s true, says Lavine, regardless of whether the chosen course of treatment means surgery to remove the cancer-stricken gland, external radiation treatment, insertion of radioactive pellets called “seeds” into the prostate organ, hormone therapy, watch-and-wait therapy, or some other treatment form.

After all, we men have an image to protect, and Lavine was doing his darnedest to break down that irrational barrier.

Thing is, however, says Lavine, a man can no longer “depend on his sexual organs.”

“It’s the cure itself that causes the problem,” Lavine said.

Overcoming the problem can take one of several current forms. There is the so-called “Osborne Pump;” a device that pretty explains itself though Lavine had no qualms about addressing the ins and outs of this tool; pun intended.

And no one attending the meeting was even close to putting their hands over their ears and shouting “Enough, enough!”

Nope, we all listened attentively, maybe squirming inside some but not overtly showing any display of discomfort.

Neither did we openly blush when Lavine spoke about using a vacuum pump, let alone employing a syringe to inject medicinal fluid directly into the penis to cause an erection.

There is also a prosthesis which requires an operation to implant, and for the men who have gone all ready experienced some form of prostate surgery they are inclined to say that they don’t want to “ever do that again,” Lavine said.

Of course, there is the magical little blue pill or its counterpart, Lavine says.

Such drugs as Viagra, Levitra, Cialis and their siblings can do wonders.

That being said, as often as not, many men who swallow such pill are probably downing as much advertising bling as they are a potent product, Lavine insisted.

“In medicine we have a lot of treatments that aren’t very effective,” Lavine who added later that “advertising is an acceptable way of lying.”

Yet perhaps most importantly of all, stresses Lavine, is that the matter of prostate cancer treatment/sexual activity is a two-lane highway and not just a single track for a horse-drawn carriage ride for a man only.

“Psychiatrists understand that when a man gets prostate cancer so does his sexual partner,” Lavine said.
“That’s why the real patient is the couple and not just the individual.”

To which, a husband and a wife “can still have romance,” Lavine says.

So while a prostate cancer-surviving man may not have the wherewithal to enjoy the same sexual pleasure he once did, that need/urge can be mitigated at least in part by working to satisfy one’s spouse, says Lavine.

“If she knows that you want to please her, you can help overcome the blow that Nature gave you,” Lavine said.

It was at this juncture in Lavine’s hour-long presentation that drew the most attention; from the women as much as from the men.

To hike this path of mutual satisfaction, Lavine says, a couple can engage their hands as well as their tongues.

And while such talk rarely - if ever - surfaces within the confines of the Baby Boom Generation, let alone that of the Greatest Generation, the up-and-coming ones representing our children and even grandchildren have no such qualms, says Lavine.

“There are many different ways of having sex,” Lavine says. “But it is seldom an issue until a couple confronts something like prostate cancer.”

And that remains a hill whereby the best journey to the top is not undertaken alone.


- Jeffrey L. Frischkorn
JFrischkorn@News-Herald.com
Twitter: @Fieldkorn

What to wear - and NOT wear - on the other side of 60

It would appear that I’ll soon have the entire ensemble of a genuine card-carrying old geezer.

In a couple of weeks I’ll be addressing a young lady who’ll smile, call me by name (likely the formal old person’s “Mr. Frischkorn” with “Jeff” also possible), and then escorted into a windowless room. There’s the nice young lady will stick something in my ear and attach it to an electronic sound amplifier.

Isn’t that a much more nicer term than “hearing aid?”

Okay, so my wife Bev has been pestering me for more years than I can count about the need to install an electronic sound amplification device into my left ear.

Up until now I really haven’t been listening. And not just because my overall hearing is some point downstream from the 50-percent mark.

Those “things” makes a person look old, and I suspect at least initially, makes one FEEL old, too.

And I feel that way already. I’m taking more medicinal tablets than I care to count, I’m going to undergo treatment in September for prostate cancer and my glasses are bifocals, for crying out loud.

Shoot, I’m even wearing suspenders. And I don’t give a thunder if I wear a striped tie with a patterned shirt or if that tie is tainted with splotches of aged mashed potato gravy or dried blood from when I nicked my neck during shaving.

Oh, and I wear boxer shorts instead of briefs. Take that, Michael Jordan.

Nope, and I am to the point where being required to use a cane while walking in civilization or a hiking staff when afield now comes second nature to me.

For that matter I now look for a handicapped parking spot just so I can raise the placard flag that was awarded to me by the Department of Motor Vehicles following the required recommendation of my family doctor.

But wearing a hook-behind-the-ear electronic sound amplification device? I don’t think so.

At least not until after a July 12 meeting with a hearing specialist. She put me through the ringer during a thoroughly rigorous 2 1/2-hour evaluation of my hearing and as it relates to balance.

Margie was - as always - kind, humorous and friendly. She also verbally poked, prodded and jabbed me on the need for an electronic sound amplification device.

These tools have come a long way, Margie said, from the days of clunky models that stuck out one’s ear further than those belonging to President Obama.

Thing is, she’s correct. So is Bev and our daughter, Rebecca. So is, for that matter, everyone else who has pestered me for these, oh, so many years.

Yes, my hearing is shot. I don’t know what a cricket sounds like nor can I hear the notes of a warbling song bird.

And it’s not entirely my fault. Blame the aging process for some of it, of course. And in my youth I should have worn better hearing protection on the skeet field.

However, lay the vast majority of the hearing loss to a bout with rubella, which used to be called “German measles.”

That infection happened more than 55 years ago when I was five or six. It destroyed my right ear’s ability to detect most ranges of sound, especially the higher ones.

Which means that the right ear cannot be salvaged. The left one can, though, and this is the ear that one of Margie’s accomplices will attempt to bring up to par.

So I will go through the hoops, sit and have a thing or two stuck into my ear. I guess I’ll also try out a few models, each of which will be of the variety that hangs in back of the ear.

It seems that with the type of hearing loss that I have an inside-the-ear electronic amplification device would offer more feedback than a heavy metal rock band’s sound system.

One of the uncomfortable parts in all this is that whatever I do choose to buy - and that step is not certain by any means - the money will have to come out of Bev’s and my own checking account.

The reason being is that almost no insurance plan - not even under ObamaCare - pays for electronic sound enhancement devices.

At anywhere from $1,200 to $2,000 that’s going to be a pretty serious blow to our collective wallet.

Unfair? You bet, but it is what it is.

However, I guess if it will bring me peace at home, help me to hear the soft rush of the wind or the gentle notes of a whip-poor-will then the expense may prove beneficial.

Besides, no one can say that I actually have to turn the (sigh) hearing aid on.


- Jeffrey L. Frischkorn
JFrischkorn@News-Herald.com
Twitter: @Fieldkorn

Is it ever OK to say "no" to love?

The reaction to well-meaning folk who strongly opine on what I need to do in seeking medical advice and assistance runs between a half loaf of frustration and a half pint of resignation.

No offense to myself but I knew it was coming. I just was a little surprised on how pervasive the need is for others to try and put their best foot forward only to watch them stumble and fall with their good intentions.

Which - as I've ever so often instructed my wife  - is what the road to you-know-where is paved with.

Way back nine or 10 months ago when my seriously painful and chronic joint inflammation sent me to seek answers from one specialist after another, the unsolicited advise started to trickle in. Then it came a little more steady, the way a heavy shower does where the windshield get splattered with a few drops just before  when the wipers can't keep up.

I understood what and why the not-so-professional and free advice was coming from. It was love all packaged up in the person's way of saying that this worked for me and therefore it will work for you.

Alas, no two snowflakes are ever perfect matches. And neither are medical treatments. We are all uniquely made and thus we all can expect some fine-tuning whenever a physician or teams of physicians get to treating you.

Besides, in my case things were becoming more and more baffling. Consequently, the treatments were becoming more and more a thickening brew of various combinations of tests, consults and medicines.

It was a thoroughly agrivating case of stumping the doctor. That is, unless you happen NOT to be a doctor. Then you can dispense whatever medical advice/knowledge you wish; for free and without any worry of be found in violation of the law for doing so without a license. Much less sued for malpractice.

So when the nice little old lady stopped Bev and me after church one Sunday and urged me to look into this and that medical device/treatment/drug we - as pleasantly as possible - smiled, nodded our heads, and expressed something of a surprise about something we all ready knew.

And then we kept the next doctor appointment, no less the worse for wear.

Things became more contorted when I became diagnosed with prostate cancer. Oh, make that much more distorted.

Opinions, advice, personal histories -  which including those of friends and loved ones who had complications or nasty side effects - flew from every corner of this New Age of instant communications.

Bev and I were told that this was going to happen, that people genuinely want to do right and see that you come out on top. More than a few web sites that deal with prostate cancer cautioned us that this would be so.

Thus, whenever I received an email, telephone call or general post letter I didn't just dismiss them outright.

That is why I checked out everything from exotic and cutting edge proton and neutron radiation therapies available pretty much only in Texas to chowing down on a daily basis so much fresh asparagus that by doing I'd have put a serious dent in the availability of that vegetable.

Of course, had the recommendation been broccoli then I would not have contained my patience, that vegetable and me not being on speaking terms.

There was the time as well when one unsolicited opinion came in which the communicator opined that my specialist's partner was not a very good doctor and so I should consider myself  fortunate not to have chosen him.

But like all of the other offerings I accepted this piece of misplaced advice in the spirit in which it was given. That person thought  enough of me and my health that the individual wanted what was best to help ensure a long, prosperous and healthy life.

So, no, it is never OK to say "no" to love.

But there are times when it's best to say nothing at all.

- Jeffrey L. Frischkorn
JFrischkorn@News-Herald.com
Twitter: @Fieldkorn

Oh, boy, here comes juicy part about prostate cancer treatment

One typically harvests in the fall, not sows with seeds in autumn.

In my case, though, dumping about 80 radioactive titanium pellets - called “seeds” in official oncology parlance - into my slightly larger-than-walnut-sized prostate gland on Sept. 10 will be a good thing.

Finally, after week after seemingly endless week of visits with white-coated doctors talking about the black threat of cancer, a date with the surgery room was announced.

Only that Dr. Jon Prescott bulks at calling his seed-sowing work surgery. If anything, the good radiological oncologist fumes about surgery the way a surgeon might dismiss anything else but.

What’s going to happen on that date is something called a “brachytherapy,” a really fancy word with all kinds of Greek-to-me meaning.

In this hour-long procedure I’ll be wheeled into an operating room reserved just for me - and probably several other men in need of Prescott’s handiwork that day - and be conked out with some sort of happy juice.

Good thing, too, as what will come next is not really something that I have any desire to undertake while awake and kicking.

During a brachytherapy procedure the unconsciousness male (this is after all, a guy thing) is laid out on his back. His (my) legs are then spread-eagle-split-apart while the feet are harnessed into stirrups.

Yep, if you think this is just how a woman undergoes a pelvic exam you’d get a lollypop from a doctor.

It’s really the closest thing a man can get to experiencing child birth, though in all honesty us guys are fast asleep while the women folk are very much awake.

Yeah, we may be wimps but we’re SMART wimps.

For the next hour Prescott will work with my urologist Dr. Lawrence Wolcoff in a two-person tag-team. Their collective goal is to hunt down and search out the cancer during their seek-and-destroy mission.

A ultrasound fluoroscopic device will be inserted into my rectum, guided the short distance to the nearby prostate gland. This tool will help lead the doctors to the promised land where the nasty business of cancer is found.

Prescott will make a minimalist insision into what's called the "perineum," that piece of flesh located just down the street from the scrotum and slightly up hill from the rectum.

He'll then employ his dart gun, so speak. He’ll fire the 80 or so roughly rice grain-sized pellets, each of them strategically placed so as to maximize the power of the Iodine-125 radioactive isotope that is the delivery system’s warhead.

In brachytherapy’s Dark Ages of the 1960s and 1970s doctors would install seeds indiscriminately. That shotgun approach left useless gaps and seed overlays.

Such random, hit-and-miss procedures didn’t help brachytherapy’s reputation. That is, until starting in the 1980 and working through the 1990s the researchers hit on the capital idea of accurate targeting.

Seed implantation further blossomed in the full sunshine of the 21st Century.

Now, says Prescott, for men with early stage prostate cancer like what I have, the 10-to 12-year survival rate by undergoing a brachytherapy is equal to or better than the radical surgical removal of the prostate.

Thus, the one-time “gold standard” for curing prostate cancer - surgery - is being outrunned and outgunned by sending in the titanium canisters with their fully primed radioactive isotopes.

It’s going to take some time for the radiation to work, of course. What it does is not kill the cancer cells outright as much as the radiation destroys their DNA. This prevents the cancer cells from reproducing.

Then too, says Prescott, there are fewer adverse side effects than with radical surgery. Just as these side effects are less severe also, says Prescott.

What I can anticipate following the seed implantation is just a few hours of recovery in the hospital and more than likely I'll be discharged the same day. That compares to a several-day hospital stay when surgery is undertaken.

Also, says Prescott during his most effective sales pitch, very few men who’ve have a brachytherapy must likewise wear a catheter inserted into their penis for a period of days. Say “ouch” if you wish at this juncture. If you’re a male you are permitted.

At home a patient should take it easy for a few days, relax and not lift anything much heavier than a call to your wife to bring you a beverage and snack along with the television remote control device.

On the downside is that I’ll likely encounter frequent night-time urination, possibly on the order of every 90 minutes or so, for a couple of months. And this necessary bodily function will also probably come with some pain for a while, too.

But I encountered that condition a few weeks back when my prostate gland’s four nearby lymph nodes were removed for their biopsy. So I understand what’s ahead.

Considering that men who elect or must undergo surgery likewise must often wear a protective undergarment for up to several months, the brachytherapy further became a no-brainer.

Another goody: The odds for encountering erectile dysfunction and impotency are lessened via a brachytherapy than with the removal of the prostate gland through surgery. Besides, there's all kinds of stuff that a doctor can prescribe for those conditions.

About the only suggestion that a urologist offers is for a patient to wear a condom for the first few intercourse trysts. That's to protect against an escaped radioactive seed from being accidentally implanted into a woman's vagina.

Lessened as well is the risk of post-operative infection. That is because the brachytherapy procedure is minimally invasive, a term I’ve picked up during my Internet wanderings regarding prostate cancer and its various treatment options.

Is everything all bright, cherry and roses? Not at all.

Since we are dealing with radiation, the government has to stick in its regulating nose. The standard protocol says that young children can’t sit in your lap for two or three months and that you and a pregnant woman need a three- to six-foot diameter no-fly-zone for about the same duration. The government’s concern is radiation exposure to these at-risks groups.

I asked Prescott if this advisory includes dogs, since my two Labrador retrievers view my lap as their personal bed sheet.

His answer was “no.” Thank heavens, too. I was worrying that I would have to find a used lead apron of the kind radiologists use when giving X-rays.

Another item or two; the chances for temporary diarrhea exists along with possible fatigue due to the radiation, some Internet sites suggest.

Yet I consider all of these potential and probable short-comings to be trifling when compared to radical surgery.

Or, worse, doing nothing at all.

And that, alas, would have happened if I were living in Sweden with its government-run health-care program. Or any other similarly run state-sponsored health-care program, says Prescott.

The reason being is that such systems are far more stingy about doling out preemptive medical care than in the United States.

If I were in Sweden, says Prescott, the best I could hope for with my stage of cancer would be to undertake a watch and wait requirement that would track how fast the cancer grows with a likely seven-year wait until some sort of action is taken.

And that, I’m afraid, very well could have led to the cancer in my prostate spreading and becoming a truly life-threatening disease.

All without so much as a government “oops, we’re sorry” apology from a bureaucrat who thinks of numbers, risks and life expectancy odds more than the needs of a patient with a time bomb ticking away in his groin.

Thanks, but no thanks. September 10 can’t get here soon enough for me. After all, Ohio’s archery deer-hunting season is right around the corner.

- Jeffrey L. Frischkorn
JFrischkorn@News-Herald.com
Twitter: @Fieldkorn

Worst part is the waiting

You have your good news when the boss presents you with a $1 per hour raise.

Your great news comes when your daughter announces that in nine months you’ll become a grandfather.

And then you have your everyday variety of life-saving news; the kind you know means that you’ll have the opportunity to collect on your boss’ generosity and your daughter’s unspeakably wonderful gift.

Last Friday I was awarded the last of these news announcements, thanks to a cell phone call from my urologist, Dr. Lawrence Wolkoff.

(Amazing, isn’t it that when a person is bushwhacked by some sort of serious ailment that all of a sudden a physician becomes “my” doctor? Sorry, I digress.)

Wolkoff called to say that the four lymph nodes he extracted from around my cancerous prostate gland were all clear. Thus, that most horrible of all horrible diseases remains locked away in my slightly larger than average-walnut-size prostate. Consequently, the enemy is surrounded.

The lymph nodes were removed with precision care three days earlier, sent to a pathologist who was assigned the task of reading the organs’ tea leaves.

From this rather mundane procedure I was pronounced fit for active duty on an operating table at some point within the next several weeks. That is when Wolkoff will team up with radiological oncologist Jon Prescott to snipe away at the diseased prostate.

While Wolkoff will insert an image-making tool into my rectum and guide it to the nearby prostate gland, Prescott will arm and then man the cancer-fighting armament that will fire rice grain-sized radioactive titanium capsules into the two cancerous tumors and surrounding tissue.

With careful and deliberate motions Prescott will squeeze the trigger anywhere from 75 to 150 times.

All the while I’ll be slumbering thanks to some really potent happy/sleepy juice poured into my system by anesthesiologist John Hagopian.

Don’t get me wrong, though. I’m not complaining about the medical equivalent of the Three Musketeers taking on my case. Just the opposite, in fact.

That last Friday I cleared a really tall hurdle to find myself in front of this next one leaves me happy. And thankful.

For half a week as I recuperated at home from the lymph node removal/biopsy phase of the process I was something of a basket case.

I’ve never been one to handle anxiety very well, and it showed as friend upon friend upon co-worker upon church brother/sister told me they were thinking of me, praying for me and more typically, both.

Finally the prayers had sunk in along with the observation that I’d have to deal with the cancer regardless of any actuary table on survival rates.

So on Friday morning when I awoke I found myself curiously - and refreshingly - at peace. Hopeful, of course, that the news would be rated AAA-grade yet as prepared for any bad news as one possibly could be under such circumstances.

Sometime around 10:30 a.m., I believe, Wolkoff called to say the pathology report was written as a clean slate.

With my eyes closed and a relaxed exhaling of air I silently said “thank you” to the One who delivers before verbally repeating it for the record to Wolkoff.

This trip is not over, of course. I still have to meet with Prescott, take in the actual two-hour “seed” implantation, face possible unfortunate and uncomfortable side effects as well as in the very long-term encounter a stretch of follow-up tests.

Yet now the trail appears not so steep nor the path ensnared by the vines of distress. I’m going to make it, this I believe.


- Jeffrey L. Frischkorn
JFrischkorn@News-Herald.com
Twitter: @Fieldkorn

We're not alone

It was a bad day that ended well.

And any day when you’re troubled to the marrow of the bone that can catch a glint of sun through the shadows that haunt us all is by its very definition a good day.

Some 24 hours after having urologist Lawrence Wolkoff poke three holes into my gut to extract four lymph nodes I was anxious, nervous over the prospects that the cancer I’m feeding has begun to pillage beyond the two tumors contained within my prostate.

As if the pressure waiting for a reply as to the biopsy were not enough the stress of what the good doctor and his staff said regarding post-surgical ticks was becoming a heavy hammer blow. Small things, you know, like when you head for the loo to “make water” and the stream becomes a fiery icicle.

Not pleasant, I assure you. At least that plumbing was in order, however.

More uncomfortable to deal with – and not any easier to discuss – is the traffic jam backed up in the colon. This rather sad state of affairs is the dog that hunts me whenever I have to go under the knife and get some sleepy-time juice poured into my blood system by a smiling anesthesiologist like Dr. John Hagopian.

(As an aside Dr. John would later tell me that the whole operation was “rather boring,” which gives an entirely favorable meaning to the word, I assure you.)

In any event here I am with a bladder that sloshes to the point of being dangerously topped off  along with a digestive system that is held hostage by one very nasty road block.

And still no word from Wolkoff as to what the pathologist found – or hopefully didn’t find - by examining a quartet of lymph nodes arrested from the prostate’s neighborhood.

The day, in short, stunk.

Fortunately God was not done for the day, or with me, as it turned out.

Enclosed by a chain-link network of people who have sent their best wishes and thoughts my way I am in good hands. And with countless prayers ascending heavenward as a sweet savor offering I consider it an honor that Bev and me are so bundled in such love.

First came dinner, prepared some time ago by a cadre of women who attend our church; Bible Community Church of Mentor, to be exact.

These women of the church’s Heart and Hands group anticipate that sooner or later a church family would undergo a trial and might like having a meal awaiting nothing more then being nuked in a microwave oven.

These fine ladies have a keen eye on such things.

So do the men and boys of the church’s congregation. The lads are part of Bible Community’s Christian Service Fellowship. They meet briefly on Wednesday evening and then launch themselves into some service opportunity, mating their grunt work with a member’s need.

In our case that invitation was to spread five tons limestone gravel; about two tons to be confined within a 9-foot-by-12-foot corral of landscaping timbers and the rest to gloss over the low spots in our driveway.

The frame is for the base to support a new shed that will occupy the space and assembled there by my two older brothers. No doubt Terry and Rich will argue as to how best assemble that shed as well as chase me away without even allowing me to supervise their work. Which is fine, considering that how older brothers are suppose to act.

As for the church lads they attacked the small mountain of dusty limestone, carting enough fill to flood the wooden frame to its brim.

At that point they worked to raise the driveway’s low spots.

Remember that scene in the 1960s movie “Cool Hand Luke” where Paul Newman leads his fellow chain gang inmates into feverishly tossing gravel onto a rural road’s freshly laid tar?

Well, that is what the lad’s tribal elders Scott Stabler and Alex Mclean had their six youngsters perform. A little late to arrive but still tossing some pretty mean-sized coal shovels of stone of his own was Dustin James.

Before one could say “what we have here is a failure to communicate” the team was finished. Not only was the shed’s future home prepared but better than one-half of the driveway was smoothed over with a fresh deposit of crushed limestone.

The kids especially enjoyed the grilled hotdogs, cans of soda and being able to grab fistfuls of chips, cookies and pretzels that Bev had made ready

Storms of tears began to well up as Bev and I thanked them, one and all.

Not just because of the cheap labor, either; rather because of their unspeakable gift of brotherly compassion.

It’s been a tough sled ride and I can still see a dark line of clouds out on the horizon. But at least I am comforted in knowing that somewhere behind it all is a silver lining, sewn there by Heaven’s Master and never forgotten by those who will never let me – or Bev – forget that we are loved.

Hopefully, prayerfully, I will have good news to report at the next meeting here.

- Jeffrey L. Frischkorn

JFrischkorn@News-Herald.com

Twitter: @Fieldkorn

Tests, answers needed to battle prostate cancer

Fresh-faced and all chipper-like the nurse invited me to sit down before she began asking the usual battery of pre-surgical questions.

The Q-and-A session is part and partial for any surgery. In my case, that carving knife work will take place next Tuesday within the bowels of Lake Health System’s TriPoint Hospital. In the “out patient” section to be exact, though I’m not entirely sure where that sterile venue is actually located.

I’m sure I’ll hunt it down, especially since I’ll have my wife as the accompanying blood hound. When it comes to my health Bev is doggedly determined to do whatever it takes to get me there and ensure that my medicines go down with or without a spoonful of sugar.

Even if it kills me, or her, if that becomes necessary. You gotta’ love a wife who loves you that much.

Tuesday’s surgery will entail the removal of a pair of lymph nodes, located on either side of the gland associated also with the bladder. These nodes will then make their short journey to a laboratory where a pathologist will poke the things and determine whether the cancer has spread into my lymphatic system or remains locked inside the prostate gland.

The latter would be a good thing; the former, not so much. That would mean the cancer has made a sneak attack and infiltrated the allied lines. Under such a circumstances I’ll be looking at a three- to five-year life expectancy with treatments to suppress the disease rather than one that would whip the medically criminal antagonist at its source - the prostate gland.

My urologist - Dr. Lawrence Wolkoff - says in my case the odds of the cancer having spread is 10 to 15 percent. He noted also that I’ve been quite a good lad in getting both an annual rectal examine of the prostate as well as a PSA test.

I’m praying he’s correct and I’ve got a whole regiment of prayers warriors backing me up as well.

Back to the examination, the kind nurse did her duty, asking a gurney of questions not only related to my health but also that of my immediate blood family.

She answered my questions, among which included the likelihood that the surgery will require the shaving of my pubic hair. Yep, as distasteful as that imagery may be it is still necessary to help prevent bacterial infection.

“You’ll probably be asleep when they do it,” the nurse said.

Passing me off to a physician’s-assistant the nurse said I’d been a right fine patient. She put it by saying I’ve got a really decent sense of humor.

Good, I thought, the nurse didn’t pick up on the fact that I was nervously whistling in the dark, trying to wrestle with demons of my own mind’s making.

The physician’s-assistant also was top-of-the-line friendly as was a young woman who sat me down in order to draw a vile of blood.

For the former I answered a few more questions and promised that I’d be a good boy by peeing into a plastic specimen cup.

“The doctor ordered it,” said the physician’s-assistant.

Good thinking, I figured, since when in doubt, always blame the physician.

Similarly the blood-taking vampire was superbly pleasant, going so far as to ask which arm I’d like to volunteer for the mission. The right, as is usually the habit for such work, I replied.

After nearly 90 minutes the process was completed, about the same length of time the surgery will take, as I’ve been told.

So now I’m in the chute, waiting for the gate to open and for me to ride the bull out onto the arena floor. The prayer is, of course, that I can stay on and not fall off.

- Jeffrey L. Frischkorn
JFrischkorn@News-Herald.com
Twitter: @Fieldkorn

Just how old are you, anyway?

This blog has been pretty serious lately - and will be again tomorrow when I review my pre-surgical visit to TriPoint Hospital for the start of my prostate cancer work. In the meantime here's a neat test provided by my aged cousin, Larry "Doc" Lee. History Exam... Everyone over 40 should have a pretty easy time at this exam. If you are under 40 you can claim a handicap. This is a History Exam for those who don't mind seeing how much they really remember about what went on in their lives. *** Get paper & pencil & number from 1 to 20. ****Write the letter of each answer & score at the end. Before you pass this test along, put your score in the subject line. Send it to friends so everyone can have fun remembering the good ol’ days. 1. In the 1940s, where were automobile headlight dimmer switches located? A. On the floor shift knob. B. On the floor board, to the left of the clutch.... C. Next to the horn. 2. The bottle top of a Royal Crown Cola bottle had holes in it.. For what was it used? A. Capture lightning bugs. B. To sprinkle clothes before ironing. C. Large salt shaker. 3. Why was having milk delivered a problem in northern winters? A. Cows got cold and wouldn't produce milk. B. Ice on highways forced delivery by dog sled. C. Milkmen left deliveries outside of front doors and milk would freeze, expanding and pushing up the cardboard bottle top. 4. What was the popular chewing gum named for a game of chance? A. Blackjack B. Gin C. Craps 5. What method did women use to look as if they were wearing stockings when none were available due to rationing during WW II. A.Suntan B. Leg painting C. Wearing slacks 6. What postwar car turned automotive design on its ear when you couldn't tell whether it was coming or going? A.Studebaker B. Nash Metro C. Tucker 7. Which was a popular candy when you were a kid? A . Strips of dried peanut butter. B. Chocolate licorice bars. C. Wax coke-shaped bottles with colored sugar water inside. 8. How was Butch wax used? A. To stiffen a flat-top haircut so it stood up. B. To make floors shiny and prevent scuffing.. C On the wheels of roller skates to prevent rust. 9. Before inline skates, how did you keep your roller skates attached to your shoes? A. With clamps, tightened by a skate key. B. Woven straps that crossed the foot. C. Long pieces of twine. 10.. As a kid, what was considered the best way to reach a decision? A. Consider all the facts.. B. Ask Mom. C. Eeny-meeny-miney-MO.

11. What was the most dreaded disease in the 1940s and 1950s?
A. Smallpox
B. AIDS
C. Polio

12. 'I'll be down to get you in a ________, Honey'
A. SUV
B. Taxi
C. Streetcar

13.. What was the name of Caroline Kennedy's pony?
A. Old Blue
B. Paint
C Macaroni

14.. What was a Duck-and-Cover Drill?
A. Part of the game of hide and seek.
B. What you did when your Mom called you in to do chores.
C. Hiding under your desk, and covering your head with your arms in an A-bomb drill.

15 . What was the name of the Indian Princess in the Howdy Doody Show?
A. Princess Summerfallwinterspring
B. Princess Sacajawea
C Princess Moonshadow

16.. What did all the really savvy students do when mimeographed tests were handed out in school?
A. Immediately sniffed the purple ink, as this was believed to get you high.
B. Made paper airplanes to see who could sail theirs out the window.
C. Wrote another pupil's name on the top, to avoid their failure.

17. Why did your Mom shop in stores that gave Green Stamps with purchases?
A. To keep you out of mischief by licking the backs, which tasted like bubble gum.
B. They could be put in special books and redeemed for various household items.
C. They were given to the kids to be used as stick-on tattoos.

18. Praise the Lord , & pass the _________?
A.. Meatballs
B. Dames
C. Ammunition

19. What was the name of the singing group that made the song 'Cabdriver' a hit?
A. The Ink Spots
B.. The Supremes
C. The Esquires

20.. Who left his heart in San Francisco ?
A. Tony Bennett
B. Xavier Cugat
C. George Gershwin
-----------------------------

ANSWERS

1. (B) On the floor, to the left of the clutch. Hand controls, popular in Europe , took till the late '60's to catch on.

2. (B) To sprinkle clothes before ironing.. Who had a steam iron?

3 (C) Cold weather caused the milk to freeze and expand, popping the bottle top...

4 . (A) Blackjack Gum.

5.. (B) Special makeup was applied, followed by drawing a seam down the back of the leg with eyebrow pencil

6. (A) 1946 Studebaker.

7. (C) Wax coke bottles containing super-sweet colored water.

8. (A) Wax for your flat top (butch) haircut.

9. (A) With clamps, tightened by a skate key, which you wore on a shoestring around your neck.
10. (C) Eeny-meeny-miney-mo.

11. (C) Polio. In beginning of August, swimming pools were closed, movies and other public gathering places were closed to try to prevent spread of the disease.

12. (B) Taxi , Better be ready by half-past eight!

13. (C) Macaroni ....

14. (C) Hiding under your desk, and covering your head with your arms in an A-bomb drill.

15. (A) Princess Summerfallwinterspring. She was another puppet.

16. (A) Immediately sniffed the purple ink to get a high.

17. (B) Put in a special stamp book, they could be traded for household items at the Green Stamp store.

18. (C) Ammunition, and we'll all be free.

19. (A) The widely famous 50's group: The Inkspots.

20. (A) Tony Bennett, and he sounds just as good today.

SCORING

17- 20 correct : You are older than dirt, and obviously gifted with mental abilities. Now if you could only find your glasses. Definitely someone who should share your wisdom!

12 -16 correct: Not quite dirt yet, but you're getting there.

0 -11 correct: You are not old enough to share the wisdom of your experiences.

- Jeffrey L. Frischkorn

JFrischkorn@News-Herald.com

Twitter: @Fieldkorn

Lord, teach me patience, please

Clearly it had become time to either cut bait or fish.

Weeks of intensive Internet searches about prostate cancer, its impact, its treatment and the consequences for doing nothing had built up to the point of agreeing to formulate a life-saving protocol.

With the praise-worthy word that my full-body bone scan was clear I had reached that juncture.

Besides, after sitting for well more than an hour and listening to urologist Lawrence Wolkoff present his case and all the options my butt was starting to get sore.

Much of what Wolkoff offered was material that proved to be a bedspread to the heavy blanket of material sewn by the threads of countless Google “hits” I’ve struck since first hearing the word “cancer.”.

Running through the rather substantial print-out document, Wolkoff pointed out any number of items. What’s a prostate, what’s prostate cancer, Gleason score, PSA ranking and so on; an entire lexicon of terms  that dog a mature male who is side-swiped by the disease.

Questions were raised, answers were given; sometimes the former being posed before the latter had an opportunity to express itself.

It is my curse and that of everyone else in journalism, really. We are imprinted at our writing births to probe, investigate, prod and generally make a pest of ourselves.

At least Wolkoff has a great bedside manner. He took my inquiring jabs and thrusts in stride.

For her part my wife, Bev, was the quiet one. She sponged up the presentations that fell to the floor, asking about such affairs as what does radioactive “half life” mean and what about the side effects of radical surgery.

When the document’s menu was exhausted and Wolkoff had spoken his piece, he concluded by saying that Bev and I could take some time to review the material.

We could even seek a second opinion.

On that score I had pigeon-holed in my breast pocket a slip of paper scrawled with the names and telephone numbers of two other urologists.

“No,” I thought to myself.

And with a quick nod to my bride of 40 years I made my peace and gave the green light. My decision would involve the implantation of tiny radioactive metal pins, called “seeds.”

This option was plucked over radical prostate-removing surgery. There, Wolkoff would unsheathe his scalpel, carve away at my lower torso and extract intact the diseased prostate and its two cancerous tumors.

Along with such connecting tissue that includes a pair of lymph nodes.

Noting the advantage of radical prostate-removing surgery that includes once gone, always gone, Wolkoff did not object to my alternate selection of internal radiation treatment.

“You’re an excellent candidate for either one,” he said.

Told that if I were cloned (world: imagine there being two of me. Scary, huh?) and one of me were pried open by surgery while the other one would undergo being zapped by sub-atomic particles each would stand before Wolkoff 12 years hence.

Thus, it was actually a fairly easy decision. I took the fork that I did for several reasons.

For starters, with radical surgery I’d be laid up in a hospital for several days. And I would have to tend to a catheter installed in my penis for up to two weeks, endure likely incontinence and impotence for who knows how long, plus enjoy some other side effects equally too yucky to expound upon.

The placement of radioactive seeds in my slightly larger than walnut-sized prostate does come with a “do not remove” cautionary tag, however.

I’ll have to have my PSA level rated every six months. If it rises above “1” then the cancer has returned and I will have reached a point of no return where the radiation-juiced-up prostate could not be removed.

As a result, I’d have to go into containment/remission mode.

“If you were 52 instead of 62 I’s highly recommend surgery over radiation seeding,” Wolkoff said.

The thing is, says Wolkoff, my diligence at getting a PSA test every year along with my annual check-up in all likelihood saved my life.

For one simple  reason, he says.

The recent rectal exams performed by both Wolkoff and my family doctor, Mike Baranauskas, showed only a slightly enlarged prostate. Absent were any  lumps, bumps, protrusions, ripples or any other oddity that would point to a too-late, too-diseased organ.

By me assembling a 12-year-long spreadsheet of PSA numbers the doctors concluded that the last figure had spiked. It was as striking a red flag as ever there was one, Wolkoff said.

So this is what will happen next. On June 5 I’ll file myself into TriPoint Hospital. There I will get some sort of chemical poured into my blood stream that causes a dreamless episode of sleep.

During my drug-induced nap time Wolkoff will take up to two hours to remove the side-saddling lymph nodes. A pathologist will examine the nodes and determine whether they've been compromised by cancer, a 10- to 15-percent possibility.

If these nodes are cancer-free I’ll meet with Wolkoff’s partner on June 25 for a consult on how the seeds are to be implanted.

It’s actually kind of cool. In the past when doctors used the medical equivalent of a blunderbuss, rice grain-size radioactive “seeds” were scatter-shot into the prostate gland.

Some of these pellets would land next to each other. Still other seeds would fall by the wayside and not even hit the paper let alone strike the 10-ring tumor bull’s-eye. None of these misplaced radioactive lambs could then find their way home within a tumor’s corral.

On the other hand, today’s seed-planting methodology leaves no cancerous furrow untouched.

What is now the case is a two-person sharp-shooting sniper team that can launch radioactive projectiles directly into the enemy’s camp, taking out the cancer’s command and control center.

Neat, if you ask me. And I was by Wolkoff who said this was the perfect choice for me.

Bev agreed. And now I must wait once again. And pardon me if I say “wait on the Lord once again.”

They say there are no atheists in foxholes. Well, I’m here to tell you there are not too many on operating tables, either.

One step at a time, Jeffrey, one step at a time.

-Jeffrey L. Frischkorn
JFrischkorn@News-Herald.com
Twitter: @Fieldkorn

What do you call a guy bushwacked by prostate cancer?

Okay, so later today I'll visit Lake Health's Tri-Point Medical Center.

Its radiological unit, to be specific. There I'll be injected with a radioactive dye that will take a couple of hours to blitzkrieg through my bone structure.

Then about 1:30 p.m. or so I'll return to the sterile environment, try to remain calm and steady and smiling attendants provide me with instructions on what will happen over the next 60 minutes or so. That's about how long it takes to undergo a complete bone scan.

As explained by my urologist, Dr. Lawrence Wolkoff, what an expert in interpreting this non-TSA-approved scanning gizmo is looking for is any area "that lights up."

Pray that no such illumination appears, please. The reason: Such bright areas indicate that the prostate cancer has spread to my bones, and bones (for whatever and still not understood reason) is where prostate cancer cells go to hide after leaving the walnut-sized organ.

A clear image would point to the cancer being confined to the prostate. That will greatly assist in achieving a 100-percent chance of beating the disease through any number of treatment options.

Those options and the results of today's bone scan will be released to my wife Bev and me on Friday.

Yeah, it seems that with a disease like this it's a constant battle of going to doctors, tests and fighting the urge to eat at fast-food joints between visits.

In any event, one thing that still bugs me is I'm not sure what to call myself.

I don't really consider myself to be a patient yet since I haven't submitted myself to the rigors of a hospital stay. I suppose that most people would say I'm this since I've seeing a physician specialist.

However, I do believe the word "client" is more accurate. No, I don't believe "customer" qualifies either, since that sort of gives the impression that the only reason so many doctors have seen me is so that they can keep up their membership in trophy golf clubs or gas in their Porsches. (Sorry, guys, I couldn't resist).

Maybe the best word to describe my current status is "cancer victim." Yeah, I kind of like that one.

I didn't ask for, nor did I want, to contract cancer. It snuck up on me like a thief in the night while I wasn't looking and distracted by another serious - but not life-threatening - set of physical problems.

So victim it is. For the immediate, anyway.

Sure I'll become a patient when I'm actually receiving treatment but it's still just a short haul down the road.
Ultimately there really is only one term that any prostate cancer victim wants to carry around. That being, "prostate cancer survivor."

- Jeffrey L. Frischkorn
JFrischkorn@News-Herald.com
Twiter: @Fieldkorn

Prostate biopsy not one of life's simple pleasures

Well, I can cross-out THAT one from my bucket list.

Having gone through a prostate biopsy on Monday - while no piece of cake - was not the torture-rack experience I was building myself up for.

Then again, it was more “involved” than two friends and my father-in-law, Bud Shope, had promised.

“Uncomfortable” was the way they each described their own first-hand biopsy experiences. Uh-huh. Yes, uncomfortable is the correct word for both the self-performed Fleet enema an hour or so before the procedure.

And uncomfortable was the setting where a multi-purpose probe was inserted into the rectum. (Doesn’t this sound so inviting?) I went into this thinking that the probe to be something small.

 So just imagine how surprised I became when after Dr. Lawrence Wolkoff drilled and tapped his way to the prostate gland the probe swelled to the size of a fire hose. Yeah, I grant that this portion of the process was uncomfortable.

Next came Wolkoff sending a vile of Novocaine into the gland in order to deaden what was to come next.

Come to think of it, maybe there were a couple of other needle pricks. I’m not sure since my prostate never really expressed physical displeasure before the way a bump on the head, broken arm or even a stomach ache feels.

In any event, as I was laying on my left side, right leg pulled up into my chest, Wolkoff sent the actual tool used to extract prostate core samples for further pathological study and determination.

The first drill bit startled me far more than it hurt. The best way to describe this step would be to say that the tool left me with the impression of a spring-loaded plunger that when snapped, yanked out some part of my protesting prostate.

Wolkoff then repeated this step nine more times, careful to give me advance warning what was coming. His assistant - a female, but at this point I really didn’t care who was looking at my big, fat ugly butt - gently held my feet down.

 That’s because first snip resulted in a huge recoil on my part. Which, come to think about it, defeated the long-standing law of physics that every action produces a reaction, equal in force and opposite in direction.

My reaction far exceeded Newton’s law, almost sending Wolkoff flying into the back wall. In about 10 minutes time his work was done, Wolkoff noting that he got what he was looking for.

Funny thing was, however, I could not help but imagine how any of the supposed walnut-sized prostate gland could possibly remain, given that the good doctor had extracted 10 samples in all.

Still, it was all for a good cause.

Having seen my PSA score nearly double and refusing to decline sent the alarm bills ringing. Such incidents must be explored, my doctors said, in order to unearth whether the cause is from prostate cancer or perhaps simply the result of a benign, enlarged gland.

Considering the National Cancer Institute says that about 242,000 American men are diagnosed annually with prostate cancer and that about 30,000 die each year from the male-only disease, I was more than willing to let my mind go crazy and become lost within the swamp of despair.

That’s not good, of course, and it also flies in the face of all the words of encouragement from friends and prayers from fellow Christians.

Then again, in hindsight, the experience was not all that bad. Just don’t ever ask me to volunteer to be a stand-in for another man facing the same thing.

Once was more than enough, thank you.

- Jeffrey L. Frischkorn
JFrischkorn@News-Herald.com
Twitter: @Fieldkorn

Not exactly what I had in mind for a pleasant Monday afternoon

Come Monday morning I’ll be feeling a might troubled but by Monday afternoon those feelings will go straight to the bottom.

You see I’m scheduled for a prostate biopsy; that nasty treat in which tens of thousands of men - most of them being old men of varying age - have to go through. That is, if we want to live longer by avoiding the likes of prostate cancer.

Annually, around 242,000 American men are diagnosed with prostate cancer. And the male-only disease will steal the lives of around 30,000 of them, says the National Cancer Institute.

Had many of these men gone through the uncomfortable blood-letting to extract the body’s elixir for the prostate-specific antigen (PSA) blood test and also submitted to the yes-embarrassing rectal prostate exam many of these men would still be alive. That’s why I’ve been having both tests done for 12 years now, ever since I turned 50. However, it was my unlucky turn this year to see a spike in my PSA readings.

These numbers that didn’t shrink much following two subsequent blood tests and one more physical exam.

As a result, urologist Lawrence Wolkoff said I needed the prostate biopsy. The Cancer Institute explains that the so-called “transrectal biopsy is “.. the only sure way to diagnose prostate cancer.” Pressed for odds as to what he possibly/likely will find and Wolkoff reluctantly said the odds were 60-40 in favor of finding prostate cancer.

That was more than enough to convince me to go through with the biopsy.

Not that I’m expecting the 10- to 15-minute procedure to be one of the year’s top highlights. It’s going to be uncomfortable, yes, says Wolkoff, who (sort of) scoffed at my suggestion that he first juice me up with a Valium tablet.
And why not? The process includes a requirement for a “Fleet enema.” This little bit of medical gear is bought over-the-counter at any drug store. And because trying to give yourself an enema would require having all the arms of a Hindu god I’ll be required to employ my wife, Bev, for the rather unpleasant, shall we say, enterprise.

A little more than an hour later I’ll visit Wolkoff who’ll have me strip, put on a hospital gown, step into a smallish room and lay on my side.

At that point (pun intended) Wolkoff will “insert” needles through the rectum and then into the prostate gland. Those needles will include a type of Novocaine to help deaden the pain. Along with inserting the nerve block the needles will drill out about 10 or more “cores” from various parts of the walnut-size prostate.

The reason is to take samples from enough locations so as to ensure that a diseased portion of the prostate is not overlooked.

Fair enough, I figured, and just as scientifically sound. Once the cores are removed they’ll be labeled and bundled up and sent to a pathologist who’ll poke around the samples, looking for any cancer cells.

After the pathologist has concluded his survey work he’ll issue a detailed report and send it to Wolkoff who then will either ease my mind or drop the bombshell. I’ve heard from men who’ve had the procedure.

Among them being both my father-in-law and one of my brothers-in-law. Not exactly a piece of cake, they say, but not like I’m going to be put on the rack or have my fingernails pulled out.

Yet I am aware that at least one study says that 55 percent of the men who’ve undergone a transrectal biopsy report being uncomfortable during the procedure. Meanwhile, another study found that 20 percent of the men who’ve experienced the procedure would undertake it again only if they were first given a general anesthetic.

Ain’t going to happen, the pros tell me. I even asked an anesthesiologist who attends our church - Dr. John Hagopian - if he’s ever knocked a wussy old man old for a transrectal biopsy.

His answer was short, blunt and to the point: “No.” And so I’ll fret the rest of this weekend away, a habit that I’ve refined to an art form.

Then on Monday I’ll visit Wolkoff and pray that it’s the fastest 10 minutes of my life. -

 Jeffrey L. Frischkorn
JFrischkorn@News-Herald.com
Twitter: @Fieldkorn

Growing old as a male has its health responsibilities

WARNING: What is being described is graphic but also vital for life-saving male health, especially for those men age 50 or older and particularly for those of us on the other side of 60.

The cell phone call had disturbed the pleasure of an afternoon’s worth of crappie fishing. I hate when that happens, too.

But this call was important and the telephone number appearing on my cell phone’s screen appeared vaguely familiar.

 In general terms the conversation started with “Hello, Jeff, this is Doctor Wolkoff. Your PSA numbers haven’t gone down very much.”

If that wasn’t disturbing enough what followed certainly qualified as a personal earth-shattering moment.

“You need a prostate biopsy,” the good doctor Lawrence Wolkoff said with a soberness that I may have misread more than I should have. Following Wolkoff’s address and after speaking with his assistant, we set May 14 as the date for the biopsy.

Ever since I had turned 50 some 12 years ago I have insisted on what I call my “old man’s physical.” That has included both a physical as well as a prostate-specific antigen (PSA) blood test.

I’ve always been a touch paranoid about being invaded by prostate cancer in spite of the fact that I do not fall within the most-likely-to-get categories.

Those markers include: Black men get prostate cancer much more than do male members of other racial or ethnic groups; a family history of the disease; being age 65 or older; and a couple of other medically technical points that I’ve found to be complicated enough so as to blur my brain cells.

But the raw statistics and the stark realities demand that any guy over age 50 should get tested; annually, too. And the older one becomes the more red-line the need for this testing becomes as well.

After all, the National Cancer Institute notes that annually about 242,000 American men are diagnosed with prostate cancer. And the male-only disease will steal the lives of around 30,000 men. That figure is only about 10,000 less than the number of women who will die of breast cancer, by the way.

(As an aside, and a point that I’ve always been upset about, the federal government allocates just under $700 million annually for breast cancer research but no more than $390 million for prostate cancer research. It’s a matter of the squeaky wheel getting the most government grease, with the nations’ men having allowed those gears to rust barrel-tight.)

Still, when my family doctor - Mike Baranauskas - saw that my PSA numbers demonstrated a fairly good spike in elevation it was time to reassign me to the care on an urologist.

In this case, Dr. Lawrence Wolkoff. Wolkoff was good about his business when he sat me down in his examining room. He noted that on daily basis he sees any number of men demonstrating the same PSA measurement parameters.

Just to be on the safe side, however, Wolkoff performed what has sometimes become a Hollywood slapstick joke about the male anatomy.

He put on a pair of Latex gloves and with what I assume to be one of his trigger fingers, penetrated my rectum and then approached and began feeling the prostate gland, one of a man’s pretty-important reproductive organs.

The prostate gland is typically described as being like a walnut in size and surrounding the urethra, the tube in which urine flows.

What is being sought is a judgement call by the doctor as to his evaluation of the prostate’s size, its hardness, whether any lumps exist and a host of other factors.

As explained by Wolkoff and other scientists, if the prostate is too large it puts a headlock around the urethra tube. That belt-tightening then arrests the flow of urine from the bladder to the penis. This is the physical portion of a man’s two-part prostate health examination

 Guys, the entire process takes under maybe 10 or 15 seconds. Take it from a pain wuss, while the pressure is mildly uncomfortable it is hardly painful. Next up is the PSA blood test. This test requires a visit to what is called a “phlebotomist,” the medical term for the vampire who draws the blood required for laboratory analysis

 Once the lab results are reviewed a report is given to the requesting physician. Those results are often made available within a couple of working days.

Yeah, I know all about the PSA controversy; whether the test is reliable, does it cause more harm that good, does it upset patients more than is necessary, are there false-positives, should men in their 70s and 80s even bother getting the test, blah-blah-blah; I’ve read them all .

I also know that some studies suggest that one-half of all men in their mid-70s or older likely have prostate cancer. And that such men often die of something else long before normally a slow-developing prostate cancer does its dirty work.

Fact is, I’m not in my 70s, let alone my 80s. And I hasten to remind everyone, I’m pretty much paranoid about prostate cancer, either of the jack-rabbit-quick kind or else the creeping-at-a-snail-pace variety.

So I’ve shoved aside any thoughts of macho manhood and have undertaken the yearly ritual of an examination of my prostate.

Yep, including the one where a physician pokes around where the sun doesn’t shine, so to speak. I even once allowed a female doctor to perform the task.

My belief is that of the James T. Kirk-character famously played by William Shatner in one of the “Star Trek” movies: “The first order of business is survival.”

 Would that more men my age shout “amen” to that pithy piece of logic.

Yet when it comes to logic and one’s health, a woman has it all over a man. As one female editor here at The News-Herald put it: “Once you give birth you stop being embarrassed.”

 Men - many men, anyway - just don’t get it. They often shun a frontal thought about their health in general and their prostate health in particular.

It’s not what men want to talk about in their man caves when their discussion is more focused on things like ERA’s, passing statistics and who is the Cavalier’s best free-throw artist. Neither will you hear even a whisper of the word “prostate” in a deer camp, my hometown.

Rather, there it’s all guy-speak regarding MOAs, illuminated reticles, bullet drop and the controversy about issuing too many doe tags. That’s okay for those situations, I guess, though a brutally frank look at the subject is so important that it can literally be a life-saver.

After all, the survival rate for prostate cancer victims is high; no, make that, very high.

But ONLY if the affected male overcomes his squeamish pride and junior high giggles and makes the effort to save himself a whale lot more in the way of pain, grief, and assured death by waiting until it is too late.

I’m not looking forward to the biopsy procedure - and I’ll cover that subject next - but I am trusting that my rigorous commitment to having my prostate examined each and every year for more than a decade is going to pay a living dividend.

- Jeffrey L. Frischkorn
JFrischkorn@News-Herald.com
Twitter: @Fieldkorn