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
Friday, September 21, 2012
Tuesday, August 21, 2012
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
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
Thursday, July 19, 2012
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
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
Friday, July 6, 2012
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
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
Tuesday, June 26, 2012
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
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
Tuesday, June 12, 2012
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
Wednesday, June 6, 2012
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
Twitter: @Fieldkorn
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