The Odyssey, Part 1
We arrived in Houston on Sunday the 3rd about one-hour later than scheduled due to a delay on the connecting flight for the usual hang-up, i.e., “mechanical problem.” We arrived at the apartment “Complex” after dark without any idea where or how to enter through the security doors. Fortunately a resident drove up and assisted our entry and walked us to our apartment door. We had anticipated the possibility of a late arrival and prevailed upon our landlord to send us the apartment key in advance of our departure. The “Complex” is humongous with approximately 450 apartments stacked four high in a trapezoidal envelope with interior courtyards. The corridors have open access to the outdoors from both sides which under current weather conditions provides a breath of frigid air smack in the face when leaving and entering the apartment.
Having arrived late without groceries in the apartment and a lust for dinner we called a Yellow Cab to take us to whatever would be the closest restaurant. That’s when we were able to connect with Curtis, the cab driver who provided personal attention to our immediate needs for dinner and grocery shopping over the next few days. Lacking transportation of our own we are dependent upon taxi service and the shuttle service that runs between the complex and the various buildings that makeup the MD Anderson Cancer Center.
Our apartment is a basic kitchen/bedroom/bath unit with the usual attributes. We would prefer more windows for view and interior light. The common room has a glass door to a small patio and one window that are shielded by larger shrubs, which effectively diminishes the outside light. The courtyards are nicely done with fountains and seating which we’ll likely make more use of once the weather warms up.
I’m afraid we didn’t anticipate the arctic chill that has brought temperatures in Houston to their lowest since 1963. We had packed with expectation of more moderate weather. Nevertheless, we are fairing much better than the local natives who are being cautioned by the local media to bundle up, insulate exposed water pipes (which are bursting anyway), and keep pets indoors. We keep telling the locals that by our standards the weather is rather balmy. A warming trend is expected through next week which should give us more pleasant conditions.
I had my first medical appointments Monday for fiducial and simulation procedures prior to proton treatment scheduled to start tomorrow. I’ll skip the specifics on the none too pleasant procedures other than that each is required to define the location of the gland for precise focusing of the proton beam for each successive treatment. My schedule requires that I be at the Center each day, Monday through Friday, 30 minutes prior to treatment at 11:50 each day, with once-a-week earlier visits with my physician. If we can abide strictly to schedule the last treatment is on March 5th which would allow us to return home a few days after.
The biggest hassle so far has been coordination with the (so far unreliable) shuttle service to get me to the appointment on time. We’ve discussed our concerns with the apartment manager who has hopefully resolved the problem with the shuttle company’s supervisor. We’ve taken a few “dry runs” the past couple of days to reassure ourselves. So far, so good. The real test comes tomorrow.
MD Anderson is perhaps the world’s largest medical campus with high rise buildings of every kind and description scattered throughout for patient care, research and education. The University of Texas, Baylor, and others have medical, dental and nursing schools here, and other buildings funded by philanthropic organizations devoted to specialized research in various diseases. Patients come here from throughout the world for treatment. It’s a humbling experience to walk the corridors and sit in the waiting rooms seeing patients in various stages of illness — all of them and me in the hope of cure. All said, I can’t think of a better place for the culmination of hope.
Yesterday, I attended a meeting of the Houston Investment Association where I made contact with a few friends developed from my interaction over the years on various internet forums involved with investing. One of those friends, whom I had never met face to face before, nevertheless was the guiding force behind my decision to seek treatment at MD Anderson. He had undergone the same treatment here several years ago with success and subsequently became one of the founders and leaders of the protonpals.net group that provides information, support and liaison to the proton treatment center for patients past and present. It was he who setup my referral to the center and enabled me to exchange email with the attending oncologist and others who gave me encouragement and assurance that my condition is treatable.
It’s interesting how the internet has given the common man the empowerment of knowledge and friendship that would not otherwise be afforded toward making life’s appropriate choices. I can tell you from my personal experience that you must be your own advocate in all affairs, most particularly medical. The internet is one of those primary doors to advocacy. I encourage you to explore it wisely and thoroughly.
The Odyssey, Part 2
Yesterday, Friday, marks the conclusion of the first week of proton radiation with no discernible side effects. Only seven more weeks to go. The only problem is a sore calf muscle. One of the side-effects associated with hormone therapy. I had my first weekly “see” with my oncologist who recommended ibuprofen. Muscle soreness requires close monitoring. It might signal a blood clot with more serious complications.
Radiation is quick and painless. It takes about five minutes. The preparation preceding is more complicated and time consuming. My treatment is scheduled for 1:50 p.m. (changed from 11:50). I’m required to arrive thirty minutes before for an ultrasound measurement of the liquid content of the bladder. An optimum level of “fill” is required to ensure a more defined separation of the bladder from the prostate gland. I have to monitor my intake of water (about twenty ounces) before the ultrasound to accomplish the desired level. I was a little over the optimum the first day, but have since been able to balance intake to coincide with the crucial moment.
From the “prep” room, I’m escorted through a tunnel to the radiation room and then put face up on a cradle located under the machine. My position must be aligned precisely with the radiation beam. I have Crucifix marks below my hips on each side that were marked with indelible ink earlier last week in the fiducial and simulation processes. I am now capable of warding off vampire attacks from each side. The rear is more problematic.
The radiation beam is aligned to center upon the marks. A small balloon is inserted in the rectum and filled with water which aids in separation of the gland and provides some protection to the underlying tissue. (I am now a member in good standing with the “Brotherhood of the Balloon” (http://www.protonbob.com/proton-treatment-homepage.asp)). Once all is in place, an X-ray is taken to confirm the alignment. I am cautioned by the technicians to lie absolutely still. Any movement may jeopardize the placement. If I have an itch, I’m told to let them know. They’ll scratch it. All said I’ve been on the cradle from start to finish about twenty minutes.
There should be a warning sign placed at the front door of the Proton Center:
“PARK YOUR MODESTY HERE. MANAGEMENT NOT RESPONSIBLE FOR LOSS.”
The only male I’ve seen aside from fellow patients is my doctor. Females are everywhere: nurses, technicians, support staff, security, janitorial, etc. — all highly courteous, dedicated, and competent — young, pretty, and enthusiastic. So, the process I’ve described requires a high degree of undress. I wear a surgical gown, front and back, which must be rearranged to accommodate access. At the prime moment the only thing that stands between the essential me and the sunshine is a draped towel. Through it all, the technicians remain steadfastly unabashed as they have seen it all before, so I think — unconvincingly! But, what choice do I have?
My fellow patients and I assemble in the prep room attired in our fashionable gowns (light blue with darker polka dots), sipping water, exchanging pleasantries and awaiting our turn for treatment. We are from many different places, but we share similar stories of diagnosis and agreement upon why we have coincidentally arrived here to seek our cure. Some, like me, are “freshmen.” Just starting out. The veterans who are at mid-term or near “graduation” clue us in and offer reassurance. On the day of graduation (that’s what they call the final day of treatment), the graduate and staff assemble in the hallway for the farewell. The graduate whacks a large Chinese gong with finality as the clang gives rise to a crescendo of cheers from the assembled that echoes throughout the building.
My wife sits in the waiting room anticipating my return. She passes the time reading and chatting with other patients’ wives. Because we depend upon a shuttle to take us to and from the Proton Center, we must time our trips to fit their schedule. This means having to leave two hours preceding the scheduled appointment, and then wait 30-plus minutes afterward for pickup. With travel and treatment it’s a long afternoon until we arrive back at the apartment around 4:00 p.m. We try to work some time in for exercise in the morning. I use the treadmill in the exercise room along with some free weights. She prefers an outdoor run/walk in the park across from our apartment. The arctic chill of last week wasn’t too accommodating. Warmer weather in the 70s is due later in the week.
My wife will be returning home on the 19th for a break from the routine and to catch up with needs there. She’ll return within a few weeks and probably stay until the end of February. I’ll finish up in early March, and follow her home a few days later. She is concerned about leaving me on my own. I try to reassure her. After all, how difficult should it be to microwave a TV dinner? We shopped today and the larder is stocked well enough to last several days. I can fill-in as needed until she returns, and there is cafeteria on the main medical campus. I know the daily grind is wearisome. The break will do her good.
The Odyssey, Part 3
Two down, six more weeks to go. Monday was a skip date in observance of Martin Luther King. We didn’t find out that the Proton Center would be closed until we were half-way there. I thought it odd that we were the only passengers on the shuttle. The main campus was bereft of the usual hubbub of people and traffic. Duh! A quick recheck of my treatment schedule brought awakening that national holidays are excluded. So, instead of forty treatments over eight weeks, as I first assumed, it works out to 38, which I was told later, is S.O.P for all patients.
My wife left for home on Tuesday. Reluctantly! There is much anxiety about abandoning me to the ill-winds of misfortune. I reassure her. Certainly, unintended consequences can happen; but there is ample medical help nearby if needed, and, in spite of her many doubts, I am capable of cooking and caring for myself. In fact I prepared a nice dinner for myself last night — salmon, rice, salad, dessert. (Does anyone have suggestions for removing splattered grease from the ceiling and walls? Nah, just kidding (but it might prove useful to know anyway)).
She would’ve stayed if I had said. I’m sure the break away at home for awhile will do her good. These past weeks have been stressful, what with getting settled at the apartment; navigating to my initial appointments on time; orienting ourselves to a maze of hallways and waiting rooms; coordinating with the shuttle for my daily trips to the treatment center; and just generally forging through the long grind of the day. We’ve had phone conversations since her arrival home, and I can tell from her voice she is becoming more relaxed and re-energized for the return trip a few weeks from now.
The misbegotten trip to the Proton Center on MLK day had a side benefit. Being alone on the bus gave us a chance to get to know our driver, Michael, a little better. I’ve made it a point to get chatty with the shuttle drivers in hope of receiving a favor now and then on promptly getting to and from my appointments. The drivers work a rotating shift. Michael drives Monday and Tuesday and generally has become more accommodating to my needs. The others are a work in progress, but are coming around.
Prior to Michael’s two-a-day jaunt with the shuttle, he worked in commercial real estate with a small brokerage. As you might guess, Houston has not escaped the recession much better than elsewhere. He was let go. Ever resourceful, he tells us that the worst of the commercial real estate market in Houston is yet to unfold. Even so, on his own he has picked up a few clients seeking space for commercial ventures. We sometimes overhear his conversations with clients as he shuttles around. Right now, he tells us, he’s negotiating space for a restaurant and is arranging an appointment with an architect. He’s also working on a marketing deal with one of the patients he met from Ft. Worth who wants to setup a website for landlords to list apartments for lease. He would get a cut on the finder fee for each completed deal between landlord and leaser.
The recession shock is in evidence on our daily route. We see homeless standing on corners with cardboard signs looking for a handout. We notice a foreclosure sign on a major apartment complex. In the newspaper we read about a high rise nearby that has recently filed for bankruptcy. And, another that filed awhile ago. Michael tells us that the high rises in question are nearly empty of residents, and the retail spaces are unfilled.
The recession has obviously cut deep here, more than might be expected given the presumed impact the Medical Center would have on the economy. But, there are other factors at work in Houston, the demise of Enron, for one, and the overall decline in oil prices and refining. Like so many other cities, residential and commercial property was overbuilt on great expectations and easy money.
The Medical Center, Michael tells us, was built originally on 760 acres donated by the M.D. Anderson family years ago, and has since expanded well beyond that. He says there are 146 different medical entities involved in all facets of medical research, education, and patient care. And it’s not done yet as we see several different major construction projects underway. For better perspective of its enormity, take a peek at:
I’ve written late into the evening and the day has caught up with me. Tomorrow is another day.
Saturday, 10:00 a.m., CST: Another sleepless night. Sleep has become a test of will . . . tossing and turning, hot and cold, awake, asleep, until the rise of dawn when I’m not sure that I’ve slept at all. Last week, in a more than realistic dream, I fought-off an unknown adversary with fists flaying in the air. Some landed on her. Now we’re both startled awake. She angered by the affront; me, barely aware of the reason.
I’m told to expect this as potential side-effects of hormone and radiation therapy. I’m particularly affected by hot flashes at night, which I suspect is the primary reason for my sleepiness as I cover and uncover the blanket between episodes of hot and cold. I discuss the problem with Dr. Lee, my primary physician, during my weekly “see.” He advises that I take an herbal remedy: “Black Cohosh.”
I’m on the remedy for three days now without material affect. On my next weekly “see” earlier this week, I run into the nurse practitioner, Tai Ly, who is my principal liaison with doctors and staff at the Proton Center. She gives me a hug (she’s that kind of sensitive, caring person). I tell her I’m taking the herb, one capsule three times daily according to directions on the label. “No, no,” she says, in her cryptic Asian accent, “You take two or three capsules, three times daily.” She tells me she, too, takes the herb. I learn that she has been on hormonal therapy for the past two years, with three more to go to encounter breast cancer that had been in remission, but is now re-emerging with tumors elsewhere. She remains optimistic.
We also talk of other side effects. She admonishes me to remain sexually active. “Use it or lose it,” she tells me. “The wife will be glad to hear that,” I tell her, uncertainly. Later, when I return to the apartment, I re-read the label on the herbal bottle: “Black Cohosh (Cimicifuga racemosa) is a traditional herb for woman with mild-estrogen like activity, helpful during menstruation and menopause.” (Whoa, does anyone see a difference here?)
A notice is posted in the “gown” room that Dr. Lee will be unavailable this week for my “see” on Thursday. Dr. Nguyen will stand-in. I go to the nurse station on Wednesday for confirmation. I ask the nurse in attendance: “Am I supposed to see “Doctor Nah-Goy-un” on Thursday. “Who,” she asks? I try again. “Oh, you mean N’geen.” I’m reassured. On Thursday, I meet “Dr. N’geen” (another young, pretty woman). To be certain I have the correct pronunciation, I inquire again. She says it’s: “Win, as in Wing.” I’m wondering now how “Ngyuen” translates to “Win,” but not wanting to divulge my stupidity, I let it pass. Later, I discover her full name is: “Quh-N Nguyen” and “Win” must obviously be her first name. I still don’t know how to pronounce her last name.
There must be an Asian conspiracy afoot here: The roster reads as follows:
Drs. Eric L. Chang; Sejungtaek Choi; Andrew E. Lee; Anita Mahajan; Quh-N Nguhyen; and James Cox (how did he get in there?). Nurses and other staff: Tai Ly; Lillian Mugo; Navtividad Rupita; Veronica Ramsey; and I’m sure I’ve just barely scratched the surface. Interesting isn’t it?
Riding the shuttle each day gives me a wider perspective of the drama here that I think other members of the “gown” miss by having their own transportation. They go from residence to Proton Center, back and forth each day without other interaction. People of all interest come and go on the shuttle. The other day, we meet a young twenty something who is studying nursing. Her husband works here as a medical equipment technologist. They’re from California. She talks about her dream one day to stay at the Grand Hotel on Mackinac Island, but that must await the future as she completes her studies.
On another day, dreary and rainy, a young girl and her father step on the shuttle. Her head is covered with a hood to protect from the weather. She’s pretty. Days later, she reappears. Her head is uncovered. She is bald, but in her way, pretty nevertheless.
Yesterday, the shuttle pauses as an SUV stops in front of the main cancer center and temporarily blocks our passage. A five tier decorative cake, iced white with blue trimming, is being placed delicately in the cargo area. A plush teddy bear, and other toys, dangle from each tier. I wonder: is it a cake to celebrate a child’s completion of treatment, or is it in recognition of a birthday or similar event? There are many children treated here. I see them sometimes. They, too, show baldness or thinning hair. It’s a sobering reminder of the insidious affect of cancer showing no boundaries.
The fellow that sits across from me on the shuttle tells me he’s back for treatment for bone cancer. He was diagnosed four years ago and told to wrap up his affairs. He was given six months to live. Fortunately for him, an experimental treatment worked. He went into remission. But, it has now recurred. He tells me that he’s back for several weeks of additional treatment involving bone marrow transplant. That will be followed by intravenous infusion of “killer cells.” Radioactive isotopes will be attached to some of his blood corpuscles with capability seek out and destroy cancerous cells.
An older couple at our apartment complex waits with us for arrival of the shuttle. We introduce. They’re Mr. and Mrs. Jack Renfro from Ft. Worth. He’s back for follow up radiation after thyroid surgery some months ago. He’s carrying small bags containing jars of salsa which he will gift to attending medical staff. He shows me one of the jars. I recognize it as “Mrs. Renfro,” a brand that I have purchased many times at my local grocer. He tells me “Mrs. Renfro” is named for his mother. I’m impressed.
The Odyssey, Part 4
I now have it on good authority from my son who assures me by virtue of his extensive interaction with Asian physicians through his work in the medical field, that the correct pronunciation of Nguyen is indeed “Win.” I have re-confirmation from my radiation technologist whose last name also happens to be Nguyen. On further inquiry, I’m told that the oncologist’s first name, Quh-N, is pronounced “Quinn.” Ah! “Qhuin Win.” I’m thinking her parents either have a unique sense of humor, or a short memory.
While speaking of names, “Bob” comes to mind. I first met Bob, or I should say encountered Bob, in the early stage of preparation preceding radiation treatment. Bob “aided” my oncologist, Dr. Lee, in the placement of carbon markers internally to outline the prostate for precise targeting of the proton ray. This involved lying on my side with my right knee bent upward to my chest with my posterior exposed for the coup de grace.
All would have gone well if I had understood fully beforehand the proper positioning and the procedure to come. Bob, standing well over six feet with muscles to match and a personality in need of an extreme makeover, grasped me into the assumed position with a strangle hold on my torso and a thrust of my knee upward. My oncologist, who stands astride with plunger in hand, obviously is refereeing this match in favor of Bob since I am now questioning his empathy for my persona (he keeps calling me “Sir”). At the very least, I think, Bob should receive a mandatory 10-second penalty for an illegal wrestling hold, and definitely disqualified for a sneaky finger poke up my butt. I now come to understand that the referee is part of a tag team with intent to qualify my rear end as a conduit for further transgression. I am clearly outmatched.
(Good Old Bob is not representative of the exceptional care that I have received from so many others at M.D. Anderson. After I broach the subject with Dr. Lee a few weeks later, he promises to discuss it with Bob. I also remind Dr. Lee that as long as he and I have this intimate relationship that it would be most agreeable if he would at least refer to me by my first name rather than “Sir.” I am not sure he is completely comfortable with that. Would he prefer to maintain a professional arms distance relationship for obvious reasons, I wonder? (I think we have made some progress. At my “see” on Thursday, he referred to me by my last name. I once again remind him that my given name would be preferable.))
There is an enigma among the selected few that receive “The Odyssey” as noted by the email addresses above. All are family, close friends, or former co-workers with whom I share a special relationship. I know each of you, and some of you know each other. However, there is among you, a person that I know only by his pseudonym, “Jim T”, but who is no less a special friend. For whatever reason of his own, he prefers to remain anonymous. Beyond that, I know he is one very smart fellow.
The story with Jim starts a continent down under in New Zealand a few years ago. There resides another bright fellow with a special ability to encipher software code into operative language specific to a trading/charting program known as “MetaStock.” In other words, he pops the “Genie” out of the bottle by writing a monthly newsletter by subscription that enables traders seeking the “Holy Grail” of trading to become more proficient in the application of indicators and systems within MetaStock. For better or worse, I am one of those seeking to stroke the “Genie!”
Eventually, the bright fellow down under invites Jim to write a guest article that provides greater insight into the usage of the software in the development of practical trading systems. At last, instead of the mumbo jumbo of esoteric algebraic formulas, I am finally given something I can put together into a usable trading format. I am elated. Only trouble is: Jim stuffs the “Genie” back into the bottle. Trading systems, I learn, are workable only until they are unworkable. Trading is a never ending zero sum game where the conditions are ever changing, and so, too, must the system. There is no “Holy Grail.”
I am nonetheless impressed by Jim’s expertise and matter-of-fact approach to trading. Jim and I strike up an email version of pen pals. We discuss investing and trading. And, eventually over time, we become less impersonal friends. He learns of my prostate condition. By his response, I learn that he regularly delves into published medical research and is quite aware of developments in the field. He is also apparently knowledgeable about nutrition and holistic medicine and offers advice intended to help me with the side effects of radiation and hormone therapy. He recommends that I try a special preparation of tea as well as some other herbal products to induce calmness and restful sleep. I’ll let you know later how that works out.
I have spoken before of the empowerment of the internet. I am thankful that in our time that people from anywhere in the world, from all walks of life, can forge friendships and share common interest to the benefit of each, even though they may remain an enigma. Thank you, Jim. (I hope one day you will tell me who you are.)
The weekend beckons. The forecast is for sunny weather, though somewhat chillier than the moderate weather of the past days. There’s a park across from the apartment complex that contains a golf course, a Japanese flower garden, a “Choo-Choo” train that circumvents the park, a lagoon for paddle boats, walking/jogging trails and a zoo. I’m told the zoo houses 4600 species of animals. I’m anxious to visit it. I want to see if Good Old Bob is back in his cage.
Today, as I waited for the shuttle I saw a young girl, about seven or eight, frail, nearly bald, with her mother getting ready to leave. She was wearing a jacket with the following words imprinted:
“Live, Love, Laugh” That’s worth remembering.
My wife returns to Houston on Tuesday. It’s time to see if the vacuum cleaner works.
The Odyssey, Part 5 . . .
“Houston, the Eagle has landed;” that is, the ‘American Eagle’ on Tuesday with the wife aboard after two weeks away-– a momentous arrival (not on the moon, of course) but here: our home away from home. With her motherly hand, I’m now on the straight and narrow path. No more frozen dinners, late night snacks, piled up laundry, and a faded memory of bachelorhood. I’m toast!
The trip to Houston was less trying for her than the SuperShuttle from Bush International (IAB) to our apartment. The van was fully occupied requiring several stops along the way to drop-off passengers. For her it was a test of endurance, made no less tolerable by a fellow passenger who mistakenly thought she was on an ego trip. She babbled about herself incessantly to the annoyance of all. By the time my wife stood at our front door, she was badly in need of a wine transfusion.
A semblance of normalcy returned after the first glass. But, alas, the first was also the last. I had failed to restock the wine cellar (the fridge as some might call it.) With dinner and a further thirst beckoning that could not be satisfied by “Hungry Man” dinners and water, we set out for the Hotel ZaZa. I had noticed the hotel several blocks away on a walk the preceding weekend.
What a great find. The Hotel ZaZa is one of those off-the-beaten path “luxury-styled” boutiques with great ambiance, great rooms, great bar/restaurant, and GREAT! Prices ($12 per glass of wine). We had our dinner seated at the bar with full view of the room, enjoying our food and wine: the allure of subdued lighting, the interesting artwork — and, the “gay” scene unfolding around us. We couldn’t tell for sure about the fuzzy hair deep voice with plastic purse sitting next to us with a lady friend: “Not that there’s anything wrong with that.” (http://en.wikipedia.org/wiki/The_Outing). Regardless, it’s a special place. We will return.
Our view of Houston, the city, is limited to our freeway trips back and forth from Bush International with views of older, faded neighborhoods; the frequent daily route to the Proton Treatment Center; walks in the nearby neighborhood; and occasional shopping trips. Houston is a city of contrasts, as most are, but maybe more so. It sort of sprung up without benefit of zoning laws. Commercial buildings, business offices, retail stores, restaurants, sit side-by-side with single or multiple family residences. The downtown is a gleaming jewel of modern high rises. Elsewhere, over a mostly flat landscape, single high rises jut up out of nowhere, some like obscene finger gestures as monuments to ugly.
My Houston friend, Joe, has been a God-send by providing transportation, enabling us to restock the larder. On one of such earlier trips, he took us to the “Central Market” grocery which I can best describe in type as a “Whole Foods Market” on steroids. The fresh fish counter was at least thirty feet long: Special foods, deli, breads, produce, meat, wine, etc., in abundance and variety as I’ve never seen before — a gourmet’s delight. He has since taken us to other groceries that offer on average a variety and selection of delights that are not usually available at home. I’m afraid it has become too tempting. Our grocery bills are frightful.
Our apartment is located in an area known as the “Museum District.” The museums of Fine Art; Contemporary Art; Natural History; Buffalo Soldiers; Health; and several others are all within blocks of each other. Last Sunday, I set out to find the Museum of Contemporary Art. I thought I knew where it was, but after walking block after block into an area that began to look less appealing, I decided it might be wiser to double back. I finally came upon the sculpture garden adjacent to the Fine Art Museum and from there into the museum’s main building. By that time, I had grown tired and my right leg, which had become strained, was giving me trouble. My journey ended there without exploring the museum, but, with another great find: a cafeteria on the lower level of the museum that offered a full menu of food and drink. Now, in addition to the hotel we have two relatively nearby places for occasional dining out.
My treatments have become a daily routine, now half-way done. Last Thursday, the routine was interrupted by a power surge that knocked the radiation machines off-line. It took two hours before they were back up. I had described previously the need for us to have an optimum level of fluid in our bladders at least 30-minutes prior to radiation. Now, with an unknown period of delay, maintaining the appropriate fluid level became a fine balance between grin-and-bear-it, and give-it-up. So, we’ve got eight geezers in medical gowns doing a Hopi Nation whooping dance up and down the hallway to invoke the spiritual gods of fire and water.
I’ve had relatively few side-effects so far. Hot flashes and sleepless nights have been the worst of it from the hormone therapy. Dr. Lee has recommended supplements to alleviate the effect, but I haven’t noticed significant change just yet. The other problem has been some discomfort in my right leg similar to a shin-splint which keeps me off the treadmill and limits my walks. There was concern of the involvement of a blood clot. That was eliminated after an ultra-sound scan of the veins and artery in my leg. Tai Ly, the nurse practitioner, scolds me: “You rest. You stay off feet. You take ibuprofen. We want you live.” I take her advice.
I’ve done the best I can to get Dr. Lee to call me by my first name. My friend, Joe, who has a closer relationship over more years, is still greeted as Mr. Landry. I guess I’ll have to live with my last name which is much better than “Sir.”
Super Bowl Sunday beckons. The Saints seem to be the favored time in Houston. So, until next time . . .
The Odyssey, Part 6
Alfred tapped the gong lightly at his graduation on Monday. Mike banged it loudly on Friday the week before. Alfred and Mike are like left and right brackets that mark the diversity of fellow patients that come and go each day through the “gown room.” Alfred is the genteel southerner from Tennessee – retired phone man. He grins widely and speaks softly. Mike is the gregarious northerner from upstate New York — finance and insurance maven, also retired. He has a sharp sense of humor. (He needles the radiation technician as she readies insertion of the balloon: “I need to tell you something,” he says. “What,” she asks? “Come closer,” he says. She moves closer. He whispers: “Don’t touch me there unless you love me.”)
The technicians take it all in stride and give back as much as they take. They keep our spirits up. They declared Friday this week as “Hawaiian Day.” (I asked, why? Nobody seemed to know. It was just fun, that’s all.) The Center was festively decorated. Men wore Hawaiian shirts; women grass skirts. We were given leis and refreshments. Treatments are being completed on schedule. We’re not backed up. It’s a good day.
As we wait our turn, we of the gown get to know one another a little better. Bill from Houston runs a printing business; Rodger is a retired DNR forester from Iowa; Tom is a Texas high school biology teacher; Bob from Colorado is an energy consultant; Sid, oil and gas engineer on rotation from Dubai (his next assignment to Algeria has been postponed); Ned, Houston attorney; Ray, a retired petroleum instrument engineer expatriated years ago from Massachusetts to the N. Padre Island boating community, (“The best place the world to live,” he says); Joe: retired electrical contractor from Pennsylvania; Jim: former Texas congressman, nee Washington lobbyist (http://en.wikipedia.org/wiki/Jim_Chapman). Here, we’re simply prostate cancer patients with different life stories.
The wife and I bump into Jim at the apartment house later that day on our way to the community room. Jim joins us for coffee and conversation. We get the insider’s view of Washington politics. His term in Congress ended some years ago when he decided to enter the run-off for the Senate (“Voters reserve the right to be wrong,” he observes wryly).
There’s an informal dinner planned by patients of the Proton Center for the evening at the “Saltgrass Steak House” (highly recommended). We had not planned to go, but Jim offers us a ride and we accept. We arrive late. There are approximately forty others already seated — husbands, wives, others — mostly gray haired grizzlies, like us – it looks like senior’s night out.
We’re seated next to Dan, a prostate patient, and his wife from Dallas. Dan works for an investment company that buys pre-packaged mortgages at auction from banks and the FDIC. The market for distressed mortgages is firming up, he says. Across the table are another gentleman and companion from Georgia. He’s receiving proton treatment for esophageal cancer. Following dinner, there’s a round robin of personal introductions. Most are from Texas. One couple is from southern Illinois. Talk centers on the stage of our treatment, the reason for our choice of proton therapy at MD Anderson, and our hopes for a successful outcome. There’s much congeniality. Once strangers from distant places, we are now friends seated in common bond.
This week marks the halfway point to the finish. The success of my treatment won’t be known for sometime thereafter. Blood samples will be taken periodically over months and years to track my PSA. As long as it remains stable within a low range, it can be assumed that the cancer has been contained.
I remain optimistically hopeful . . .
Happy Valentine’s Day everyone.
The Odyssey, Part 7
Andre, a cyber security specialist with the Houston police department, is the new freshman in the “gown room.” It’s his first day on Tuesday. He’s fresh meat for good natured ribbing from us wizened elders who’ve walked the gauntlet earlier. Andre wants to know if any of us have experienced side-effects in the course of our treatment. Tom, the high school teacher, who stands about 5’6” fully decked-out in his gown and cowboy boots, says: “Well, Andre, before I started treatment, I was a lot taller and better looking.”
Most of us have come through so far relatively unscathed. One fellow has developed a few lesions at the radiation point on his hip. There is some unavoidable skin irritation from radiation, but mostly minor for the rest of us. Others report some urinary sensitivity upon evacuation of the bladder. Cranberry supplements and ibuprofen are recommended for remedy.
Talking, laughing, joking eases our time together as we wait our turn in the gantry (that’s what they call the radiation room). Sometimes we’re backed up. As each person arrives for treatment the first questions usually asked: “Are we on time?” “Are you ready?” There are occasional breakdowns. A power surge put the gantries out of commission for two-hours a couple weeks ago. Being ready refers to the “fill” of the urinary bladder prior to treatment. It must be at optimum level. If not, the person next in turn, if perked, leap-frogs and gets on his way earlier. The skipped-over guy will start guzzling water in frenzy to makeup the deficit, oftentimes getting over-filled as he endures a prolonged wait and receives bogus empathy from the gowned chorus. (On my first day of orientation, I’m forewarned by the nurse: one new patient was needled into drinking twelve glasses of water.)
That’s the nature of the games we play to pass the time.
Andre, the newbie, is 52 years old. It’s a poignant reminder that prostate cancer, or any cancer for that matter, respects no age. My wife sees it perhaps more than I as the children and their parents come and go through the Proton Center waiting room. Some of the young are no more than babies. There’s a teenager I see now and then in her wheelchair as she and her parents leave following treatment. Her head slumped down, eyes covered by the bill of a ball cap. She’s asleep. (Some are put under to avoid movement under radiation.) She is warmly covered under a blanket of bright orange and yellow. I am thinking when she awakes that the hue will perhaps bring an aura of sunshine and hope into her life.
I make it a point to discuss the correlation of PSA levels and the occurrence of prostate cancer with Dr. Lee at my “see” this past week. Most of the men say they had much lower levels than I did when they were biopsied with positive cores. Their cancer was caught at a much earlier stage which greatly improves their chance for a successful outcome. I’m told PSA (prostate specific antigen) is not an entirely reliable predictor of prostate cancer. Some men, such as me, can have a higher PSA for a variety of reasons, none of which may be associated with cancer. The best that can be understood is that an abnormal reading or a rising PSA over a period of time would suggest the need for confirmation by biopsy. Other analytical methods are currently under study. Until something better comes along, PSA is the best we got. (http://www.cancer.gov/cancertopics/factsheet/Detection/PSA).
Our family money manager, Michael, was in town yesterday, Saturday, for a partners meeting to update us on hedge fund performance and to introduce staff and third party administrators. I suspect some of you may not have a totally positive regard for hedge funds (aka: Madoff). But, I can tell you that there are conservative hedge funds, and there are speculative HEDGE funds. Michael’s is of the former. I can also tell you that it has been a very honest and successful partnership.
I have known Michael for more than 16 years. He’s a retired Navy Captain who turned his penchant for investing into a full-time business after retirement from the military. He is also a prostate cancer survivor for the past six years. In fair disclosure to the partners, he discusses his health and reassures us of his well-being. He also comments that for the majority of men it’s not a question of will you get prostate cancer, but when. It is something all men should take seriously and monitor carefully. He attributes his successful treatment to his oncologist, Dr. Charles Meyers, whom he recommends highly to anyone seeking guidance in determining their options (http://www.prostateforum.com/about-dr-myers.html).
During the past six weeks I have matriculated from freshman to senior, and in two weeks to graduate. It’s a metaphor for my progression through the treatment process – a feat that college tuition paying parents wish their children would accomplish with similar expediency (although the final cost may not be that much different). Tomorrow I receive my second hormone injection in a series of three month intervals that I may have to endure for the next three to five years. Hot flashes are the worst of it so far and something I may have to live with for the duration of my treatment.
Today, Sunday, we took advantage of one of the warmer days we’ve seen in awhile and finally visited the zoo in the park across from our apartment complex. The good news is the lions and other predators are well contained. The bad news: Good Old Bob is still on the loose.
The Odyssey, Part 8
The rodeo is in town. It’s BIG! How big? Oh, I’d say about five tons of horse and livestock manure, maybe more. The rodeo is an annual event that begins weeks ahead with trail riders starting out for Houston from all directions in a range as far out as 200 miles, riding and camping along the roadway with chuck wagons in tradition of the Old West. The ride culminates with the customary parade through the center of town to mark the formal start of festivities. While this is going on other daily events kick-off at the Reliant Arena with private tent parties — sponsored by Jack Daniels and other beer and booze makers — , a cook-off, carnival, nightly concerts, livestock judging, cutting horse contests, and much, much more as shown on their website: http://www.rodeohouston.com/events/events.aspx. What it amounts to is a gigantic city-wide block party that goes on for two-and-half weeks. We’re told it takes about that long for everyone to sober up.
Next week marks the end of my treatments with graduation on Friday. It also marks the end of this chapter of my personal narrative. When I first started writing, I had little more in mind than an occasional update on my progression to family and friends. When I plucked the theme, “The Odyssey,” from thin air, I thought it would be nothing more than a metaphor for my effort to overcome prostate cancer, though, hopefully less perilous than the epic journey of its nemesis, Ulysses, in the Homeric Greek poem of the same name (http://en.wikipedia.org/wiki/Odyssey). That this has turned into something more is the unintentional discovery of personal situations and friendly encounters that have enriched the value of my experience.
As many of you know, I had devoted a good many years with photography as a hobby, and have now turned that interest into collecting the work of others who are far more accomplished in turning the vernacular into fine art. What continues to intrigue me about photography, and art in general, is the ability of the artist to visualize and render a subject in such a way that it takes on new intensity and relevancy. It is as if the artist has shown me a new way to see something that I had overlooked before.
I am not an artist, but in similar vein writing has channeled me more intensely upon people, their stories, and other circumstances that might have otherwise passed without notice. It is in this manner that “The Odyssey” has probably become more significant and memorable to me than for you, and for that I hope you will forgive my overbearance.
A certain few of my dedicated readers have suggested that I expand my experience with prostate cancer as reported in my weekly mutterings into a book for publication. I respond that that road has already been paved by many others, and that it’s unlikely that I could add substance beyond that which is already in the public view. If I were to reconsider, the opening line would go something like this:
‘It was the best of times; it was the worst of times . . .’
Yes, of course, it’s from Dickens’s “A Tale of Two Cities,” (http://en.wikipedia.org/wiki/A_Tale_of_Two_Cities). But, dear reader, my story also is a tale of two cities, home and Houston, in which I the protagonist seek professional guidance from urologists and oncologists with different experience and opinion. Unlike the original tome, my story would be about revelation, not revolution, and the ending would be truly the best of times.
I realize now I have been unfairly critical of the opinion and direction I sought from doctors at home. I failed my own advice of being my own medical advocate by not recognizing the signs of advancing disease much earlier, and taking the initiative in researching my options before they became more limited. There are good doctors everywhere, but some better than others by specialization and peer recognition. I have found mine in Houston. You may find yours elsewhere. I would hope you would benefit by my experience and seek out the very best.
Now, that I’m approaching the end of proton radiation in Houston, you may ask if I have any regrets. None as far as treatment is concerned. Absolutely no pain and very few side-effects other than the hot flashes from hormone therapy. My only regret is not having taken full advantage of all the amenities of Houston. Not having a car available was limiting. Cold weather the first few weeks following our arrival wasn’t conducive to wandering. And, my encounter with Good Old Bob left me with a gimpy leg for awhile. Now that everything is falling into place, it’s time to leave.
I want to thank my family and friends for their good wishes and encouragement, and most particularly my Houston buddy, Joe Landry, who mentored me before and during my stay.
Is this the end of the story? Only time will tell . . .