The 9mm solution

I am a handgun enthusiast...and I try to get to the range at least once a week in my desire to improve my skills.

Last week I mentioned I had not disposed of the package of Depends I purchased in anticipation of the incontinence that never, (much to my surprise and delight) occurred.

Last night I combined the two and had a great time using one of the afore mentioned Depends as a target. Fifty rounds of 9mm ammunition did a great job of obliterating the diaper while, at the same time, affirming my own “Declaration of “InDependsence.” (even I groaned at that one)

The balance of the package will now be donated to a local nursing home.

As I was first telling the above story to the staff here at the office I used the unfortunate phrase, “...and I shot the crap out of my diaper,” which was not at all what I had intended to communicate...

Denial...a (mostly) male affliction

One thoughtful reader, Robert, sent me a link to an article looking at the issue of prostate screening generally and PSA testing specifically. Robert prefaces the link with the following observation:

"I'm all for looking at all the information that is available when you make any important decision but this article concerns me. We men have a strong tendency to switch on the denial when there is a threat to our health. I can see how reading this could add fuel to that fire."

The article itself, the major thrust of which is research demonstrating the questionable value of regular prostate screening, is filled with wiggle words like:

“That's not to say there's no benefit from screening,”

“We shouldn’t be predetermining for patients" whether they should get screened,”

“meaning the researchers cannot definitely say that screening for prostate cancer is not beneficial,”

So...the article attempts to remain firmly grounded on both sides of the fence. And, like Robert, I worry such articles may be used by men as justification to avoid dealing with “issues prostate.” Women do a much better job of working honestly with their physicians than do we.

Yes prostate cancer is, a great percentage of the time, a slow growing disease making most patients very likely to die of something else before the prostate cancer. Yet the CDC tells us, “Prostate cancer is the most common cancer in men in the U.S., not counting skin cancer. It is the second most common cause of cancer death in men.” http://www.cdc.gov/Features/CancerAndMen/

It's old, but true, ”Denial is not a river in Egypt.” and for some with prostate cancer, it can be fatal.

Play the odds

Today, February 27, marks exactly fourteen weeks since my surgery. On this anniversary, it is fitting that, following my run this morning, the final scab fell off from the surgical site. Once again I present the smooth, sleek, athletic body I possessed prior to the procedure.

OK, I never looked that good to begin with, but I've come a long way, baby.

Reading a report this morning, one statistic jumped off the page at me. A full 60% to 85% of those who opted for radical prostatectomy report a period of 18 months before return of erectile function.

As I have noted previously, I was fortunate in regaining function very early in my recovery.  But discounting my experience, I none-the-less find the above statistic very encouraging as it reads that 60% to 85% regained function after only 18 months.

Given there must be a percentage of patients who, like myself, regain function in less than 18 months, the odds of regaining function in 18 months or less are even greater.

There are men who will never regain function, a known risk of the procedure, and there is a percentage who will wait longer than 18 months. But the odds are in your favor.

Abundant choice

At a meeting yesterday, a friend approached me to talk about his father who recently decided to go with seeds for treatment (Brachytherapy).  He wanted to know what I thought of the decision! I told him everyone with whom I've spoken who made that choice has been very happy with the decision.

On this Friday, let's agree to not argue about the best therapy, but be happy we have so many excellent therapies from which to choose and more (and more exciting) on the way.

Crotch crutch

I received another email asking for details of my diagnosis and what factors contributed to my decision to opt for surgery. I provided a brief synopsis of the requested material, and referred the writer to my early blogs detailing the process from diagnosis through my treatment decision and beyond.

While it's gratifying to know I can be of some assistance to men facing decisions, I need to be clear that I am not a champion of surgery for all...my treatment decision is just that, my decision and cannot be generalized to others. Everyone needs to evaluate his own circumstances and arrive at the decision with which he and his family is most comfortable and makes sense.

On another topic, I noted this morning the package of unused Depends on the floor of my closet. Interestingly, I realized (and I'm not proud of this) I did not want to either throw them out or contribute them to someone who has a need.  Instead, I chose to leave them where they are as a reminder of how fortunate I've been...that and just in case ('cause you never know).

How long will it be before I give up the Depends crutch (crotch crutch)? I have no idea...it's sort of like the question, “How long will I be able to use my disease/surgery to get out of doing things I just don't want to do?” At some point it no longer makes sense...a point probably evident to everyone else long before I figure it out.

Free beer tastes better

A friend and his wife stopped by the other evening to drink beer and talk, what else, prostate. His doctor found a nodule during a DRE and then saw a slightly elevated PSA; next step...biopsy, but my friend was already concerned and wanted to talk about options and outcomes.

His personal circumstances are far different than mine and, having yet to receive a diagnosis, I suggested it may be premature to talk about treatment before the biopsy, but we had a long discussion none the less. Further, he is ten years my senior which also makes his decision different than mine.

Add to this his family physician and his urologist telling him he may have a decision to make, but offering options without opinions, has only served to increase his anxiety. It's a familiar story to those of us who have been through it, and that's where we can be of service.

Although he never said it, it was my impression he was more concerned about the possibility of having a catheter than anything else. I completely understand this as well.

In the end, I believe he was seeking someone to listen who understands. We had another beer and ended the evening with him feeling somewhat better and assured we would be there to help in any way we could if needed.  Best of all, he brought the beer!

A story of successful surgery

My friend who chose open surgery for his treatment sent me a note yesterday:

“We are now at exactly three weeks since the surgery. I was in the hospital
from 5 am Monday to 2 pm on Tuesday. Thanks for the email.
My pain was minimal and I did not have to take a lot of pain meds. I had the
catheter until a week last Thursday - we named it "Peabody the First" (with
an English accent!) The removal of that puppy was a non event thank
goodness! Went back to work last Monday and just took half days for the rest
of the week. The biopsy came back completely clear!! So, I am good to go for
the rest of my life - yehaa! Haven't enjoyed the Depends - but am off of the
undies now am on the small pads for security reasons. Have three more weeks
before I can start working out. Thanks for all of your prayers and thoughts,
it has really meant a lot to me. I guess God has got some more work for me
to do.”
As I've mentioned before, one of the factors making a treatment decision so difficult is the outcomes for the various options are almost identical. I know that sounds counter-intuitive (if every choice is good, how could it be difficult...just pick one and go)...but it's a fact.

For me, yesterday marked thirteen weeks since surgery and, as Lucia noted this morning, I've come a long way.

Here's hoping positive outcomes for everyone.

Blog Obscura....................................sex (sorry)

Arriving at the office more than 90 minutes early today, I logged onto the internet and reviewed my emails and usual general interest sites...then I thought, “I wonder how high up the pecking order my blog ranks after 80 posts?” Huge ego error...

First I queried “prostate blogs” resulting in 31 million results. I searched through the first 15 pages and discovered several interesting blogs, but mine was not among them. Some of the blogs I of note included “Ronnie's Prostate Blog,” “Rick's Prostate Cancer Blog,” “God and Prostate” (who knew?), “Harry's Prostate” (which I first read as Harry Prostate and laughed until I reread it), the unfortunately named “Peter and Prostate Cancer,” and a blog about which I wish to know absolutely nothing titled “Prostate Milking,” eeeeuuuuwww.

I decided to refine my search to the name of this blog and entered “There Goes My Prostate” resulting in more than 14 million results...again, I did not make the first 15 pages.

Further refinement to William Sharp There Goes My Prostate (including Bill Sharp in the search) again failed to list my blog in the first 15 pages of results.

And so:  Congratulations, you have found one of the most obscure blogs on the planet. Apparently, blog optimization is not a subject I can teach. But this does not dampen my dedication and desire to bring hope and information to men, and their families, facing prostate issues.   Hell, you found me!

Weekends are made for this

Having spent from 6:45am to 8:00pm yesterday engaged in community activities, I did not have an opportunity to post.  And I just recognized it has been more than 24 hours since I have even thought about my prostate, prostate health, or my surgery...I guess the recovery remains on track for resuming what passes for normalcy in my life.  Nice.

Enjoy your weekend.

A friend in need

A friend stopped me in the store the other day, I could tell he was upset.  “Bill,” he began,”I'm going to need your help.  I'm dealing with a prostate issue now, and I know what you went through.”  To be honest, I went through very little.

I asked if he had had an biopsy, and he told me he had not, but that was the next step.  So I told him to give me a call with any questions about the biopsy before the procedure, or to call me once he has the results if they find anything.

My friend has significant challenges, unrelated to his prostate issue, I did not face at the time of my experience.  Should he find himself without someone available to be with him at the time he returns for the biopsy results...I can be with him.  Should he find himself in need of treatment without someone to assist with transportation...I can be with him.  Should he need someone to assist with physical activities during recovery...I can be with him.

But what he said to me was, “I'm going to need help getting through this mentally if it proves to be anything of consequence.”  And I can be with him there as well.

Today, a diagnosis of prostate cancer, even an aggressive prostate cancer, is not a death sentence.  New treatments are being developed regularly...many with very encouraging results.  But my friend is correct, there is a huge mental component to illness that cannot be ignored...and having a strong support network is imperative to a successful outcome.

Male teens: bizarre lifeform

I work with a group of high school sophomores from every public high school in my county as well as the two largest parochial schools. As I prepared their work for today, I wondered how much male teenagers might know about prostates and prostate health...after all, it's something most of us were not even aware of until well into our adult lives.

I put together a very brief quiz that listed six organs, and asked the male students to identify the location of each organ in the body and it's function. The organs were:

Heart

Lungs

Liver

Kidney

Pineal Gland

Prostate Gland

Admittedly, the pineal gland was a bit of a stretch for high school sophomores...but I never said it was fair.

The majority had little difficulty with the first four organs, and several got the pineal gland location right (none knew its function). The prostate was another story.

Every one of the male students (11) had the location close enough for my purposes...one was quite specific and correct. When it came to function, I believe there was either chatter or texting going on because every paper, with the exception of the location winner who had no idea, listed the function as “Dude Juice.”

Although not a definition I was expecting (and remember, they're only sophomores), they at least had some vague limited idea of anatomy and physiology.

This brings to mind the question; when should we begin to talk with men about prostate health? Is there any reason for a sixteen year old to be introduced to something that is, for the most part, not an issue until well into adulthood? Is it unreasonable to introduce a disease so ubiquitous among males in our culture at an earlier age?

I have a lot more questions and no answers...but I'll entertain any opinion(s) you wish to share.

Whitney and me

With the death of Whitney Houston, and stories of her life of excess filling the media, I was reminded of my own experiences at the time of surgery.

When the anesthesiologist visited before I was taken into surgery, he asked if I'd like something before I left pre-op to “calm me down.”  I was surprisingly relaxed (given I had never had surgery before) but, being a child of the sixties and living by the motto “take anything they offer you”, I said, “Sure!” and soon he was back screwing something yummy into my IV.

Following surgery, I don't recall I had any particular pain...but when the nurses asked if I wanted something, I said, “Sure!” and soon they were back screwing something into my IV. This went on for about thirty-six hours. Then it hit the fan...

The difficulty I experienced was, apparently, due to my lower GI being slow to awaken. And my lower GI was slow to awaken due to the pain medication I so eagerly accepted. I could not blame the nurses, they only responded to what I told them. Nope, I did it to myself; and it delayed my release by another day and one-half.

Lesson learned: “Sometimes that which we accept in an attempt to avoid potential pain can inhibit our growth and healing.”

True beyond the hospital

Throbbing sex thingy

Hypothesis confirmed: By using the word “sex” in the title of my post yesterday I received more hits within the first hour of any post to date...hence the title today (I pledge this will not happen after today...probably).

As I was running this morning I thought, “There just doesn't seem to be a lot of prostate cancer humor.” So I googled “prostate one liners” and confirmed my belief with a search producing a mere 2,700,000+ results. That seemed absurd to me, so I narrowed the search to “prostate cancer one liners” thereby reducing the results to a paltry 151,000 (look it up).

Admittedly, most of the results I visited proved to be far below even my standards of humor...Ron Paul is funnier. But at least there appears to be enough cultural awareness of the disease(s) to merit consideration in the arena of humor.

When I started this blog, it was my intention for it to play several roles. For the recently diagnosed, I hope to provide a perspective of one patient who shared their feelings of fear, anxiety, and confusion...and the reassurance that if I can deal with the feelings, anyone can.

I also hope to demonstrate there is joy and humor to be found in every experience if we are open to find it (which requires a willingness to be the butt of the humor...insert puns here).

I hope this will, given time, become a marketplace of ideas, with contributions by others (hint, hint), and conversations among readers.

That's it for this week; excuse me while I find the punchline for why single men are diagnosed far less frequently than married men (actual set up found on first page of google search).

Better sex

Today I finally had to acknowledge a change that may be the first side effect of my prostate cancer and treatment.  At first I didn't notice any big change but, over time, it's continued to increase to the point I can no longer ignore it.

While surfing the net this morning I became aware of a change in the advertising along the side of the screen. The internet search engines have, apparently, identified me as someone inordinately interested in prostate cancer. Here is the list of ads that appeared at the same time:

Shocking Prostate News

Prostate Cancer Treatments

Advanced Prostate Cancer?

Prostate Pill Review

Shrink Prostate Fast

Bladder Cancer Causes

Not sure how that last one sneaked in there but it is, admittedly, anatomically close.

I fear I've become a one trick pony to the all seeing eye of the internet. Gone forever are all those provocative ads seeking single men for lonely Russian women, or women in my area over 50, or the never ending search for someone who can satisfy Katrina's burning desire.

Gone too are those ads promising to add inches (no, not to my height), increase my stamina, and make me irresistible to women named Katrina.  Nope, I get prostates...but then again, I am currently short one prostate.

OK, technically all this has very little to do with sex, but I have found that the better my title, the better traffic my blog generates. Deal with it.

I've got issues

There are some issues that bubble to the surface when recovering from treatment that should be addressed (feel free to either provide insight or add issues of your own to those below):

1. What the heck does one do with leftover diapers? Mine are unused (I'm sure you're happy to know that.), and will not, hopefully, be needed in the immediate future. I did reserve one to utilize as a pistol range target...sort of a “Take that incontinence,” statement.
2. Approaching three months following surgery, how can I continue to use my “condition” to get out of doing things like shoveling snow, vacuuming, washing the car, and attending events I'd rather ditch?
3. What do I say to people who ask if I'm OK? I've never had cancer before, how the hell should I know?
4. When people ask me if “everything” is working...how much to they really want to know; and how much is any of their business?
5. Is it inappropriate to discuss my catheter experience while out drinking wine with friends?
6. Does anyone really want to see the incisions?
7. Will husbands get pissed if I continue to tell wives they should nag their spouse about prostate health? Do I care?
   I'm sure there are more but you know, ever since the surgery, I've noticed I...oops, almost started again.

More questions

I asked for additional questions readers believe important to be asked when prostate cancer has been diagnosed; here are a few submitted by one reader:

What other ways to treat this are there?
 
  Why is this the best for me?

Where can I get other treatment methods explained and/or done?
 
What happens if I don't do anything for a while?
 
  How long can I wait? 

Is there a support group that can help me and my loved ones, before, during and 
after treatment? 

What am I facing, nerve-sparing or non-nerve-sparing and why?
 
If the ED is severe, how can it be dealt with? Medications? Surgical 
implant?
 
If incontinence is a given, how can it be treated? Sling? Urethral
sphincter? 

                  How certain are the results?

We have not exhausted the questions that might be asked (In fact, my first question was, "I've got what?")...feel free to continue to offer questions you either asked or wish you had asked (I always think of the best questions about thirty minutes after I need them).

Husband won't do what she'd like

Over the weekend I ran into a friend who told me she reads this blog but can't get her husband to do so. Her husband has been treated for prostate cancer, but his PSA is climbing again and she's concerned (so is he, I'm sure).

Having limited experience, and absolutely no qualifications, I'm not the best person to deal with her husband's situation from a medical (or almost any other) perspective, so I don't blame him for not finding your truly as a source of information. I can, however, understand how upsetting it must be to have made your treatment decision and then be faced with having to do it all over again...and things get a little more difficult the second time around (which, by the way, is not true only of prostate cancer).

Perhaps if another reader who has had a similar experience would choose to share his story it would be of benefit (and that's really my agenda, to become a location for the exchange of information, education, and connection...'cause I certainly don't have enough juice to carry this alone).

On a personal note, this morning I ran the same distance I ran just a few days before my surgery. It felt good at the time, but now I'm having some discomfort in the area of the incisions...perhaps a bit too much too soon (yet further proof...as if needed....I'm an idiot).

Questions please

As I've preached recently, no one is going to make any decisions for you, so you need to gather as much information as possible. To that end, there are questions any prostate patient should ask...besides “What the hell is your finger doing there?”  The question list below is far from exhaustive (and more is better), but it's a start.

What are my numbers?

In order to speak intelligently about your condition, you need to be able to give doctors the results of any testing you have had including, but certainly not limited to, PSA numbers (I know, I know) and, if you've had a biopsy and the results were positive for cancer, your Gleason score(s).

This may sound obvious, but while my urologist referred to my numbers he did not give them to me until I asked.

Where can I go for a second opinion?

Your physician should be eager to provide this information...if he/she isn't, find another physician.

How many cases like mine do you treat? What are your outcomes?

Having decided upon surgery, I wanted a surgeon who performed a boatload of procedures like mine...no practicing on this body. I opted for a surgeon who performs 400 robotic prostatectomies a year.

What are the likely post-treatment complications and how do I address them?

I was well aware of the possibility of erectile dysfunction and incontinence following my surgery, and had a plan in place to deal with each.

It's always a good idea (actually, it's essential) to have someone go with you to any consultations. There often is so much information provided you might miss something; another person might also ask important questions that haven't occurred to you. Further, it's good to have someone there to provide support as you are confronted with the realities of your condition or disease.

Finally, here's the first “There Goes My Prostate” challenge...send me questions you think are important to ask and I'll post them here for others. Now, send me your questions!

It's your gland...

I received another note regarding the PSA test, questioning whether one should refuse the test based upon recent articles indicating the test does not, in fact, save lives.

The extent of my knowledge and qualifications to discuss matters medical is restricted to my own experience...in other words, I have no valid credentials to make suggestions or offer opinions on such matters.

Warning: Pay no attention to the man behind this blog (medically).

That being said, I mentioned in an earlier post a friend who brought her husband to me at a social event and insisted he tell me his PSA test results. After we both shared a moment of discomfort (obviously we're both smart enough to be scared of our wives), he told me his test came back a 56. 56? Holy crap, mine was only 5.2 and I was having my prostate removed! I suggested he seriously consider the biopsy his urologist ordered.

Well, he had the biopsy and guess what? No cancer, zero, zip, nada, none. He was placed on a course of antibiotics to see if that might offer a cure. Two months later, his wife told me he had another test...the number was now 84. The doctor prescribed another course of antibiotics and the couple is seeking a second opinion to determine what the hell was going on.

I mention all of that for one reason, a PSA test, as I have mentioned, may not be definitive, but it can be a marker for some extant process. If a man's PSA number is out of the normal range, or is moving up at an accelerated pace, it's a pretty good hint additional testing may be indicated. It does not mean cancer...many things can cause an elevated score (even intercourse within a few days of the test, according to the Johns Hopkins Health Alert); but wouldn't you like to know what's going on? I would.

The decision of treatment is always the patient's. Did I rush to surgery before it was absolutely necessary? Probably, but that was my decision and I'm glad I made it...I'm just as happy for those who choose other treatments including “watchful waiting.” I cannot be so happy for those who choose to ignore the issue. But, hey, it's your gland.

I got nothin'

The muse has left the building. My plan...drink enough wine tonight to reignite cognition.