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.