Empathy is not always EZ.

I participate in a Facebook-based support group for prostate cancer sufferers, patients, survivors, and their supporting family, friends, and lovers. There have been many discussions of the symptoms and impact on the body of the cancer and the effectiveness and side effects of the various treatments. Side effects that often include urinary incontinence and erectile dysfunction (ED) formerly known as impotence. Everyone's journey through this often fatal landscape is wildly unique and different. Today one of the partners of a cancer sufferer posted a note that ED just didn't matter and implied that forum members should just be glad to be still alive and shut up about that issue. A couple of men (both suffering extreme cancer-related life-threatening problems) posted that, in their dire situation, sex simply no longer mattered to them. The original poster (OP in today's language) then congratulated those two for "being comfortable in your own skin and for having good self esteem and for knowing what a REAL MAN is." I found her words to be insensitive and hurtful, and did not immediately have the words to respond. 

A couple of other cancer-suffering men did chime in and post to the effect that she simply did not understand. One man went so far as to call her patronizing. I'm not sure I'd have used that word. Anyway, after some time pondering, below is what I posted in reply to her REAL MAN comment:

Thank you, Robert and Henry. I wanted to respond to Patsy but needed some time to think so that I could, hopefully, respond in a way that does neither diminish those with greater problems and suffering nor hurt Patsy for her lack of understanding and empathy while making it plain that her words were hurtful.

My dear wife and I have remained committed and faithful for over 48 years. We have raised a great family who are doing well and enjoying life. I am thankful for her and our children and grandchildren, for my life, remaining health, and capabilities, and I have great sadness for those, like [name withheld here] and many others, whose situation is really much more dire and difficult. My PC was originally diagnosed as stage 2 with a Gleason of 4+3 with “excursions to 5.” Twelve of fourteen biopsy cores were positive for cancer although my PSA had never been over 4 and all of my DREs had been unremarkable. The biopsy was recommended because my PSA went from 2 to 4 in a three-month period (followed because I did have BPH, and the PSA increase was verified with a follow up and a second lab). The RP surgery proved the cancer had spread outside the prostate capsule so my diagnosis was changed to stage 3. I have, and continue, to receive what, to the best of my ability to judge, is excellent medical care and I have excellent insurance. My oncologist, supported by post-surgery pathology, believes that all the cancer was removed. At six-months post-surgery, my PSA is ND. I do recognize that in many, many ways, I’ve been exceedingly blessed.

I have no idea how to communicate the loss that my wife and I both feel, other than to say that it hurts. Our hurt in no way diminishes anyone else’s pain. But it is real. We have benefited from joint counselling post-surgery. Depression meds (for both of us) have helped.

I am as “comfortable in my own skin” as I know how to be, take responsibility for my health where I can, and continue to work full-time now that I’m past my initial recuperative period. I provide for my family and provide emotional, intellectual, loving support for my family. I ride my motorcycle regularly. My youngest daughter and I rode our bicycles in a 20-mile fund-raising event for the American Diabetes Association. I’m training for my first 5K running event in support of funding for PrCa research. I try to be supportive to others through this forum and our local chapter of Us Too. I meditate daily and do yoga on non-running days. I share the housework and read to my vision-impaired wife. She and I do enjoy intimacy and I’ve tried to be a sensitive and giving lover within my current capabilities. But our loss still hurts. It hurts her and that hurts me. And, deep down, there are the fears voiced by Henry (Explanatory note here -- Henry voiced fears on Facebook that his wife would leave him for a more capable lover) —and I do not mean to slight my wife nor disrespect her in any way when I voice this. I believe that if you have not suffered the loss of something that, for your adult life, has been part of your being and part of what you could offer in a loving relationship you probably don’t really understand. And for that, you must be forgiven.

So, Patsy, what is a real man?  And how can anyone define that for any other person?

I await her reply.

Positively EZ or easily positive?

October 20, 2015

My biopsy was collected on the afternoon of September 24, 2015, by Dr. Duffey in the urology clinic at the Brooke Army Medical Center (BAMC) within the San Antonio Military Medical Center (SAMMC). As I dressed afterward, Dr. Duffey said, "Make an appointment to come back in two weeks. I don't share results over the telephone -- good or bad, I do it face to face."

My appointment for receiving the results was made for the afternoon of October 8th. It was a convenient time, as I already had an appointment scheduled at the ophthalmology clinic on the morning of that same day. For at least 10 days prior to my appointment I found that I was unable to accomplish anything and could not concentrate for 10 minutes. I couldn't read, I couldn't write, I couldn't watch TV or a movie. I did not know why until I realized that at some level I was frightened. Upon that realization, I went and talked to a friend, really opening up. That helped.

I checked into the urology clinic after lunch on the 8th and was directed to the waiting area to see Dr. Duffey. As I sat on the slippery vinyl I tried to anticipate my appointment and receiving the feedback that the biopsy was negative. I mean, after all, I'm not sick, I have no pain, must be no problem, right? What, exactly, would I tell my family? Would I write about it in my blog? Would the doctor ask me to repeat the biopsy at some future date? With these thoughts in my head, I drifted into a light sleep.

"MR. MOYES!" Oh. My name. My appointment. Shaking my head to awaken, I stood and received my direction to Dr. Duffey's office, where I was greeted and seated.

Dr. Duffey did not mince words: "Your biopsy was positive."

There was more; a lot more, and I think I actually recall most of it, but I don't need to write about it here. The summary: of fourteen needle biopsy samples two were negative for cancer, four were questionable, and eight were positive. Of the eight positive samples, some had as much as 60% of the cells cancerous. This cancer, prostate cancer, is rated for risk using something called the Gleason Scale rated from 2 - 10. I recall that Dr. Duffey was professional, positive, and kind. He had earlier, before the biopsy, explained carefully that prostate cancer is not a death sentence -- it is generally not aggressive and most men of my advanced years that are diagnosed with prostate cancer die with the disease, not of the disease. And it is common: nearly half of the men who reach their mid-60s will have prostate cancer. With a Gleason score of 7, I am a patient of "Intermediate Risk." Dr. Duffey outlined my options: (1) Watchful waiting; (2) Prostatectomy by surgery; (3) External radiation therapy; (4) Implanted radiation "seeds." I, the patient, must decide which course to follow.

• Option 1, watchful waiting is not a good choice for a Gleason 7, Dr. Duffey says.
• Option 2, surgery is Dr. Duffey's choice, but he is a surgeon and admits to prejudice here.
• Option 3, external radiation is, he says, also a good choice and tells me I'll consult with a radiation oncologist before I make my decision.
• Option 4 is not done at BAMC.

So that leaves options 2, surgery, or 3, external radiation. Dr. Duffey assures me that I don't need to make the decision right away but again stresses that I will have to make the decision. He explained that I (and my wife) would be enrolled in their comprehensive prostate cancer clinic whereby we would receive broad counseling from every medical and helping specialty known to man. I was introduced to Janet, who runs the comprehensive cancer clinic and she enrolled me (us) and gave me a verbal overview. In addition to the counseling, we will meet with survivors and current patients and have group sessions. Our first appointment for the comprehensive clinic is scheduled for the 28th of this month. Only after meeting with and being briefed by surgeons, radiation oncologists, nutritionists, psychologists, financial counselors, and the kitchen sink will I have to decide on a course of treatment. I left the clinic on the eighth of October with a bagful of reading assignments: books, leaflets, pamphlets, sheets, and a long list of internet links.

So, I have cancer. Cancer that is common and is not normally considered to be aggressive, not normally considered to be fatal. But my particular cancer is on the more aggressive side of the scale for prostate cancer, hence the Gleason score of 7. I have cancer. It does not have me.

I will have to make a treatment choice. Right now I'm leaning toward the surgery, but I won't make a final decision until after I speak to the range of counselors. Modern surgery is much less invasive than in recent past years. They use an orthoscopic technique with robotic assistance. The doctor says convalescence is normally comparatively short and most men are back to full function within about three months. Some men experience a loss of sexual function with the prostatectomy. Some don't. There will be other side effects with surgery and with radiation therapy. We will deal with those as needed. This is so new to me, because, you see, at age 65, I've never had any invasive surgery; never been hospitalized, and rarely ill beyond a head cold, so I've been blessed up until now. I did have a small skin cancer removed from my upper back a couple years ago, but that was outpatient, quick, and painless.

Now I'm reading the book, "What helped me get through" written by and about cancer survivors. I have shared the news with close friends and family. I don't see any reason for this to be a secret, but I don't think the world needs to know, either. But I need to clarify my thoughts, and writing is one way I do that, so I'm writing. I'm working. I'm scheduling and attending events with my family. I'm enjoying things that I want to enjoy.  I've also told my three sons that they are at increased risk of prostate cancer (their uncle, my eldest brother, is a prostate cancer survivor, so the tendency is definitely in the family) and advised them to ensure they talk to their doctors and get their checkups.

Over the next weeks (months?) we will be busy with appointments and procedures. We will deal with it and do what needs to be done. I thank our Father in Heaven for the good years I have had and for the good days I am having now. My last two blog posts are about family and friends time. It seems sweeter now than ever before and I am thankful. Friends and I are working on an idea for founding a nonprofit organization that should do a lot of good. I am thankful for the opportunity to contribute in a small way. I think I'll take the initiative to do my home teaching, visiting the few families in our ward congregation that I've been called to minister to. I am thankful for that opportunity.

And with this, and for now, I wish you all well. Guys: Talk to your doctor. Have your exam!!

2009, so far...

Let me tell you about 2009 so far.

Everyone knows about the economy. Nothing need be said, here, about that, except to mention that we have not been immune from cuts in income and losses to our retirement plans.

March 2, 2009. My wife’s mother passed away. She was 79 and had been ill and declining for some time. While not a big surprise, you can never be truly prepared. My beloved wife of 40 years, called G here, and our youngest daughter flew to Idaho for the services. G still grieves and occasionally becomes very blue and weepy.

April 10, 2009. G had a stroke. While driving. After her loss of consciousness, she struck another car. Her car slewed to the right and rolled 1 ½ times, coming to rest on the roof. Amazingly, no one was seriously injured in the accident, although our car was totaled and there was damage to two other cars and some minor injuries. My wife’s injuries from the accident were limited to minor bruising from the seat belt. She is recovering well from the stroke and has no paralysis or loss of speech, but she has suffered some loss of vision and of skills and memory—and these losses are painful to her. She cannot drive now and has had to close her business, with the loss of income and pride in self-determination that brings. Our insurance paid off the loan on the car. All in all, it could have been so much worse.

She was hospitalized for a week after the event, mostly for follow up of the stroke. During her medical care, the doctors found an enlarged thyroid which may be cancerous. We are still working on the follow up and tests for that. Many medical appointments have been on our calendar. Since she cannot drive any more, I have had to take time off work to drive her or arrange other transportation. We don’t live on a bus line and a one-way taxi ride to our medical facility is about $50.00. Thank God for our good medical insurance.

Also April 10, 2009. G’s step mother fell on her front step and hit her head on the concrete. She had to be air-evacuated 160 miles to a hospital in Boise where they operated to remove clots from her head and relieve pressure on her brain. She required several weeks of in- and out-patient convalescence. She is 85, and is doing well now. I hope my Father-in-law has good medical insurance.

While G was in the hospital, between visits to her and my work, I struggled to complete our IRS forms. Last year I had under-witheld and had to pay a large amount when I filed my taxes. So, I increased my withholding in April of 2008. But not enough. This year, even though I’ve not had a raise, the additional amount I had to pay was even greater ($3500 on top of what had been witheld) plus I had to pay a penalty for underpayment. So I called my company’s HR department and again increased my withholding. The very next day: the Obama administration announced reduced withholding as a “benefit” to workers and part of the Stimulus Plan. My withholding has actually gone down as a result. So next year will probably be a replay with underpayment and penalty.

On the first of May, we received a letter from the State informing us that we had been accused by an un-named party of sexual abuse of two of our grandsons. The letter explained that an investigation had been completed and the charges were found to have no merit and that we could write to request the records be destroyed. We don’t know who filed the false charges, but we have our suspicions, and, if true, the scurrilous action, taken as revenge for imaginary wrongs, does not bode well for family harmony. We have not seen those grandchildren nor their mother since the end of March. G has taken this especially hard, and we are now seeing a counselor to learn how to deal with the grief of our losses this year and this hateful false charge against us. Had the investigator not had the integrity to publish the true findings, if she or he had had an axe to grind or a name to make, the false charges could have literally destroyed our lives. I wonder if the person who filed the charges has any idea of the potential impact?

On the morning of May 5, on my way to work I stopped at a stoplight. The 20-year-old girl, texting as she drove the car behind me, did not. She was doing about 30 when she hit me. I was on my motorcycle. The 1-year old customized 1300 cc V-Twin was totaled. But it could have been so much worse. I was not hurt at all—did not even have any stiffness the next day. But I miss my bike. Her insurance paid off all but $432.00 of the loan, so the debt is gone, but so is the bike. After nearly 45 years of driving with only a couple of minor accidents, we have totaled two vehicles in less than a month.

In mid-May, we had our home air conditioner serviced before its summer workout. The technician found a Freon leak in the inside air handling unit. So that had to be replaced. Another $3500 gone.

At the end of May, G received the settlement from her Mother’s estate: $12,000 from her Mother’s traditional IRA. Now since it came out of a tax-deferred IRA, it becomes a “taxable event,” meaning we would owe taxes and penalties on the total amount. To avoid having to give the IRS about a third of her inheritance, we chose, at the advice of our broker, to put $6,000 dollars each into our own IRAs, thus canceling out the taxable event. I gave the broker a personal check for $12,000 having deposited the cashier’s check from the estate into our joint checking account. At the time of deposit of the inheritance check, the teller said they would make an exception to the 5-day hold rule for deposited checks, since we have been with the credit union for nearly 40 years and have a good record, and it WAS a cashier’s check, after all. Guess what. When my personal check for $12,000 was presented for the deposit into our IRAs, it bounced because the $12,000 deposit was on hold. Result: who knows? So far fees and embarrassment and no resolution. This was the biggest check I've ever written--by far--and it bounced! Oh, the shame. The credit union did refund their fees on my account (after I complained) but we don’t yet know what the other financial institution is going to do. It’s been two weeks and I’ve not yet heard from them. Our broker is not returning my calls.

Still, we have so much to be thankful for. We have each other. We have our faith and a God we feel good about praying to. We can still pay the mortgage and utilities. We have one good working vehicle and it is licensed, insured, and inspected, and has good tires and a full tank of gas at the moment. The pantry is full and the (new) air conditioner keeps us comfortable. We sleep soundly at night, comfortable and relatively secure. We launder our clothes and bathe in fresh, clean, heated water. We even still have 200 TV channels of nothing to watch, internet, and a Netflix subscription. We are breathing, upright, walking and talking. We have many loving family members (and maybe one that is not so loving) and a number of very good friends at work, in our neighborhood, and at church. As tough and frustrating as this year has been, so far, our lives are still better than most alive on this earth today.