More rebounding: Little Si Again

Memorandum: May 30, 2017

Today I'm not writing a letter to Tracy because Tracy was part of the event. The two of us climbed Little Si, the first real hike since I climbed Little Si on April 11. Last time it took four hours to reach the top; this time it took two hours. My knees were a little weak, and I was tired afterward, but I'm encouraged. Normally what takes 90 minutes took only 120 minutes. The day was a cool 60 degrees or so and I was able to complete the hike with a minimum of eating and moderate water. I had hot flashes and had to rest at times, but this was a triumph compared to the difficulty of just climbing from Alaskan Way to the Condo via Madison Street. My pack weighed under 20 pounds.

In June I hike the Canadian Rockies near Banff. I feel up to it.

Recovering stamina

May 21, 2017

Hi, Tracy,
This week I'm starting to focus on restoring stamina. Yesterday I hiked 2.6 miles round drip to Recreational Equipment Inc. to use up a rebate coupon to purchase camping supplies. The climb up Denny Way isn't that long, but I felt myself worn down by the walk back home.

And last night I went dancing with a friend. I found myself surprisingly weak and sitting out several dances. Before the evening was over, I was soaked with sweat. I think the weakness from my treatments has discouraged me from getting enough exercise, and that this has led to a decline instead of a recovery from the radiation and hormone-blocking treatments. So I believe it's time to stop recuperating and start exercising.

June 4-11 I plan to be hiking in the Canadian Rockies near Banff. Between now and then I'm going to try to get in a small hike every day to recover my stamina. And when I return from Banff I intend to hike regularly the remainder of the summer.

Love,
Dad

Collateral damage: $237.44 light bill

The May light bill is three times the level of the previous year.

May 13, 2017

Hi, Tracy.
Just when you think the story is winding down, another shoe drops.

Most of the effects of the Lupron shots and bicalutimide pills, as well as the radiation treatments will have worn off by the end of this summer, but a collateral effect has shown up in the form of a humongous bump in my City Light Bill.

What's that got to do with cancer treatments? It's the "manopause" I've undergone as my internal symptoms responded to hormone blocking and radiation effects. You know that I've had hot flashes followed by cold sweats, but I haven't told you how I coped with them. First of all, in February and March I spent most weekdays around the house, and I wasn't gone hiking on the weekends. That was coupled with a lot of time spent at the computer -- sometimes dawdling, sometimes being creative, and sometimes spent on a class on Web design, well after the radiation treatments ended.

That was matched with chills that I alleviated with help from my space heater -- and hot flashes, which I mitigated with a small table fan. Sometimes I would turn off the space heater, take off a wrap, and then turn on the fan because I became chilled. Sometimes I would turn off the fan and turn on the space heater -- or grab a wrap.

Electrical heating and cooling affects your usage of electricity. When my electrical bill arrived (the image at the top) the tale was told. My electric bill had tripled over the prior year. It probably didn't help that this was a record year for rain.

Love,
Dad

The ambiguity of remission

May 8, 2017

Hi Tracy.
This is an update from my follow-up consult of May 4, illustrating that there's always something else to think about.

The small print on my "report card"

After the exit interview I took time to read the paperwork they provided me on the way out the door. At the bottom, there was this phrase:

"Cancer of prostate w/high recur risk (T3a or Gleason 8-10 or PSA>20)

That got my attention, and I sent off an e-mail to my  physician's assistant. My question was:

I remember (that) once before my numbers indicated I was stage 3, but you told me that this was likely due to my high PSA, which was likely distorted by my enlarged prostate.
So my question is, do I fall into a catetgory with a high recur risk, or is this a result of a computer algorithm that doesn't really apply in my case? How should I interpret that phrase?

And here is the clarification:

You are still considered to be high risk based purely on the numbers; however we suspect you are more likely a favorable candidate and that is why we only did a short course of hormones instead of two years of shots.
For diagnosis purposes we have to put in the high risk. It is difficult to squeeze you into a specific category because of the low risk Gleason and the high risk PSA.
Your report card is that you have an A.
You responded well to the hormone blocking injections, hormone blocking pills and the radiation as evidenced by your dramatic drop in your PSA.
I would recommend you interpret this as you were in a high risk category, but did not quite fit into that full bell curve of that, so we believe you will likely fare better than other gentleman with a high risk prostate cancer (for example Gleason 8).
Hope this helps.
Take care.

Making ends meet

Many years ago you gave me a present -- a small wooden desk sign with a brass inset that said, "Just about the time you think you can make ends meet, SOMEBODY MOVES THE ENDS.

It's still sitting on the roll-top in the apartment -- a reminder that the only certainty in life is its uncertainty.

But I'm feeling good.
Love,
Dad

Follow-up consult

May 4, 2017
Hi, Tracy.
Today was my follow-up consult following the end of my radiation treatments March 28 and my blood draw that showed such good results. Now we just watch and wait. This high points of the interview:

• The hot flashes and night sweats could continue for a few weeks or perhaps up to 6 months.  (I'm having a hot flash as I write this, and my arms and face have become damp.) The fact that I can arise from a chair easily indicates my strength is returning, but I still have periods of weakness, particularly when I have hot flashes. Since I have no significant other at this time to entice me, I have not taken the measure of the other side effects, although I'm confident that I could interview for a position as towel attendant at a harem shower room and be pretty sure of landing what now would likely turn out to be for me an insufferably boring job.
• The precision radiation has meant that my bowel and bladder have fared well. It's still possible for my urethra to develop scarring, and there are treatments for that, if they should occur.
•  My urinary tract infection seems to be gone, yielding improved control. I can taper back on the Flomax.
• The Lupron shots and Bicalutimide pills had both the effect of preventing testosterone from feeding the cancer and also fighting the cancer as well as a type of chemotherapy. They, along with the radiation, have killed the cancer cells. There's the possibility that all cancer cells were eradicated, or that those that weren't don't have an environment that will nourish them, and they will not survive. The prostate's ability to produce PSA and generate seminal fluid is reduced, and a share of the mass is now represented by scar tissue. It's not the same old prostate.
• My PSA will likely rebound slightly. If it gets up to a score of 2, it's something I should pay attention to. That would be 100 times its current level.
• Around Halloween I will have another blood draw to measure my PSA, after which I will consult with my urologist.
• I remain a little lethargic; I take afternoon naps; and I have gained weight. I'm going to do something about that.

Love,

Dad