Cancer KMA: Part One

My doctor put on his most somber face.  In that instant I read his mind and heard the words before he said them out loud:

“You have cancer.”

That’s when things got really interesting.  But let’s go back a few months first.

Four o’clock in the morning and I have a pain in my lower abdomen like nothing I’d ever felt.   Sheer agony.  No cramp or bruise or broken bone had ever felt like this.  I postpone my morning bike ride, which I don’t do unless the Apocalypse is well under way.  It must be my appendix on the verge of bursting, so it seems wise to make a trip to the hospital.   Call 911?   Tough guy.  I drive.

In the emergency room, a nurse watches me hobble through the lobby and smiles.

“Kidney stone.”

A couple of days in the hospital.  It’s the weekend – I work from my laptop.  Don’t have to miss any days in the office.  At one point a guy comes to my door.

“Hi, I’m Dr. XXXX (that’s not his real name – you’ll see why…).  Let’s give you a prostate exam!”

Wow, and he doesn’t even offer to buy me a drink.

I go home.  Turns out I had managed to give myself a kidney stone.  Here’s the recipe: Bike like a maniac in the morning and replace most of the five pounds of fluid you lose, then lift in the evening and, if you’re really nuts, throw in an extra bike ride at night to burn off the extra energy.  Oh, and don’t replace those fluids because it’s late and you don’t want to wake up in the middle of the night to pee.  Repeat for a few months until your kidneys are just begging for fluids.  “Please, give me some water, you moron, or I’ll grind almost to a halt and make a stone.”

I’m pretty sure I heard my kidneys telling me that, but thought it was the neighbors fighting.

That was Funny Thing #1.

Funny Thing #2 happens six months later.  On my way to an unrelated appointment, I pass a door with big letters spelling out the name of…Dr. XXXX.  I had no idea he existed anywhere but at the hospital.  So I stop by to look at the report.

The nurse shakes her head.  “If he saw you in the hospital, then you have to make an appointment – the records need to be sent over.”

I make the appointment for the next week and come back.

I sit down with Dr. XXXX.

“I’m glad you came by, since the exam I gave you  six months ago was abnormal.”

I figure he means he gave me an abnormal type of exam, or he behaved abnormally during the exam.   Turns out he meant the results.

“I’d like to do another exam.”

Cavity search number two!  Still no flowers or dinner first.  The results are similar.  Stern look and “I’m finding abnormality.”

“When you say ‘abnormal,’ do you mean two out of three guys have something a little unusual and I’m one of them, or do you mean ‘that’s some weird stuff I felt down there’?”

Straight faced, “I’d like to do a biopsy.”

Have you ever had a prostate biopsy?  It involves five people including a “pre-med student” – isn’t that a college sophomore??? – in a room the size of a large toaster and me with my butt hanging off the edge of a small exam table.  Oh, and a tool that is like one of those geologist’s devices that takes core samples from rock.  That’s right, “core samples.”  Let’s move on.

Biopsies just sound bad.  No one ever ordered a biopsy of a sunny day.  Biopsies  happen because some doctor somewhere thinks something is WRONG.  And they don’t know right away what is wrong.  They send the damn stuff ripped from your body to Johns Hopkins on the other side of the country and wait a very long week for the results.  Okay, fine.  Worst case scenario was a little prostate cancer.  The old saying is that no guy dies from prostate cancer and  most of them die with it.  Uh, wait – that’s for old guys.  I was 48.  Thirty years early for the “don’t sweat it” approach.  But what the hell – I’m as healthy as a horse, strong as a bull, with Olympic lungs.  Invincible.

The next week I’m at work, heading out to lunch with a colleague.  My cell rings and I recognize the number.

To my colleague: “Hey, can you give me a minute?  I’ll meet you in the lobby and we can walk over to Burritoville.”  I go every day.  I mean EVERY day unless a colleague talks me out of it.

I step into an office and take the call.

“Hi, this is Dr. XXXX.”  (Still not his name).

Pause.  “Okay, I’ll assume that pause means you have my results.  What did they find?”

Shorter pause this time.  “I’d like you to come in to discuss the results.”

Big sigh from me.  I’m not interested in drama.  “I assume that means they found something, or you’d say otherwise.  Let’s skip the soft landing – is there cancer?”

I can feel him starting to pause but he interrupts it.  “Yes.”

Okay, that’s a start.  “I’ll make an appointment, but let’s cut to the chase.  Is it bad?”  I assume the answer will be some version of “no,” so I’m surprised when he says:

“There were cancerous cells in most of the samples.”

Now, “most” is somewhat meaningful here because the industrial-strength, diesel-powered boring tool they used to excavate my prostate during the biopsy takes twelve samples.

The burrito that afternoon tastes a little bland.

Back to the doctor’s office.  We look at pictures, read reports.  Prostate cancer, pretty far along.  There are good treatment options, etc.  Oh, but first we have to see if it’s spread.

Spread?  Turns out that you’ve got two options.  Option 1: the cancer is only in the prostate.  Treat it.  How aggressively depends on how far along it is.  Option 2: the cancer has spread beyond the prostate.  That’s unpleasant.  When people die from prostate cancer, it’s because it spread.

“Hmm…so which is it for me?”

Of course, there’s only one way to find out – scans.  Brain, bone, organs, luggage.  How worried am I at this point?  Honestly, not very, but one thing is very much on my mind.  If it hasn’t spread, we treat it.  It’s all business, no matter how far along it is.  But if it has spread, I’m going to have to tell my kids that their daddy might not be around for…well, everything they do for the rest of their lives.  Now I’m getting a little pissed at this cancer crap for potentially causing my kids suffering.  Unacceptable.  If someone causes my kids pain, they are in for a world of hurt from me.  No exceptions.  Prostate included.

So we scan.  Results come back.  The cancer is knocking at the door – it WANTS to get out, it’s TRYING to worm its nasty little self out of my courageous prostate, but it hasn’t.  Not yet at least.  Funny Thing #3: if any of this had happened a few months later – the kidney stone, the unrelated visit to the office – someone else would be writing this because I’d be…uh, gone.

But that’s not what’s going to happen and I like the odds now because it’s business – treat, recover, move on.  And the conversation I’m going to have with my kids is very different.

Quick side note here.  If not treating it like a life-threatening, world-changing, terrifying event sounds blasé, that’s because, as anyone who knows me will attest under oath, I am a bit of an odd duck.  I care about two things: my kids, and getting things done.  In that order.  The first is covered at this point, and the second is on deck and ready to bat.  Freaking out won’t help.

Come back later and read the rest.  And by “rest” I mean finding the right doc, having surgery, recovering, and trying to set speed records for it all.  Shooting for the Guinness Book.  For me that’s the interesting part of the story.  It was something I could DO, something I had control over.  It was time for CancerKMA (that’s right: Cancer – kiss…my…ass!).


Murder In Mind at Amazon

Murder In Mind at Barnes & Noble

A Twisted Path at Amazon

A Twisted Path at Barnes & Noble

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