Cancer KMA: Part Two

Quick recap: too much exercise leads to a kidney stone that instigates an exam that reveals cancer that would have remained undiscovered if chance and the universe hadn’t intervened.  On tonight’s episode, which is a little anticlimactic because we already know the protagonist isn’t going to die, we follow his escapades.

I’m having a chat with Dr. XXXX.  What are my options?  What’s the recovery rate?  Does it return/metastasize/lurk for years?  I’m hungry for data, because that’s how I do it in the real (non-cancer) world so why should this be any different?

Dr. XXXX only performs the traditional surgery – slice open your belly (“belly” is a little diplomatic) and cut out the prostate.  In the old days, they’d cut right through the nerves the prostate rests on.  Those nerves are…important.  VERY important.  Nowadays, they engage in “nerve sparing” surgery.  That means instead of just buzz-cutting through the nerves, they try to gently remove the offending organ while leaving the nerves intact.  Like peeling a soft-boiled egg out of a shell.  Sometimes that goes really well.  Other times, you get shreds and yolk and a lousy breakfast.

The main problem with the traditional surgery is the recovery time.  Weeks and weeks, because a big, wide slash through muscle doesn’t heal overnight.

“HOW long did you say I’d have to stop working out???”

Dr. XXXX describes a second approach.  “A few years ago, a machine called the Da Vinci became popular.  It makes a series of smaller incisions and the surgeon operates robotic arms to remove the prostate.”

I’m picturing Tom Hanks and some crazy albino guy hunched over me in the operating room (Da Vinci Code?).  But I’m in, because smaller cuts means faster recovery.  Buh-bye, Dr. XXXX.

Good news: City of Hope is one of the top cancer hospitals in the country and is under an hour from my home.  More good news: One of the best urology oncologists with vast amounts of Da Vinci experience is there.  Bad news: The hospital is full of people who have real, deadly, how-long-am-I-going-to-live cancer.  Not my wussy little one-organ cancer, the kind that hasn’t spread and is totally treatable.  Still, I’m fortunate to be part of this exclusive club of people getting extraordinary treatment from the best in the biz.

On my way out to COH I notice a small sign on a post.  Simple, unobtrusive, guiding, it says City of Hope.  This doesn’t qualify for Funny Thing #4, but for the first time, I get a little emotional.   Just a lump in my throat and that misty feeling you get in your eyes when you see your kids do something unexpected and loving, or when there’s a touching scene in an otherwise stupid movie and you weren’t expecting to be moved.  I let it wash over me, blinking a little, and maybe because I give it its due it goes away.

Free valet parking at the cancer hospital on your first visit.  Very cool.  I’m Platinum at Starwood hotels and don’t get free valet parking.

The hospital processes me efficiently and quickly.  This isn’t their first time at the dance.  Blood, vitals, etc.  Then I meet with Dr. Kawachi, renowned fixer/genius/Mother Teresa/real Da Vinci of prostate cancer.  I’m not sure what I was expecting, but he didn’t match it.  Sweet, gentle, almost wizened man.  Soothing voice, matter-of-fact and a listener.  I start asking him questions – standard recovery time, ways to minimize recuperation, angle of entry of the blades on the Da Vinci.  His tone doesn’t change, his demeanor remains gentle, open, helpful.  He drops any hint of needing to hold my hand and assuage me.  He goes along with me as I do what I do – gather data.

“Let me tell you a couple things so you understand.  I want the fastest possible recovery – anything you can do toward that, do it.”

We have a very clear conversation.  No BS.

“Well, if I make the extraction incision a little lower than usual, I won’t cut as much muscle.  That should help.”

I like this guy.

“I trust your judgment to do what works, and to balance that with the fact that I plan on breaking records to recover.”

We talk about typical recovery times – a couple weeks off of work, longer before I can work out.

“Nope.  That’s too long.”

He smiles.  I smile.  We set a date for the surgery.  It’s soon – the cancer keeps knocking at the door.

A couple weeks later, I go back to COH.  Dr. Kawachi’s only flaw: he does surgery on Friday, not Saturday, so I have to take a day off of work.  Early in the morning they’re prepping me.  The anesthesiologist reads my note where I explicitly tell him to use the minimum amount of drugs necessary to keep me under (that stuff stays in your system – I don’t want to have to deal with the extra time!) and promptly labels me (silently) a pain in the ass.

A couple hours later I wake up.  A little sore.  Turns out the Da Vinci truly is a work of art.  I look down at my “belly”.  Seven incisions, all an inch or smaller.  One for the light , another for the knife, another for the grabber to rip my prostate out, and a couple for…I don’t know, alien probes.

Then I look up and my ex-wife is sitting there.  I assure her I am alive and the life insurance will not be paying out yet.  Her disappointment is palpable (okay, quick confession: that last bit is silliness.  My ex-wife – let’s call her “Robin” – is one of the best people I know.  We amicably co-parent and she remains my emergency contact, and vice versa).

Dr. Kawachi stops by.  We have a little chat.

“It’s good if you can get up at some point today and walk around a little.”  He puts his hand out as I reach to lace up my running shoes.  “Just a little walking around the hospital.”

Then we get down to business.

“How aggressively can I push recovery?”  In fact, I ask half a dozen questions along these lines just to make sure he knows what I’m saying.

His answer is perfect: “Pain is your guide.  You won’t do any damage if you use pain as your measure.”

Did I mention I like this guy?

I take a couple dozen strolls around the hospital and I’m ready to go home.  My pal Christine – who is more familiar with cancer than anyone should ever have to be – is there along with Robin.  They’re going to drive me home – hospital rules.  Fat chance.  I’ll drive.

One complication: following my little surgery, I notice there is a hose attached to my “nether regions”.  It is a catheter.  If you don’t know what that is, I’m very happy for you.  One of the reasons they don’t want you to drive yourself home, aside from the obvious, is they are concerned you might have to slam the breaks on and in the lurching of the car, rip out your catheter.  If you think a prostate exam is invasive, yanking out your catheter makes it look like a holiday.

I don’t plan on slamming on the breaks.  After some negotiation with Robin and Christine (and some subterfuge [lying] to the hospital staff) I agree to permit Christine to ride in the passenger seat in case I pass out.  We make it home safely.

Time for another break…Part Three below.


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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