I Miss My Bike

Weather here is supposed to be 70 degrees and sunny today. Days like this would be great to bring the bike to work and go for a ride at lunch. I suppose I'll settle for a walk. I miss my bike.

My Own Little Victory

The question of which Pennsylvanian has it worse, me or Ben Roethlisberger, has been raised. Here is my analysis.

Ben: Riding his motorcycle in June when he T-boned a car and crushed his jaw.
Me: Riding my bicycle in August when I was hit and run by a pickup truck, scraping the entire left side of my body in road rash.
Loser: Ben Roethlisberger

Ben: Diagnosed with acute appendicitis; emergency operation to remove the appendix.
Me: Diagnosed with testicular cancer; emergency operation to remove “Lefty”
Loser: I think we can all agree this one is Me

Ben: Concussion knocks him out of commission, still shaky on his return; throws four interceptions and loses AGAINST THE RAIDERS
Me: Bronchitis knocks me out of commission, but I work from home and still manage to close a deal
Loser: Ben Roethlisberger

Ben: Backup comes in and performs admirably; people begin calling for Charlie Batch (!) to replace him
Me: As long as I’m closing, I’m golden
Loser: Ben Roethlisberger

How about that! In the final analysis, as bad as I had it, I am not even the worst-off person in Pennsylvania. How refreshing, that my life is better than last year’s Super Bowl Champion quarterback.

It is finished...

I finished my radiation this week! I actually feel pretty good...check that...REALLY good (which is to say, normal). After the radiation was over, my body spent a couple days purging it. I was still very nauseous and had some "intestinal issues", but all in all, the transition has been easy. Also, I noticed the front of my abdomen didn't have any signs of radiation, but my back got a little burned.

Next Steps
Now I begin ten years of tests and follow up. Most protocols seem to indicate five years as a massive indincator of success, but people who work with testicular cancer say ten years is the REAL cutoff for total success. Either way, I'm just glad to be through with radiation.

Welcome to the Club
I had lunch, which I set up via networking and a cold call, with a prospective client. I had never seen him before, and when I met him, I saw he had lost the use of one side of his face. He sat down and explained he had cancer, and they had to take out the muscle controlling the side of his face because it had cancer in it.
"Yeah, I have cancer, too."
I felt bonded to him. We talked about our respective cancers for a while, and then moved on to business, but it was always there. We concluded by wishing each other well with continued recovery and good health.

I remember when I was looking for help when I first got diagnosed, and I turned to a very health conscious person who had cancer for his advice. Before he told me what I wanted to know, he started out with: "It sucks. But, welcome to the club."

Be Still....

I went to my General Practitioner yesterday. He did a couple of basic tests, asked me some questions and told me I had bronchitis. Basically, it means I have to take it easy for a couple of days, get lots of rest, and drink lots of fluids. As a Fish, the last one is easy, but the other two are a little harder. Still, after spending the entire weekend in bed, I figured a couple more days would do no harm. I have now watched more television in the last four days than I have since college.

I've also been reading, and am just starting Snow by Orhan Pahmuk. While I've just begun, I must confess I really like his style of writing. My friend Susan gave me a book after the surgery called Poetry for the Spirit, edited by Alan Jacobs, which has inspirational poems from the dawn of man through the twentieth century. I turn to it in times like this, just opening it to see what's in there. Today, I found this poem by Emily Bronte, the last words she ever wrote:

Last Lines

No coward soul is mine
No trembler in the world's storm-troubled sphere
I see Heaven's glories shine
And Faith shines equal arming me from Fear

0 God within my breast
Almighty ever-present Deity
Life, that in me hast rest
As I Undying Life, have power in Thee!

Vain are the thousand creeds
That move men's hearts, unutterably vain,
Worthless as withered weeds
Or idlest froth amid the boundless main

To waken doubt in one
Holding so fast by thy infinity
So surely anchored on
The steadfast rock of Immortality

With wide-embracing love
Thy spirit animates eternal years
Pervades and broods above,
Changes, sustains, dissolves, creates and rears

Though Earth and moon were gone
And suns and universes ceased to be
And thou wert left alone
Every Existence would exist in thee

There is not room for Death
Nor atom that his might could render void
Since thou art Being and Breath
And what thou art may never be destroyed.

I read something the other day (again, I had the time) from a book my friend Bill sent me (Cancer: Fifty Essential Things You Must Do by Greg Anderson)[Note: If you know someone diagnosed with cancer, I recommend getting them this book first. It is filled with practical advice, profound help, and incredible stories of healing and hope]. It said I must choose to live a healthy lifestyle. It doesn't necessarily mean I will be healthy all the time, but that I have the power to make choices that positively affect my health, every day, often from moment to moment. He also asked me yesterday about my "genie", the dark force that creeps out when you're not looking, not paying attention or just can't keep bottled up any longer. Actually, I've been keeping it at bay very well; between prayer, meditation and just learning to be okay with being still (the hardestof the three, I assure you). When the genie comes out, instead of shoving it back in, I acknowledge it, address it, and send it away with force. It holds no sway, because I choose not to give it power over me.

All things considered, my friends, in spite of the adversity slung my way, I am still doing quite well. I have also dipped into Job, and while his burdens were much greater than mine (can't even imagine!) I am getting an understanding of his character. Thanks, as always, for your thoughts and concerns, but rest assured, this too, shall pass.

Sick...

I think the radiation and the bike accident have simply worn me out. I got sick on Friday and have been pretty much in bed all weekend. It totally sucks, but what are oyu going to do. Off to rest....

Video of My Trip to California

It was all just a big misunderstanding, but I'm glad I lived to POST THIS VIDEO.

Slow and Steady...

...wins the race. I'm wrapping up my first full week of radiation treatments today. I am tired, and somewhat nauseous, but otherwise okay. I leave work, get treated go home and take a nap for about half-an-hour to forty-five minutes.

I am eating normally for breakfast and lunch, and midmorning and midafternoon snacks. Dinner hasn't been great for me, but I'm still trying to get something in at night. Had pizza last night because I had a craving for salt. It really hit the spot. I have lost about 13 pounds since the whole ordeal began, and am now at 190, which isn't bad (I'm 6 feet, so I'm almost at my fighting weight...Bernard Hopkins, BEWARE!). I'm not going to recommend this as a way to lose weight, but it has to be better than starving yourself to death(check out the woman on the magazine cover...UNCONSCIONABLE, as Cassandra and Lou pointed out!).

Everything is healing from the bike crash. The road rash has all but disappeared, exept for three holes where I must have hit rocks when I landed. They left two holes in my forearm and one on my thigh. I'm still stiff in my left calf, and there is bruising all up and down my left side (doesn't hurt, though...or perhaps it's just relative), but otherwise I am good. Took my bike to the shop, and while he couldn't declare it totalled, he did say the damage would adversely affect the handling of the bike, and that it was not repairable. We shall see how that goes with insurance...

I still have another week and a half to go with the radiation, but the end is in sight. Thanks again for your thoughts, well-wishes, phone calls, e-mails, PMs, and especially prayers. They are very much appreciated.

Maybe I was Misleading You...

Yesterday I posted this picture of a linear accelerator.


My friend Eric wanted to know if mine looked like this...If I was able to request other pictures...if I got to play Nintendo? The truth is: NO. Mine sits in the back of a dimly lit room, with no picture on the ceiling, no brightly lit machine. Mine isn't even new and shiny like this one. It's more like this artist's rendition, showing how one is rotated through different angles:


Okay, maybe it's not that bad...but it's not like the first picture, either...

Update...

Consultation
I went to Dr. Kottapally and got my measurements for the radiation. It’s kind of funny because I was expecting something high-tech and he took a CT Scan and then whipped out a Sharpie and drew the pattern on my abdomen. Basically, it’s a rectangle, about 4 inches across and 8 inches long, from the base of my sternum to just below my belly button.

I started the radiation treatments last Wednesday through Friday. It’s a fairly easy process. I showed up and Stephanie, the office’s cheerful receptionist, checked me in. I went in and met Tracy, Mark and Jeff, who introduced themselves as the technicians who will be responsible for my care.

I dropped trou and laid down on the table on my back. They covered Righty with a lead shield to keep him from harm and adjusted me so I was aligned with the target field for the linear accelerator.

I’m fairly certain they put the shield in the freezer about an hour before I got there. Nice… Then they left the room, zapped me from above, the machine spun on its axis and zapped me from the bottom (I call it "radz to da abz"; my wife called it "radz to da nadz"). It all takes about fifteen to twenty minutes and then I am on my way.

I felt pretty awful by the time Friday rolled around, as the effect of the radiation is cumulative. I didn’t feel much like eating, and I was really tired. Other than that, though, it was all right.

The Funny-Profound
One of the things I have been trying to do is to keep the whole thing from my eight-year-old daughter. We recently lost a neighbor to cancer, and I'm afraid the word “cancer” alone would be too difficult for her. When I got home, I took my shirt off without thinking, and she walked in and saw the marks Dr. Kottapally had drawn, including a cross right in the middle of my abdomen. I froze, but she just looked and said, “Huh! Holy Spirit” and pointed to the cross on my belly.
“That’s right” I said, confident she had the correct answer.

Dentist
I had a cavity, my first one in probably about 25 years. But of course I did. Normally, this would piss me off to no end, but now it’s just a cavity, one more thing to deal with.

My wife and daughter had perfect checkups, so that’s a great sign. Go GIRLS!

Life Catches Up...

I've been swamped lately, but more soon.

"Thank you Lord for thinkin' 'bout me
I'm alive and doin' fine."

--Five Man Electrical Band

UT PRO SLEEP...

I slept, finally, this weekend. An amazing ten hours on Friday, eight hours on Saturday and seven hours last night. It has made a world of difference. I feel clearer, lighter.

Turned Himself In...

The guy turned himself in after seeing a newspaper report that basically left nothing to the imagination with regard to what the police were looking for. The truck was exactly as I described it, and he drives that route to work every day. He said he was turning himself in because he "didn't know he hit a person" (Note: that screaming you hear might be an indication, Tom Druce. You might also notice the cars stopping behind you, people getting out of those cars, the bloody guy on the lawn...or, you could just gun your engine and take off, because it was a "sign") and saw the report, figuring "it was just a matter of time before they caught him."

It's been hard to shut it off.

Mondays Totals, and an Update...

Mondays Totals
Doctors seen: 2
Nurses/EMTs seen: 8
X-ray techs seen: 2
X-rays/scans: 12+
Needles taken: 4
Hospital facilities visited: 3

Update
I am feeling a little better today. I am stiff as a board, and my left leg hurts when I walk, but I CAN walk. Nothing broken, nothing strained, nothing sprained. I was concerned about my knee initially, just because I have had surgery on it twice. It is actually the sturdiest part of my leg.

My shoulder looks like it was sandblasted, and my forearm looks like a raw hamburger. My left thigh has a huge road raspberry on it as well, and my thihg is hurting, presumably from where the bumper hit me. My back also has some scratches and bruises on it. Showering was a bear this morning--water and road rash are a terrible combination...

No report on the driver, yet. The police staked out the accident site yesterday to see if he came back. It may have been a 91-92 Chevy S-10, because he lost a hubcap at the site, which the police were able to I.D. Time will tell.

I'm not even angry the guy hit me. Accidents happen all the time, and I'm fairly convinced that's what this was. At 6.30, the sun was fairly low and could have created significant glare at the scene. What galls me to no end is that he left me there.

I am getting around okay now, if a little stiffly. I'm going to try to pick up my bike this afternoon. I'm pretty convinced it's going to be totalled, but again, we'll see.

Tell Me Why, I Don't Like Mondays...Part 4

I went to Holy Spirit Hospital and they took me in on the gurney. It was just like those medical shows where you're looking up at the bright lights, but the bustle of doctors and nurses is way overdramatized. Matt and Joe, the EMTs, pushed me into one of the Emergency Room triage areas (For those that don't know, when a hospital is busy, they divide people up into three categories: Those that will make it, but only with immediate care; those that will make it, but they can wait; those that won't make it, no matter what they do. I was in category two).

Will, my nurse, came in and gave me the once over. We talked about the date, my name, my date of birth, losing consciousness...the kind of light banter that makes a nurse's night, I'm sure. He ascertained I was pretty much okay, except for the bleeding. I lay on the backboard, feeling different parts of my body seizing up. First my thigh, then my calf, then the base of my buttocks which sent shooting pain all the way down my left leg. At one point, I remember praying and asking God to take the pain away, if only for a little while. Miraculously, I felt it move away, like a tide. I thanked Him, and lay still, praying.

He hooked up my IV and started the drip. Another needle, this one in the right hand.

I asked Will if I could call my wife. He dialed the number, gave me the phone...no answer. I left a message. Then I asked if I could call my neighbor, which I did. As I explained in my earlier cancer posts, I live in the kind of neighborhood where everyone looks out for each other, takes care of each other. I explained what was going on, and asked her to try to call my wife until she reached her. My neighbor looked out her front door and saw my wife walking our dog.

For us, these conversations always go something like this: "Hi Honey. First, I'm okay...but I got hit by a pickup truck." I figure if my voice is the first one she hears, she'll know it's not too bad. She got to the hospital about fifteen minutes later.

She said my daughter crumpled into a sobbing mess when she told her I had been in an accident. I called my daughter immediately, and spoke to her, letting her know I was fine, was going to be alright, and had no major injuries. It's amazing the stores of strength God makes available to us in moments like this. I felt no pain, no fear, no anxiety--I just knew I had to make my daughter sure Iw as okay...and I did. One of the things my wife did was to ask my daughter to help pick out clothes she could bring to me at the hospital. My daughter picked the t-shirt I earned from my first triathlon--I love that kid! She also packed THE LION, because "it helps you be brave when you need to be brave." For those that don't know, my daughter, who is eight, has packed the lion in my stuff everytime I have had to take a trip. He has been to Tennessee, Belarus, New Orleans, the Appalchian Trail and more than a couple hospitals. He makes me brave because he reminds me of the strength of my family...

After about an hour (I think. Time is kind of fuzzy in situations like this), the doctor came in to see me. Note: If you get hurt on a Monday night, you KNOW you're not getting the Doctor from Johns Hopkins...or even the cream of the crop from your local medical college. The doctor walks in, looks at the television with a look of contempt, turns it off and starts asking me questions. Then he decides he wants me off the backboard, so he GRABS MY THIGH AND TRIES TO MOVE ME!
"AHHHHHH!!!!"
"Oh does that hurt?"
"YEAH!"
Joan said later she saw him start to reach for my thigh, but couldn't get the words out fast enough. She wanted to punch him when he did it. I think he made himself a mental note: ascertain full extent of injuries before trying to move patients. His bedside manner never did improve.

Then they gave me some morphine, which made me horribly nauseous. I ended up not throwing up, but it was touch and go for about 20 minutes. They gave me another drug that counteracted the nausea and I felt better. Eventually, I was wheeled to the Radiation Center for x-rays. Will came down to make sure I was feeling better. I thought it was a class move, very thoughtful. The head x-ray technician was actually really funny and engaging. He made me laugh for the first time since getting to the hospital, and his staff was equally enjoyable. They took shots of my arm, chest, thigh, calf, full leg, and ankle...probably eight or nine shots in all. At this point what's one or two more, right?

I got wheeled back to my ER holding cell and continued to wait. That's the other thing they don't show on medical shows. The interminable waiting. My wife was awesome, going up at various points and asking "What's next?" "What are we waiting for?" She kept the ball moving forward. I'd probably still be there if she hadn't done this.

They took some blood to run tests and make sure nothing was abnormal, and they also took a urine test. Another needle. Ummmm....right arm. Will looked at my arm and asked, "Did you have a shot already today?"
I replied that I had.
"Do you want to try the other arm?"
"No," I said. "I got a shot in that arm, today, too."
"Are you serious?"
"Yes."
Right arm it is...

After more waiting, it was time to get my wounds cleaned out. They were going to do stitches, but decided against it. The way they clean road rash is to pour a liquid painkiller onto it (which is in itself a misnomer, because the "painkiller" stings like hornet going on) and then get a scrub brush with the yellow disinfectant (betadine?). Will scrubbed the wound vigorously, apologizing. I just gritted my teeth and told him, "Do what you have to do." That included him digging in at various spots with a toothpick-like instrument to pull out blades of grass and gravel that were imbedded in my skin. Grit teeth. "Do what you have to do." Grit teeth. "Do what you have to do." Done. Mercifully. Done.

Then I had to wait for the doctor to come in and close things out. He came in again, looked at the television with the same air of contempt and shut it off. I think he was wondering who kept turning it on. After almost 5 hours of this ordeal, I really didn't care what he thought. On a funny note, I couldn't look at my wife because I knew I would start laughing at the doctor.
"How are you doing?" he asked.
"I'm ready to go home."
He asked, "Do you want me to wrap things up and go over them with you before we do that?"
I almost said, "Not really" but thought better of it.

He went over the procedures, asked Will to get some things, then almost dressed him down when he started to go get it before the doctor had finished his proclamation. After Will left, I told the doctor about the great care he had provided, the attention he had shown me. I'm not sure he heard it, but he needed to.

I stood up, and walked (hobbled) out of the Emergency Room, continuing my 39 year streak of never having to be wheeled out. My wife drove me home at 1.30 in the morning. It's been a long time since my bed felt so good.

Tell Me Why, I Don’t like Mondays…Part 3

One of the things I have missed the most since being diagnosed with cancer is riding my bicycle. I am used to putting in 100+ miles per week, pretty much year round, and this time of year is my favorite. The cooler weather makes it ideal, and I thought today would be a beautiful day to get out and ride. My wife wanted me to go to the mall with her and my daughter, and ride the trainer tonight, but I said no. I wanted to get out and feel the fresh air on my face. And besides, this was my first ride in more than a month, since the orchiectomy, the cancer diagnosis, the recovery, and everything that went with it. I finally felt comfortable enough to ride.

I took off, feeling pretty good. Hills were tougher, and I could feel where my fitness had waned, but all-in-all, I felt really strong, if for no other reason than I was out on my bike. I decided to take a local loop I do, which is a little less than twenty miles and not very hilly, feeling it would be a easy one to complete. Just enough to get out and stretch the legs, really (non-bikers are always amazed at statements like these, but 20 miles really is a “warmup-and-get-your-legs-under-you” type of ride for many riders, especially those that average 40+ miles per ride).

I was riding and starting to feel my rhythm when I felt this surge from behind me, lifting me up and off the bike…there was an intense cracking sound, metal on metal, metal on plastic…I felt a huge pain in my left calf…I was flying through the air…I yelled really loud…then I hit the pavement on my left side…had a split second of clarity and sprung to the grass on my right side…and came to a stop.

I had been hit by a pickup truck. The driver came to a semi-stop, ostensibly realized what he had done, then took off. I lay on the side of the road, afraid to writhe, in considerable pain.

The driver behind the truck stopped and called 9-1-1, and the driver two cars back was an EMT named Mike. He jumped up to me and started asking me questions which allowed him to ascertain my condition and made me think about the questions instead of the situation, both of which were good things. I get the sense he knew what he was doing on both counts.

The ambulance arrived (note: not the Wahmbulance—if you get hit by a car and you’re on a bike, it’s not whining), and Joe and Matt hopped out. They asked me the same questions Mike asked, and presumably compared notes to make sure my knowledge of arcane subjects like my name, date of birth, age and the month of the year all matched up. They put me in one of those neck collars, as a precaution, and put me on a backboard.


They loaded me into the ambulance and asked me what hospital I preferred. I was unsure of the extent of my injuries. I was fairly certain nothing was broken, in spite of considerable pain, but didn’t know about internally. Nothing felt wrong, even when they pressed on my spine, belly and skull. Still, in a moment of clarity, I picked the one closer to home, in case I had to stay overnight and my wife need to make hospital runs.

They got me there quickly enough, but I felt every bump in the highway…and there were a lot. At this point I began doing my own assessment of just how bad it was. I felt a really deep bruise into my left calf, I was sure I had road rash underneath my shorts on my left side. I felt wet on my arm, so I was pretty certain the road rash there was pretty significant, and bleeding. And then I was off to the hospital…

The Funny
So I’m laying by the side of the road, just been run over by a truck, presumably covered in more than a little blood and one of the EMTs asked me if I had any other present medical conditions.
“Yeah, I have cancer.”
“Are you kidding me?” he asked.
“Nope.”

Tell Me Why, I Don’t like Mondays…Part 2

So far I have been to see a urologist (Dr. Wenger) and a radiation oncologist (Dr. Kottapolly). Today I went to see Dr. Conroy, oncologist. He came very highly recommended, is Board Certified and a Fellow (which means he REALLY knows his stuff, and is affiliated with Johns Hopkins (ditto). We went through my records, my tests, scans, bloodwork, results, surgical history…just about everything, really, since Day 1 of diagnosis. He was very thorough.

Two important things happened in this appointment. First, he confirmed for me the recommended treatment for the radiation. Stage I (no evidence of spreading anywhere) Seminomas, being highly sensitive to radiation, are treated with short blasts of the stuff for 13-14 days. They used to do the abdomen and the area from just below the belly button down along the pelvis to about where the leg connects to the pelvis for 4-6 weeks. They call it the “hockey stick” because it looks like a goalie’s stick. Dr. Kottapolly wanted to leave out the pelvic area because of the increased morbidity (still relatively low) of radiating that area, which led to cancer in the bowels. Dr. Conroy concurred, saying Stage II (evidence of some spreading, usually to the lymph nodes and/or lungs) were treated with the “hockey stick” but that Stage I’s could just as effectively be treated without it, aiming at the abdomen only, for a shorter period of time.

Second, he agreed to be my quarterback. One of the most exhausting things about the whole cancer experience is coordinating the care. It’s even more so when you are handling it yourself, which is what I have been doing. Dr. Conroy is going to take over scheduling CT Scans, lung x-rays, follow up care, appointments with other specialists as needed and all of the necessary secondary questions that need to be handled. It’s a huge relief. It’s not that I am going to be relaxed or uninvolved in the care anymore (surely you know me better than that!), but it’s nice to know someone else will be helping with all of that, and that I’ll be able to breathe a little.

At the conclusion, he ordered a Complete Blood Culture (CBC), and asked me to come back in a month. Blood work…let’s go with the Right Arm this time…

Tell Me Why, I Don't Like Mondays...Part One

This was my day yesterday.

Bone Scan
Oncology Appointment
Hit-and-Run While Riding my Bike

That's an exciting year for most people, but in typical Rob-fashion, I had to squeeze it ALL into one day.

The Bone Scan
I had an early morning 7 a.m. meeting for part one of my bone scan. As mentioned previously, Dr. Kottapolly found an unusual growth on my left hip bone. He said it was, in all probability, a sports-related injury, but with my history, it was better to be sure.

So I got to the appointment and met Kimberly, an older woman with a no-nonsense approach; very efficient, very focused, knew exactly what was going on and how long it would take. I liked her right off the bat.

She asked me to roll up my sleeve (let's go Left this time) and she gave me an injection of a radioactive isotope. This particular injection/isotope is attracted to the chemicals in calcium, so it circulates throughout the body, being drwawn to the calcium in the skeletal system. In a little more than 3 hours, the circulation should be complete.

I got the injection, went back to work, then came back to the outpatient center at 10.30. I laid down on the machine and went through a series of tests. The machine looks like this, which makes me realize just how prescient Gene Roddenberry was:


So I lay down and the machine feeds me into the imaging area, where the camera takes picture of the radioactive isotope in my body, now clinging to the bones. It's not a bad test, all-in-all, except the machine is REALLY close AND they strap you to the bed so you can't move...at all. Note for the Claustrophobic: This is not the test for you! To wit:

I have had claustrophia in the past, but sometimes you just have to suck it up and go with it. This was one of those times. That being said, a fan on one of these machines blowing cool air on the patient would work wonders.

When all was said and done, I got a series of pictures that look like this:

I'll be taking those images to my oncology appointment with Dr. Conroy at 2.15 today and my next appointment with Dr. Kottapolly, time and date TBD.

The Funny
I'm laying in the machine, strapped in to the slab, getting ready for the test. Kimberly steps out momentarily to get something, and the phone rings. I'm laying there, listening to the phone ring, then stop.

Kimberly returns, sits down at her station, then asks, "Was the phone ringing?"
"Yes," I reply.
"Why didn't you answer it?"
"HEY! I just got my radioactive powers. I don't know how to use them yet!"

Radiation Appointment

I went in to see Dr. Sri Kottapolly, MD, Radiation Oncologist (known affectionately as a Rad. Onc., which is just fun to say...try it) for my radiation appointment last Friday. I walked in and he asked if I had my records, which of course I did because I now carry EVERYTHING in the Planner I got from the Lance Armstrong Foundation (They're free. If you or someone you know is going through this, get a planner to help organize your thoughts and records). I was glad I did because Dr. Kottapolly did not have online access to the database that contained my CT Scan and records.

We went back and reviewed the CT scan in his office. What the CT Scan does is takes pictures of you like a slice. If I were laying on a table and a ninja sliced me like a loaf of bread, the scan shows what each slice of Rob would look like, belly to back. We went through each of the slices, toe to head, until we reached the pelvis, at which point he stopped.

"Ummmm." As a cancer patient, the "stop" and the "ummmm" combine to release an experience that I am certain is not dissimilar to what happens to a Thompson's gazelle in those first moments when the cheetahs arrive, still out of sight. Something isn't quite right, the heart starts to race, and all you can think is, "Get ready. Here it comes."



"You have something on the left pelvis, right here," he said. "We call it a boney island. I know you are athletic, so I am guessing you probably banged it when you were doing something, causing an injury. The body healed up around it with bone. But, I would like you to get a bone scan, because with your condition, you want to be sure. I am almost 100% sure it is nothing, an injury like I described, but let's be sure." And, he was very reassuring.

He showed me on the CT Scan report, where a bone scan was recommended, and I thought, "Hmmmmm. I wonder what else is recommended?"

We continued looking at the slices of Rob, moving on to the lungs, at which point he stopped again. He showed me three growths on my lungs, which are classified as non-calcified nodules. Again, the CT Scan report recommended follow up, but did not say with whom, or what kind. Brilliant. Dr. Kottapolly recommended I speak with my oncologist (Dr. Conroy, appointment on Monday) about that.

The other thing mentioned in the CT Scan but not addressed by my urologist was the possible presence of a Medullary Sponge Kidney. More to discuss the next time we meet. Yippee...

Recommendations
Dr. Kottapolly recommended 13-14 treatments at 2500 rads, which is a little shorter, but mostly what I expected. Where he really differed from what I knew was in where the radiation will be applied. The old standard (read as: the one I had read everything about), was that they would radiate the abdomen, moving down from the sternum and hitting the lymph nodes from there to roughly just below the belly button. He would hit the area along the side where the testicle was taken out. It looks like a goalie's stick in hockey, actually, and this is how most doctors refer to it. Dr. Kottapolly said the new (last 6 or 8 years) have removed the "blade" and hit only the stick--the abdomen. This reduces the chance of radiation causing cancer in that area and the bowels, which has been a problem in the past; apparently the radiating this area presents no added benefits, when comparing return rates of cancer. Oddly, I can find nothing on this online, so I put a call in to the Lance Armstrong Foundation, who will put me in touch with a cancer counselor who can help me.

He also suggested I bring my wife next time. "They have the brains, so we like to have them here so they can think for you when you need it," he said sagely. Good idea.

The Funny
As he's describing the procedure, he draws a picture of "me" lying on the table, so he can show where the radiation will be directed. "Hey, doc?" I said.
"Yes?"
"The drawing is wrong. You gave me two testicles." We both laughed, then he looked at it and said, "One of these will be the penis. Here. I will make it bigger for you." And he did...very generously.
Still laughing, as I type this...

Why Radiation Instead of Surveillance?
I found a lot of great information about surveillance versus radiation here. I opted for radiation because I wanted to meet this thing head on, kill it, and move on. Also, with my lifestyle, the more frequent follow ups that surveillance require would be problematic. Both of these suit my plan better. I discussed this with Dr. Kottapolly and he confirmed both of these for me. Granted, he is "selling" radiation, but I was glad he said exactly what I believed.

What to expect
Treatments are expected to last about 10 minutes, or less.
The normal symptoms associated with radiation are tiredness, nausea, and diarrhea...so I've got that going for me, which is nice.

Next Steps
Oncology appointment on Monday with Dr. Conroy
Bone Scan on Monday, consisting of two separate tests
Call cancer counselor re: new procedure for radiation related to testicular cancer

Ran Yesterday

I went out yesterday morning and ran a local neighborhood route. I did a simple 5 minute warm-up and then just shuffled through the run. My pace was really slow, but it felt good, again, to get out and be moving. I was still sore from from Monday's (pathetic) workout.

It's going to be a while to get back to "running", but I'm actually more than okay with that. Slow and steady wins the race, I've read. I'm more upset (which is actually too strong a word but the right one escapes me) by my pathetic show of (or lack of a show of) strength on Monday.

...still, cutting myself slack...

Benefits of a Healthy Lifestyle...

I feel like I'm in the Masque of the Red Death, the Edgar Allne Poe story about a disease that comes to take everyone in the town. In the past two weeks, everyone in my office has been sick...except me, Mr. Cancer.

Perhaps it's a combination of eating right (lots of veggies and fruit, coupled with low fat proteins and healthy fats), drinking lots of water, washing my hands a lot and being active. Or, it might just be dumb blind luck. Or, God's Providence.

Just trying to keep it at bay and shooing people out of my cubicle.