dbmcclellan.com

“You have Prostate Cancer”

What??  When my urologist told me this, the ONLY thing going through my mind was “you have GOT to be kidding!”

And I was seriously freaked out.  I had no idea I was even sick.  Sure, I had been leaving my desk for a little walk down the hall a little more frequently, but thought that was because of the kidney stone I had back in October.  Maybe my kidney was having some trouble getting back to normal.  Or something.  But really, I was walking/riding around just fine.  And then, finding out I was nurturing some lousy cancer inside of me for an unknowable amount of time, I was pissed.  But it was scary too since I had NO IDEA it was there!

Ugh.  Confusion ruled the day.

These days, through a surgical procedure called Robotic Assisted Laparoscopic Radical Prostatectomy, I don’t have a prostate anymore.  They ripped it out by the roots.  And that is just plain WEIRD to me, so I wrote about it.  Now you can think it weird too!

The entries below are all about my thoughts regarding the surgery.  You may find some of the information a little dry but I have done my best to keep it fresh and entertaining as well (but that is what I do).  In addition to the entries below, I have peppered in some interesting facts and links to other sites to help broaden your understanding.  You’re welcome!

Leave a comment at the bottom of this page if you have the time.  And, a big Thank You to everyone who has already done so….your words make me feel like getting better!  You are what you think about most……I’m thinking HEALTH.

Peace.

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This is your first David Update

Sent May 21, 2011

Hello to my friends and family,

I wanted to give you an update on how I am feeling after my prostate removal surgery. But first of all, Renee and I want to thank you for your thoughts and prayers. I know they really made a difference because it appears the surgery was a complete success and I am recovering nicely.

The doctor just cleared me to stay in the hospital one more night and I will be going home tomorrow. Most of the time I would be kicked out of the hospital after one night, but it is such a nice room I successfully argued to stay another night! 😀

Thank you again for your kind thoughts.

David

Sent via Windows Phone 7

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This is your Second David Update

May 25, 2011

Hi all,

For any who do not know, I had prostate cancer.  And right up until the doctor removed my prostate, I had that cancer growing inside me.  These days I am in charge of getting healed up, back to healthy, and get on with living….cancer free.  And for the record, this has been a scary three months!

I am using my site to get this information to you so your email didn’t have to bear the brundt of my possibly excessive verbiage and the possibility of easily presenting pictures or video opens up too.  Hopefully you will find the site and information below interesting enough to get you to the end.

And before I get started here: I would like to THANK YOU very much for your thoughts and concerns regarding my recent surgical procedure and recovery. YES, it’s been tough and YES, it is slow, but your emails, msgs, FaceSpace updates, comments and phone calls have made it nearly bearable. Thank you for sending some love my way!

One more thing; If you did not see the first update, it can be located at the bottom of this page.

A Little History

The robotic assisted radical prostatectomy (read an article about the surgery) I went through was done because of a bicycle ride back in October, 2010. OK, not really because of this ride or even because of riding a bicycle, but this ride brought about the thing that showed us a very bad thing going on inside of me.  Anyway, it was a grueling ride of 103 miles over in Santa Rosa – which was awesome and I did great – and about a week later I was peeing blood! As it turns out, I had developed a kidney stone over the summer, most likely caused by my lack of water intake coupled with a long-term high protein diet. Too much protein + too little water = kidney stones. Advice: drink your water! Anyway, because this hugemongous kidney stone was shredding the inside of the tube carrying pee from the kidney to the bladder, it not only caused the pee to change color but generated quite a bit of pain too. I missed several days of work because of The Stone.

So, the darn kidney stone was removed via special tool #246 in the hands of my urologist, Dr. Samuel Chan. He jammed that combo-tool made up of camera/light/laser/pliers up there just short of my left kidney to blast the stone into mostly two parts, grabbed the pieces for study, and went out for a game of golf. I don’t really know a thing about Dr. Chan’s recreation time but lets just agree the surgery went well, was quick, and he was free to do what it is he does between surgeries. That was back in November/December.

Then, all hell broke loose.

From October to January, my medical chart showed entries of Prostate Specific Antigens (PSA) that were high. “Normal” PSA values, for my age group should be two point something or less. My numbers were 5.6 and 6.2. Naturally, this led to specific testing and an investigation into the health of my prostate. Another blood test and a DRE (digital rectal exam) led Dr. Chan to request a prostate biopsy. And without further discussion I was now aware of the medical diagnosis he was leaning toward: prostate cancer. Ugh!

I don’t think I can remember much about the day my wife took me to the surgery center for that prostate biopsy over in Folsom…..it was traumatic….but we got it done that day and waited for results to come back. I don’t think it was more than two days later when we got the call from Dr. Chan telling me “you have prostate cancer”. The severity of mine was pretty bad and advanced enough to need to do something, right now. An office visit followed and choices were presented. He gave me a book to read. I used on-line resources. And we decided to yank (not a technical term) the prostate out of my body.

Back in October I became a student of kidney stones. Got all book learned (internet smart) on the subject and knew what I was getting into. Didn’t like how it was going to happen but I understood the procedure. So then in March, I needed to figure out the prostate. There’s a bunch of info on-line and I got pretty smart about cancer of the prostate too.  And in my case, I had T2b or Stage II cancer.  My Gleason Score was 7 (3+4).  The timing of this could not have been better as this is the last time the surgery could be termed as “simple”.  All we needed to do is remove the prostate.  If we had waited any longer the cancer would have spread to parts unknown and we would have had a very different long-term outcome.  As it is, we need to wait for the all-important 6-week PSA test.  Update to follow.

One thing I have been asked is “why remove the prostate? Why not chemo, hormone or radiation therapy?” Those choices are really not for us young-uns. Each choice seemed to have a 5 – 7 year lifespan associated with it. Get a certain age and the procedure chooses you, not vice-versa. And then it gets confusing too. Since one type of procedure precludes you from using another type the next time, it just didn’t make sense. And, since every treatment seemed to be BABY SITTING the cancer.  Removal was the ONLY treatment I was interested in.

Bottom line: I didn’t want to die of something I could have prevented by making a correct decision.  Or because a certain treatment was easier and/or more convenient. Sometimes choosing the correct path is hard.  This one was easy.

Prostate Surgery

The prostate resides inside a man’s body just below the bladder. The “system” goes like this: kidneys process fluids the body has finished using and generates urine. This flows down in to the bladder for storage until you feel the urge to pee. Once you give the okay, the bladder opens, and the urine flows out via a tube called the urethra. This tube runs right through the middle of the prostate, out of your body and into the world wherever you are standing.

Inside the universe we call the Lower GI (gastro intestinal) tract, the prostate sits really close to the bottom of the bladder. When the prostate grows because of some anomaly, it impinges on the urethra and can cause your bladder some serious discomfort and maybe even block your pee. It also sits really close to the large intestine, and behind the small intestines. Getting close to the darn prostate for removal requires a supremely qualified surgeon with a deft touch.  For me, that guy is Dr. Samuel Chan, and he went in and got the little bastard outta there!

The confusion of the surgery or the hard part in all this…..the only delicate part at all is; it is difficult to remove the prostate without harming two sets of two special nerves. They run as a pair down each side of the prostate. Remember in biology class where the teacher talks about how nerves transmit thoughts and impulses from your brain to the thing they are bossing around? And that they are like really small wires? It is not a good thing to sever these nerves. Ever. And these two nerves run right along (are kind of attached to) both sides of the prostate. One nerve’s job is to control when the bladder opens and the other is to control erections. So, unless you want to walk around leaking piss all day/night everywhere you go, and want to have a timely erection every now and again, you will need to choose a surgery able to spare these nerves!

Which is why we chose Dr. Chan using the da Vinci robot to do the surgery and Mercy San Juan Hospital for the after-surgery care. And without getting into the specifics of the surgery, suffice it to say my prostate has been successfully removed.

Recovery

And now it is all about recovery. What does that mean to me? Get Healthy. My lifestyle is all about eating healthy, staying active, and being mindful of my carbon footprint. And this Get Healthy part is not hard. When something hurts, give it rest. When something hurts a lot, do whatever the doctor tells you, take your meds, and try to enjoy the “me” time. And that is what I am doing!

As I sit here, Renee is busy like a bee doing stuff she has wanted to do for quite some time. Jessie the cat bounces between complete paranoia running all around the house, and the absolute stillness of a really deep sleep. And it is wonderful! I sit here in a comfortable chair with all this activity going on around me, and just focus on healing.

Does it hurt? Yes, maybe a “6” as I type this. Most of the pain seems to be coming from the bladder because my body HATES the catheter (if you want to know about this part of it, type “foley catheter” in your favorite search engine), and all it stands for! The surgical entry/exit spots are practically non-events in the whole picture, and will only give pause when the office visit to remove them comes into play next Tuesday, May 31st.

To sum up this messy little chapter; I am alive and glad to be here typing this information. Also, it pleases me you are reading it!  I look forward to your comments on this post, emails, and/or phone calls.

Thank you for thinking of me.
~david

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Three

May 31, 2011

The date (5/31/2011) is finally here.  This is a RED LETTER DAY on my calendar.  This is the day Dr. Chan removes the catheter and 13 staples he used to put me back together.  And by “finally”, I mean FINALLY!  OMG, how long can it take for 10 days to go by?  If someone asked how long it feels since Surgery Date, I would say at least a month.  I mean really, how could it be any shorter than a month??  I know not.

I’ve never had a catheter, and I have never had metal staples used on me.  Back about a lifetime ago, there was this fence job I was working on and I shot myself just above the left kneecap with a 3″ staple.  Really.  But that shouldn’t count.  It’s not the same!  Metal staples be damned, I get the idea here.  They are easier to use than stitches, can hold massive (and small) sized pieces of skin together, and I guess they are simple to remove.  Yay staples!

The catheter blows my mind.  It stays inside the bladder and allows it to drain while other parts are healing.  In the case of a recently removed prostate, the tube that carries urine from the bladder to outside the body was severed and put back together (Doc used stitches here), and it needs time to heal.  The catheter helps here by allowing the tube to relax while it grows back together.  As a side effect of this, the bladder no longer fills.  The urine just drains out.  Where does it go?  Into a bag you carry around!  I stayed home.

So the Big Day has finally got here and now it is over.  Got a minute?  Here is what happened.

Since the surgery, I was told by Doc to NOT shower.  Ten days later, I stink.  Really.  So I took sponge bath #3, put on some fresh clothes, and got to the office on time.

Sitting in the waiting room I look around and notice something about the other visitors.  They are REALLY OLD!  And, then there’s me.  Oh well, someone had to skew the average age…..this time its me.

They call my name and here we go back into the little tiny room down the hall.  Holy crap, I am so nervous!

Shannon is my gal here.  She always takes such good care of me and can take my mind off of the truth at hand.  In this case, she is prepared to take out the 13 staples they used to help mend my wounds.  I removed my shirt and off she goes taking the metal away.  Yay!  We talk a little about the catheter and she goes out of the room.

Doctor Chan comes in the room next.  He is a kind man with a warm smile and a strong handshake.  I like the guy.  We sit to talk about taking out the catheter while he is putting on THE GLOVE.  HooBoy, here we go.

I think I may have blacked out cuz next thing you know he is taking off the glove and the catheter is out.  A thing of the past.  And I am kidding.  I didn’t pass out.  But I don’t really know how to describe this.  It was VERY uncomfortable.  Doc was nice to me and took his time and tried to keep the pain level really low.  I’m pretty sure he thinks I am a wimp!

And our conversation moves on.  This is where the visit gets a little messy.  During any prostatectomy the prostate is removed intact and sent to a lab for review.  They slice and dice, and chop and discect the darn thing and in this case found the cancer was quite a bit further along than they anticipated.  Before the surgery my Gleason Score was a 3+4.  When they got it out and reviewed it under the microscope, the Gleason Score was actually 4+3.  This is Bad News if your name is David.  A 4+3 generally means the cancer is VERY aggressive and there is a better chance for some sort of repercussion to be dealt with at a later date.  The cancer could have spread.  Ugh.

Now, Doc says he got all of the cancer out.  The surgery was a complete success.  He got the prostate, took the two nerves on the left side – sparing the ones on the right – and carved a very wide margin.  I guess we’ll know for sure in a month.  That’s when the next PSA test is going to happen.  Good news will show tiny or zero Prostate Specific Antigen numbers and the next Red Letter Day is June 28.

Oh, but there really is some good news to come out of this: I can ride my bike again in 4 weeks!

So here is the weird part.  The part I shouldn’t think about.  I asked the doc what would have happened if I hadn’t had that kidney stone back in October.  Remember that part of the story?  A kidney stone led to me to Dr. Chan.  During the usual testing, he gave me a PSA (which was high), and performed a DRE.  This led him to request a biopsy of my prostate which came back as cancerous which led us to make a decision to remove it from my body.  If I hadn’t had that kidney stone causing me to pee blood back in October 2010, I would have never met Dr. Chan.  That would have allowed the cancer growing inside my prostate free rein to wreak whatever havoc it cared to.  And my suffering would have been great….for about five years.  FIVE YEARS!  That’s about how long I would have lived.  Man, THAT blows my mind!

Frequent urination is a minor annoyance when your body is being taken over by prostate cancer.  At first the cancer just fills up the prostate.  This pushes on the bladder making it hard to wait before you pee.  Inside the prostate, the cells don’t know how to die, and they need more space so they can do their “job”, and they keep on multiplying.  Ultimately they bust out and look for another hospitable place to grow.  Like the liver.  Or a kidney.  They live there until those organs fail.  And do you know what the worst part of all this is?  You don’t even know it is there.

True story.

Get your PSA checked.

I love you all and thank you for your kind thoughts and positive energy.

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Red Letter Day, 6-28-2011; The Update

Today is June 28th, and you know this is the day I find out about my PSA numbers.  Positive results would be a really low number, and I get to continue what I am doing.  Negative results would be a number similar to before surgery or slightly less, and we get to figure out what is next.  Chemo?  Radiation?  Some odd combination of the two?  Or??????

You might know me well enough to know I am thinking of both scenarios, and am most likely thinking more about the latter rather than the former.  I mean, a postive outcome would be fantastic!  Nothing to think or worry about.  Just keep doing what I am doing.  But a negative outcome?  Well, that would involve lots of decisions and lots of changes to the lives of many people…..and really, you don’t just come up with ideas of how to cope with these important issues unless you spend some time thinking about it.  So I thought about it.  A lot.  And yeah, I was worried.  And nervous.

But I was worried and nervous for no reason at all because the outcome was FAN-freaking-TASTIC!!  The PSA numbers of the day are: 0.1 ng/ml (prior to surgery it was in the mid-sevens!).  So here I sit (apparently) cancer free and ready to ride my bike….in two weeks.

If there was any bad news from this doctor visit it was about the bike.  It’s always about the bike, right?  (It is for me.)  Well, I was told by Dr. Chan to stay off the bike for another two weeks.  Ugh.  Those were harsh words to hear.  But doc had a reason to tell me that, and it went something like this “you just had major surgery, give it another two weeks to heal”.

Man, I just hate it when people with bad news make sense!  I guess I’ll keep working on core strength and be that much stronger when I finally get on CashFlow (my bike).

Wish me luck!