Today I drove to RVH for my first radiation treatment session, the third stage of my treatment. One hundred forty-one days since my prostate surgery, and roughly 290 since I was first advised of my dangerously elevated PSA level. This is the first of approximately seven weeks of sessions, one every weekday.
I have to admit I was somewhat anxious about it when I left home. Going through something for the first time can do that, and, of course, having cancer is already enough to make someone anxious. I had been told by hospital staff that it would be easy and quick, but until I had the opportunity to actually experience the session, I was unsure what to expect.
The drive today didn’t do much to alleviate my anxiety. It was a rainy, dismally grey November day here, but barely 10km out of town it began to get foggy. Visibility fell to under 500m and even in several places down to about 200m. Yet the roads and the two-lane highway were busy with cars and trucks. Hwy 26 has long been neglected by the province despite a desperate and obvious need for upgrading with at least passing lanes if not a full four lanes. And because of winter conditions or today’s fog, the road can be quite treacherous.
However, I arrived safely, and a little ahead of my scheduled treatment time. And because I was there sooner, I was able to get in for my first session about 15 or 20 minutes earlier than scheduled.
As always, the staff at RVH were friendly. Their pleasant demeanour does a lot to calm their patients and helps make everything less stressful. But even simply walking into the cancer care centre can be an emotional moment. There’s such a finality about it: everyone knows you have cancer, every other patient in the section is there for cancer treatment. And cancer is a scary thing to have, especially when, like mine, it is diagnosed as “malignant.”
Shortly after registering, I was handed my schedule for the upcoming week, given some additional paperwork with phone numbers on it for various purposes, and my patient information data. Winter weather in this area can be tough for driving, so I have phone numbers I can call if I need to cancel an appointment.
Future schedules would be provided every Monday, and on that same day, right after treatment, I would have a brief review of my condition and treatment with an oncologist.
“[They] are most easily recognized by their deliberate perversion of truth and fact. Their newspapers and propaganda carefully cultivate every fissure of disunity, every crack in the common front against fascism. They use every opportunity to impugn democracy… Their final objective toward which all their deceit is directed is to capture political power so that, using the power of the state and the power of the market simultaneously, they may keep the common man in eternal subjection.”
Sounds like someone knowledgeably writing about modern Trumpist Repugnicans, or maybe even any (all?) of the populist, conservative parties worldwide. It was actually written in 1944 by Henry Wallace, 33rd Vice-President of the USA. He was commenting on the American pro-Nazi fascists. Before WWII, they had millions of followers in organizations like America First, Silver League, the German-American Bund, and similar groups. Many of them continued their subversive activities even while the USA was fighting Germany.
It’s a part of American history detailed in Bradley Hart’s book, Hitler’s American Friends: The Third Reich’s American Supporters in the United States (Thomas Dunne Books – St. Martin’s Press, New York, 2018). It’s not the first book I’ve read on this dark chapter in American history, merely the latest, but what has always puzzled me is how the lessons learned in the 1930s and ’40s about the right and their subversive activities seem to have been forgotten: today, the pro-Nazi right is again on the rise in the USA.*
Hart draws on “recently opened archives and personal papers,” adding a new dimension to the story, documenting in eight chapters the various groups, organizations, and individuals who promoted and pursued various ideologies that, if not specifically pro-Nazi helped Germany’s aims. These include both American politicians, businessmen, university student organizations, spies, and religious leaders. The support for the Nazis in the USA was strong for many years. It still is, although today’s neo-Nazis are mostly sad, puerile imitators of that ideology, with little more than hate and a poor education to collectively sustain them.
It wasn’t just these organizations that promoted racism and fascism in the USA, but also several well-known personalities pushed it (or promoted aspects of it, like anti-Semitism): Henry Ford and Charles Lindbergh are among the most notable, but there were rightwing Christian pastors and churches working for groups like the Christian Front, a pro-Nazi religious-political organization run by the deeply anti-Semitic Father Charles Coughlin. Other pro-Nazi advocates at the time included the Kansas minister Gerald Winrod, Louisiana’s Gerald k. Smith, and others.
Trump is not generally viewed as anti-Semitic, at least in public, although like his profession to Christian faith, it’s highly suspect. He has tweeted what many consider anti-Semitic remarks such as those he made in 2019:
In August, Donald Trump tweeted that Jewish Americans who vote for a Democrat are guilty of ignorance or “great disloyalty: “I think any Jewish people that vote for a Democrat, I think it shows either a lack of knowledge or great disloyalty.” Many commentators wrote that this assertion echoed the anti-Semitic trope that Jewish Americans have “dual loyalty” to Israel.
However, his anti-Muslim bigotry is well established in the public record. In 2017, he retweeted “…a series of anti-Muslim propaganda videos shared online by a high-ranking official in the ultra-nationalist UK political group Britain First” as CNN reported. By spring 2018, barely two years into his term, media had documented “86 Times Donald Trump Displayed or Promoted Islamophobia.”
The actual Nazis in Germany encouraged their American supporters and even launched an official Nazi political organization called the Gauleitung-USA, based in New York City, in 1931. However, after Hitler was appointed Chancellor in ’33, the organization was dissolved and replaced by the German-American Bund. That group included an armed wing modelled after Hitler’s Sturmabteilung (SA), trained to use force. Another group, Friends of the New Germany, which had recruited around 5,000 members between 1933 and ’35, was also absorbed into the Bund.
In the delightfully quirky, postmodern film, Synecdoche, New York, the late Philip Seymour Hoffman plays a movie director obsessed with creating a set that realistically represents New York City for an upcoming movie. But as he tries to incorporate more and more people and bits that represent the city, the set grows and grows into a micro-city itself. As Wikipedia describes it:
The plot follows an ailing theater director (Hoffman) as he works on an increasingly elaborate stage production whose extreme commitment to realism begins to blur the boundaries between fiction and reality. The film’s title is a play on Schenectady, New York, where much of the film is set, and the concept of synecdoche, wherein a part of something represents the whole, or vice versa.
I feel much the same thinking and obsession went into the creation of No Man’s Sky, a sandbox (“action-adventure survival,” plus trading, exploration, fighting, gathering, building, mining, refining, upgrading, flying, meeting aliens, and more) science fiction computer game of enormous size and scope that attempts to cram everything imaginable into one game. Synecdoche, Universe might be a suitable nickname for this sprawling, all-encompassing game.* Again from Wikipedia:
Players are free to perform within the entirety of a procedurally generated deterministic open world universe, which includes over 18 quintillion planets… nearly all parts of the galaxy, including stars, planets, flora and fauna on these planets, and sentient alien encounters, are created through procedural generation…
Eighteen quintillions? That’s 18,000,000,000,000,000,000. Beyond comprehension. I can’t vouch for anything close to that number, since in about 25 hours of play, I’ve only been to five or six of them in No Man’s Sky (NMS).
My first four game starts (three on similarly difficult planets, one sandbox in a more habitable clime) were all just learning experiences that, after fumbling, failing, and even dying, I deleted having played only a few hours each. My currently-running game has more than half of my game time logged, spent entirely on one planet with a couple of short visits to a nearby orbital space station. Most of my time on this one planet has been running or walking around, exploring. I’ll come back to that. Meanwhile, I’m still poking about on one planet while the rest of the universe awaits.
There’s a bittersweet pleasure in watching the Three Stooges these days, knowing about them, their careers, their lives. What seems like zany comedy on screen was, like so many celebrity stories, much more complex, contentious, and even tragic at times. But there’s also an insuppressible joy in their work that keeps drawing me back to watch more. Moe, Larry, and Curly (and Shemp) will always bring a smile to my face. The subsequent replacements for Curly sometimes will, too, although not as often.
And with more than 200 film credits to their names, running from 1930 to 1970 in both shorts and feature films, there’s a lot to watch. One hundred and ninety of those short films were for Columbia Pictures alone (1934-59). These can be seen today online or in DVD collections from Sony (released as multi-year sets from 1934 to ’59, and as 17- or 20-disc collections; yes, of course, I have them). There are 51 other films or shorts in which they collectively starred or have a role, 17 of which were newsreels or bio-shorts.
And that doesn’t include all the films several of them made solo (Shemp Howard in particular was prolific) nor their 156-episode cartoon series, The New Three Stooges, that included live-action segments, and ran from 1965-66. And even this doesn’t show off their impressive careers that began in the 1920s in vaudeville. Moe Howard was performing on stage with his friend Ted Healy in 1923, joined by his brother Shemp in 1924. Louis Feinberg — aka Larry Fine — joined them in 1928. The three would appear with Healy in their first film, Soup to Nuts (1930), but parted ways with Healy over a contractual dispute. For a couple of years, the trio performed onstage as “The Three Lost Soles” and “Howard, Fine, and Howard.”
Yesterday, I went for my second bone density scan — aka bone densitometry or dual-energy x-ray absorptiometry — the one that had been planned, but scheduled then delayed twice previously. My first bone scan, like my first CT scan, was done in June, before my surgery. This one was ordered by the oncologist prior to my radiation treatment.
Bone density scans are used for many types of diagnoses, including measuring bone loss and osteoporosis, but also to detect the spread of cancer cells. My previous scan showed the cancer had not spread into my bones (a tremendous relief). I hope the second one shows that same result; bone cancer is very nasty. Not that any cancer is good; some are simply nastier than others.
I arrived at the hospital — after my 60 km drive in the first taste of winter snow and wind — early, as usual, with several books to keep me occupied. I also managed to finally reach someone in the parking kiosk and buy a 30-visit pass for my upcoming radiation treatments. The kiosk sign says it’s open 8 a.m.-4 p.m., but in reality, they close at 3:45, which proves highly inconvenient for patients like me who have to stay later. I think I’ve spent more in parking at RVH than in any other aspect of the treatment to date (my usual fee is $15.25 per visit; it would be almost $20 if I wanted in-and-out privileges). I’ve also found the staff I’ve spoken to in the hospital seem unaware of, or confused about parking options, costs, or the hours the kiosk is open.
Waiting, as I’ve said before, is a big part of the process; this one starts with an injection, then a two-three hour wait before the actual scan. Or, if the nuclear medicine department is very busy, it could be even longer (one of the prior schedules for this scan had an almost five-hour wait!). I chose to get a coffee, sit in the open area, and read. I could have gone back to my car and driven somewhere to shop, but it has snowed that morning; not a lot (5-7 cm) but the streets were icy, the traffic slow, and I didn’t feel like fighting it. besides, what do I need to buy in Barrie? I preferred to read quietly.
(Among the books I brought, I was almost finished re-reading Mexico Set, the second of the first Len Deighton Cold War spy trilogy, and finished it when I got home. As usual, I was working through several other titles I had brought along. My usual calculation is to bring a different book for every 20-30 minutes I have to wait, but to be honest, like yesterday I sometimes get drawn into fewer. Still, it’s nice to have options available.)
Unlike many processes and scans I’ve been through since my diagnosis, this one required no preparation and had no limitations on food or drink beforehand. I didn’t even have to change into the usual hospital coat and gown, nor have a full bladder. For which I was thankful.
The injection takes maybe three to five minutes, mostly in getting into place for it. And the nurse or technician finding a suitable vein, of course; I’ve had so many injections, blood tests, IVs, and so on this year that my veins are a bit bruised and reluctant to participate in more. The shot contains a small amount of radioactive tracer material. Not enough to make you glow in the dark (that could be fun…), but enough for the scanner to detect once it settles throughout the body. As the Mayo Clinic says,
Areas of the body where cells and tissues are repairing themselves most actively take up the largest amounts of tracer. Nuclear images highlight these areas, suggesting the presence of abnormalities associated with disease or injury.
“… my only object was that all the world should enjoy itself and live in peace and quiet, without quarrels or troubles; but my good intentions were unavailing to save me from going where I never expect to come back from, with this weight of years upon me and a urinary ailment that never gives me a moment’s ease…”
Miguel de Cervantes: Don Quixote of La Mancha, chap. 22
I was listening to an audiobook of Don Quixote while driving to the hospital recently, and heard that bit. It just seemed appropriate. And a bit funny.
Last week I got my first hormone injection — lupron: the brand name for leuprolide acetate. “Lupron belongs to a class of drugs called luteinizing hormone-releasing hormone (LHRH) agonists. These medications block the production of LHRH in the body, which results in the testicles producing less testosterone.”
At 70, I’m not terribly worried about my testosterone levels dropping. Sure, in the near future I may not buy a pickup truck, drink a case of beer, and wear a backward baseball cap while driving with my stereo playing annoying rap at ear-aching volume, but I’ll live with that. I’ll just have to content myself with reading, gardening, playing my ukulele, having a glass of wine with my wife, baking bread, a bit of online computer gaming, and walking the dog. And if it means my facial hair grows in less, well that just means I won’t need to shave as often.
Lupron is delivered via an intramuscular injection, which I got in my left buttock. Although the syringe looked like something a veterinarian might use to threaten a cow, it actually didn’t hurt at all to get it. Later the buttock muscles and got a bit stiff and sore, but it wore off after a couple of days during which we walked a lot. I have another injection scheduled for early February. I expect to get them every three months for some time.
Possible side effects of lupron can include:
loss of muscle mass
skin irritation at the site of injection
erectile dysfunction or loss of sex drive
shrunken testicles and penis
changes in blood lipids
the growth of breast tissue
Seems I might be able to share some of these effects with Susan, who still has menopausal hot flashes. She laughed at the thought of me throwing off the duvet in the middle of the night and sitting up to cool off, as she sometimes does. The weight gain I can do without: since the operation, I’ve been less active than in the past. But will I grow breasts? Continue reading “The Cancer Diaries, Part 15”
An article on the Global News site titled “Fewer Canadians plan to wear poppies this Remembrance Day, poll finds” made me think again about what Remembrance Day is for. The article opens:
Fewer people plan to participate in Remembrance Day ceremonies or wear poppies this year, according to a poll from Historica Canada that also suggests knowledge of Canadian military history is dwindling.
To be fair, I’d suggest knowledge of pretty much everything factual is dwindling. One only need look at social media posts from anti-vaxxers, or anti-maskers to see how much knowledge of science and medicine has been lost in recent years. And, like most followers of pseudoscience and conspiracies, such stupidity is a self-inflicted wound.
And, too, it is difficult to fault people for not attending group ceremonies during a pandemic when health officials are warning against large gatherings. Non-participation on Remembrance Day in 2020 might have a lot to do with that. This year, like many others in our community, we observed our two minutes of silence at home.
I’ve found it’s a bit difficult to even find poppies this year: I have only seen them for sale in the post office, locally. Of course, this year I have not looked for them in as many places as in previous years, so I might not have visited a location where they were available.
Still, excuses aside, I wonder what other reasons people would have for not participating. Are people just getting jaded? Or simply don’t care about showing respect? Are we losing our collective memories as we lose our veterans?
I recall writing an editorial for the newspaper some decades back, asking where all the municipal employees were, who got a holiday on Remembrance Day but didn’t show up at the cenotaph for the ceremonies. And standing there during the silence, I could always see trucks and cars racing by on First Street, and pedestrians and cyclists going about their business, ignorant of the significance of the events taking place a hundred or so meters away.
More back and forth to RVH, this time for another CT scan today. I arrived early, as usual, and then spent most of my time there waiting and reading. Not as long as I’ve had to wait in the past, but still a lot longer than the process itself. Like I always tell people: bring a book. Or books.
You remember me writing last post about a mixed-up bone density scan I was supposed to have last Wednesday? Well, by Monday morning, I hadn’t been informed of any re-scheduling, so when I registered at the imaging department for my CT scan, I asked the receptionist about it. She checked her computer, hemmed and hawed, then went off to the nuclear radiation office to talk to someone.
When she came back, she gave me the bad news. Seems I was supposed to have had it TODAY, about 90 minutes before I arrived. Damn. No one had called to tell me (and, yes, they have my landline and cell phone numbers, and both have answering machines). So I had it rescheduled AGAIN, this time for next week. Another day driving 120 km, and paying exorbitant parking fees. And hours of waiting in between.
I weary of driving back and forth, and don’t look forward to the lengthy wait doing nothing in the hospital (aside from reading) for the BD process. I really would have liked to have had both scans on the same day. Communication breakdown, as Led Zeppelin sang (did I tell you I interviewed them for the Ottawa Citizen when they came to play in the capital, in 1970? Ah, those were the days…).
Anyway, the CT scan process requires a full bladder, so I drank a lot of water before I left, with a water bottle in the car to sip more as I drove. Once registered, I had to make the usual change from streetwear into a hospital gown and coat. And then sit in a waiting room, my bladder creaking with fullness. I read a couple of chapters of a Len Deighton novel, Berlin Game, (my second time reading it), and some pages from Maryanne Wolf’s delightful book, Reader Come Home, on the neuroscience of reading.
About 30-45 minutes later, I was taken to another, smaller room, where a technician inserted an IV connector into my elbow. The first attempt didn’t work, so she had to pull it out and stick a new one in the other elbow. Not painful, however, and I certainly can’t fault her for my tricky veins. Then I sat and waited some more. This time I opened Haruki Murakami’s latest novel, Killing Commendatore, and read a couple of chapters. And, just as I was starting a third chapter, I got called by another technician (nurse?) to move into a corridor, plunk my backside in yet another chair, and wait some more. Not very long, mind you; not enough to finish the next chapter.
Media reports suggest that, like me, most Canadians breathed a large sigh of relief when Joe Biden won the US election and ended the proto-fascist regime in the USA. Not that I think he’s some sort of saviour of American politics: for all the rhetoric the Trump campaign spewed at him and his party, the Democrats are not leftwing, let alone radical. The most “radical” of them all — Bernie Sanders — would barely qualify as a centrist in most Western nations. And most of the rest would be firmly in conservative camps. What Americans chose was not a leftwing president, but rather a more moderate rightwing one.
And to be fair, Biden is far better than any of the proto-fascist Repugnicans who have risen over the past two decades, including Graham, Cruz, McConnell, and others. What Biden will usher in is not a revolution, but a calming normalcy to American politics; back to the cozy, pro-corporate paternalism it’s been for many decades. While politicians take their handouts from the lobbyists, citizens will be able to forget politics for a while and get back to the things that matter to them: Instagram, TikTok, TV, the glitterati, fast food, porn, Snapchat, guns, and pro sports. What Americans want most is for politics to go away and leave them alone.
American is broken in many ways, not least of all its election process and the deeply flawed, racist-based electoral college. Trump’s polarizing presidency highlighted how badly broken the nation is, how divided it is, and how close it has edged to rightwing totalitarianism. His election loss didn’t turn that around, merely slowed the clock. Don’t expect to see any changes in the way American policies are dictated by gun, corporate, and industry lobbyists under Biden.
Of course, it isn’t over yet: the Trump regime can continue its reign of terror, incompetence, illiterate ravings, rage, and racism well into January, 2021, but it’s heartwarming to know the ongoing damage to the USA and its allies will be limited to a few months. Unfortunately, it’s likely another 100,000 Americans will die of COVID-19 in that period because the administration won’t do anything about the pandemic any more than it has done since it began.
It’s been an emotional, roller-coaster week for me (if you’ll pardon the cliché…). Back and forth to Barrie for consultations, scans, and tests, more blood work, phone consultations with doctors and hospital social services staff, schedules set, schedules changed, confusion over medication, appointments upset. All in all a rather trying time.
Prior to my next stage of treatment — radiation — the oncologist told me I needed another blood test (for PSA levels: even without a prostate the cancer cells produce the prostate serum, remaining an indicator of their activity), as well as another bone density scan and CT scan. Plus I had to go into the hospital to get set up for a radiation planning scan, and back to Barrie to see my urologist.
The oncologist also prescribed hormones, calcium, and vitamin D3. The later two are to help combat any bone loss that might result from radiation treatment. The hormones are to reduce my testosterone, which will help limit the cancer’s growth. There was a bit of confusion about when I was supposed to start taking them. Normally you start a week to two weeks before radiation, but when I got the prescriptions filled, the start date had not been set. I asked nurses when I was at RVH, and called the radiation department, but got conflicting answers. One nurse said wait, another said start now, so I did that even without a date for treatment.
Then I got a call saying my treatment would start Nov. 11, just over a week away. I was glad I had started the hormones. But what about the injection? I’d find out later.
The Monday morning planning session was at the oncology department. I had not been in that wing before. There’s a certain finality about going into the oncology wing. Everything else was medicine: this was cancer. It’s sobering to sit there, waiting to be called, knowing that you and everyone around you in the waiting area is there for cancer. I realized it deeply, sitting there, in a way it didn’t reach me when I went through the surgery and other processes.
If ever there was a moment to realize your mortality, waiting in the oncology department is it.