The Cancer Diaries, Part 12

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catheterWell, that was easy. Relatively, so. Last Monday I got to remove my catheter all by myself. Not the sort of thing one looks forward to — doing the removing, that is — but I was looking forward to having it gone and able to go back to some normality in my daily life. While I have grown somewhat adept at wearing, caring for, and changing the urine bag, it certainly isn’t something one wants over a long time.

Actually, it was quite easy and painless; afterward, I felt a bit chagrined over the anxiety I had felt prior to the act. I stood in the shower and merely snipped the drainage tube for the balloon (following the simple instructions in the pamphlet the hospital sent me home with). I let the water drip out so it emptied — only a few seconds — then held onto my penis with one hand and with the other pulled the catheter out. Gingerly, but it slid out without any problems.

Irritation was minimal, with a small expression of blood occasionally, and only for the first few days. To my delight, I suffered no significant incontinence or leakage afterward, as I had with the removal of the previous (and larger diameter) catheter I had lived with for two weeks after surgery.

And to make it even better, I have (so far) no indication of the UTI that has followed my previous experiences hosting a catheter. But this time, I’ve been drinking cranberry juice every day since I took it out to help prevent a UTI. And, of course, I had the catheter in for a much shorter time (four days) than previously.

Aside: most cranberry juice sold in grocery stores is labelled “cocktail” and is shite. It’s a diluted mix with other fruit juices, often grape or apple, and usually added sugar — no telling how much cranberry is actually present. I tried some of the cranberry cocktails from several stores and they were all awful, syrupy crap. One house brand was so sickly sweet I took it back to the store and complained. If you plan to drink the juice for UTI reasons, then buy the undiluted stuff and mix your own. I did find Terra Beata brand (a Canadian company, too)  undiluted juice at the local Loblaws store, and that’s what I’ve used, diluting it only minimally. Far superior to the cocktail mixes.

foley catheterThe most recent procedure (described last diary post) was meant to reduce a stricture (scar tissue) in my urethra that slowed the release of urine. It worked in making me pee more easily, but I’m not the firehose I once was. I won’t be writing my name in the snow anytime soon. Of course, I’m not 25, either, so my yellow-snow-writing days are well past. The good news is that I seem to be emptying my bladder without any problems or pain.

My post-catheter time has been mostly spent waiting for phone calls from the doctor’s office and the hospital oncologist. They started this week, although they set me up for more waiting. Waiting is, of course, what one does most of. Everything has to be done in order and when space is available. Of course, I am only one of hundreds, maybe thousands of patients waiting. But at least it’s not for too long this time: my first hospital visit (for assessment) is next week, as is my next blood test, and I expect another bone density and CT scan will follow shortly. All required before I can begin the radiation.

Not that I’m looking forward to radiation, but I am somewhat anxious to get through it with the hope it kills the remaining cancer cells and I can stop mulling over my mortality when I wake up at night.

Next on my schedule are two treatments: hormonal therapy (pills and injections), followed by radiation treatment. I start the pills this weekend (or soon, depending on availability), and then about two weeks later comes the injection, followed by radiation, which has to take place every weekday for several weeks at a distant hospital. Then some weeks or months later a second hormonal injection. Assuming all goes well, that should be the end of treatment. If not, then I have to start chemotherapy.

The hormonal treatment is meant to reduce my testosterone because, the oncologist said, testosterone tends to exacerbate the cancer cells, helping them grow. As another site notes,

Low testosterone levels stifle the growth of prostate cancer. That is why, if a man with prostate cancer tries to use hormone therapy to increase their testosterone levels, cancer becomes more aggressive. This leaves no doubt that testosterone increases the growth of prostate cancer.

At 70, my testosterone isn’t ragingly high, but it’s obviously higher than the oncologists prefer. Despite a healthy sexual appetite in my youth, I’ve never been a high-testosterone, pickup-truck-driving male. I boast only modest body hair, and have a penchant for chess and reading instead of watching manly sports teams beat upon one another. Hell, I don’t even remember the last time I watched a hockey game on TV (it was back when there were only six teams), and I’ve never seen a football game. The only group sport I’ve played in the last few decades was paintball. But I suppose I have had enough testosterone to help the cancer cells grow.

Using these hormones will put me through what the doctor called a “male menopause” phase similar to my wife’s, with hot flashes, moodiness, sleeplessness, and an increased need to pee (as if that wasn’t already an annoyance). I always thought male menopause involved a blonde mistress, a sports car, skydiving, and a casino, but, apparently, it doesn’t even come with a motorcycle. I guess I’ve been watching the wrong movies.

Hormone therapy is also known as “androgen deprivation therapy,” which I chuckled over because it made me think of musicians from the mid-1970s to mid-1980s. Will I join the androgynous ranks of David Bowie, Prince, Little Richard, Kiss, and Boy George? Does anyone younger than me even know who these people are? And how would I look in mascara? At least Susan and I could have that (and our hot flashes) in common. (I have this curious urge to watch The Rocky Horror Picture show again and take makeup cues from Tim Curry…).

To date, I have no sustained pains or uncomfortable tenderness in the groin or lower abdomen, which I believe bodes well. But I will admit, sheepishly, that I became lax about doing my Kegel exercises, and am now trying to catch up and do more. I sometimes just get distracted and forget to do them.

A little rough calculation suggests to me that travel to and from the hospital every weekday will cost about $12-$15 in gas, plus around $10-$15 in hospital parking fees daily.  Over the treatment period, I expect that will add up to $1,000 or more, plus any prescriptions. That sum concerns me: as a couple of seniors living off our government pensions, we watch our spending (books notwithstanding). I suppose I should be grateful it’s a lot less than living in the USA where we’d have to pay many thousands of dollars and we’d probably be bankrupt or I’d be dying. Still, it’s something to think about.

So it looks like I’ll spend the holiday season right into January shuttling back and forth to the hospital. It’s not that Christmas or New Year’s is particularly eventful for us (certainly it’s not a religious festival for us), and with the pandemic still raging we won’t be having any family or friends over for meals or gatherings. But still, I don’t look forward to driving 60 km each way in the snow, especially in the dark or when the treatment makes me fatigued.

Stay tuned… don’t touch that dial. I’ll be back with more.

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