February 28 '04 |
|
Volume 404 |
Prostate
Cancer From The Beginning
From questions
Ive
fielded over the past few weeks, I can only assume some readers were unaware
of the known problem Ive had with my prostate for the past few years.
Its a problem I discovered in 1999, when my family doctor was unable
to resolve a kidney stone issue and made arrangements for me to see Dr. Jonathan
Kalish, a urologist with Urology Professional Association of Tupelo, MS.
The urologist informed me that my prostate was enlarged and contained a
firmer-than-normal region on one of the hemispheres. However, a blood test
indicated the PSA (Prostate Specific Antigen) level was relatively low, and
a biopsy was not merited. A decision was made to monitor the PSA at six-month
intervals.
Since my family history includes persons with prostate problems and prostate
cancer, my urologist, by 2001, was convinced a biopsy was needed. The biopsy,
which consisted of 12 or more tissue samples, showed no cancerous tissue
present.
Once again, my urologist resorted to PSA monitoring as a reliable indicator
of prostate cancer, and I resumed a twice-yearly schedule of office visits
for a digital rectal exam and blood test. To the best of my memory, my PSA
was never higher than 2.81, but because of recent medical advances in blood
tests, my urologist was concerned with factors other than PSA alone.
I think it was last October that the urologist again recommended a biopsy.
With his acquiescence, I begged off having the procedure until after the
Holidays. I had an appointment for the middle of January, but SUPERVALU needed
my services elsewhere at the same time, so I rescheduled the appointment
for the following week.
"If youve not heard from me by next Tuesday, call me," Dr. Jonathan
Kalish admonished, after completing the biopsy procedure. "We usually get
the results back within a few days, sometimes a little longer."
I was in Indianola the following Monday afternoon when Dr. Kalish phoned
me with the results of the biopsy.
"Wayne," he began in his normally cheerful tone, "Ive some bad news
for you. Two of your tissue samples contain cancer. Id like for you
and your wife to see me this week to discuss our options."
The preceding is not necessarily verbatim but is representative of the
conversation. I remembered Dr. Kalish also saying the cancer was not advanced
and was a level six on the Gleason scale.
After consulting our respective calendars, Friday, February 6th
was selected as the day of consultation. Later, I phoned Barbara to give
her the report and made sure she could be off work for the visit.
I dont remember doing much more "work" that afternoon as the weight
of the words, "two of your tissue samples contain cancer," seemed to push
other concerns aside. I remember logging onto the Internet and searching
for "prostate cancer treatment options." I found a ton of material, but one
of the sites I visited had the six most common options explained in order
of most radical to least invasive. After studying the possibilities, I
didnt like any.
I would discover, that which Dr. Kalish later stated, "Saying you have prostate
cancer is like saying you have a pickup truck."
With prostate cancer, there is no one-size-fits-all approach for treatment.
The persons age, his general health, and the stage of the disease,
all must be considered.
Since I had been told my cancer was not in an advanced stage, I had narrowed
the treatment options from several to two before Barbara and I met with Dr.
Kalish. I tried to keep an open mind regarding other options, but it seemed
my best choices were 1) radical prostatectomy (surgical removal of the prostate)
and 2) radiation.
When Barbara and I finally met with my urologist and discussed the many options,
he affirmed my own thinking.
"I can do the surgery if you choose to have your prostate removed," Dr. Kalish
advised. "I dont do the radiation bead or seed implants, anymore, but
some of my partners will if you choose radiation implants. Technological
advances with beam radiation make it a viable option as well, but someone
with the Oncology Group would be responsible for that procedure. If it were
me, Id have the prostatectomy or radiation, but theres no rush,
and you dont need to make a decision today."
"No rush, huh?" I questioned. "So, we can wait a year?"
Dr. Kalish smiled at my absurdity, "No, more like a few months, just think
over what you want to do and call me in a week or two."
On the drive back home, Barbara and I discussed the possibilities, and I
shared that I was definitely leaning toward choosing the prostatectomy, though
my older brother, Fred Carter, chose the bead implants five years ago and
was recently told hes now free of cancer. My cousin, Neal Huskison,
chose a combination of beam radiation and bead implants more than a year
ago, but I was uncertain whether or not hed received a clean bill of
health. I had read that surgical removal of a radiated prostate gland was
next to impossible, and while I didnt know the odds of such being
necessary, I figured thered be less for me to worry about if I initially
chose a prostatectomy.
The following Monday, I was back in Indianola and decided to check with the
insurance clerk regarding any forthcoming changes in our health care benefits.
Im glad I did, because I had not been able to attend any of the overview
meetings held in January, and since our fiscal year ends at the end of February,
I knew any benefit changes would be implemented on March 1, 2004.
"Amber, if I were to have surgery, is there any reason to try to have it
done before the end of F04?" I asked.
"Well, its going to 80/20 on March 1," she stated, referring to the
ratio responsibility of the insurer and the employee.
"What is it now?" I responded.
"Its 90/10, and also the reimbursement for out of pocket expenses is
being reduced the first of March."
As long as Barbara was an employee of South Delta Planning and Development
District of Greenville, she carried me on her medical plan. However, when
she began working for Habitat, at a greatly reduced salary, we could ill-afford
the additional premium to add me to her policy. As long as I was covered
under Barbaras insurance, it didnt really matter to me what yearly
policy changes were made to the SUPERVALU plan, because I could count on
her insurance picking up the difference. Suddenly, I did the math, saw that
my co-payment was about to double, and figured I had better try and save
myself a bundle by scheduling the surgery during February.
I phoned Barbara to let her know about the insurance change and then phoned
the Doctors office and left a message for Dr. Kalish to call me. I
was driving home later that evening when Dr. Kalish called. He understood
my situation and said he could definitely work me into his schedule on either
February 17th or February 24th and would let me know
the next day, once he was back in the office.
Earlier, following the office consultation, I had thought the anticipated
surgery would be perhaps in mid March, but now circumstances seemed to dictate
a date much sooner. What was once a distant appointment was suddenly a time
at hand.
Dr. Kalish phoned me the next day and confirmed February 17th
as the earliest he could work me into his schedule and was told to await
a call from his nurse regarding forms, Pre-Admissions Testing, and pre-surgery
instructions.
Realizing I might be away from Indianola for the next four to six weeks and
already having scheduled myself off for Thursday and Friday, I found it necessary
to return to my office there on Wednesday to finish my workweek.
In the week prior to my surgery, word spread among family, friends, and work
associates of my situation. I was a little overwhelmed by the response. Folks
went out of their way to let me know they would be praying for me.
In Christian circles, prayers lifted to God on behalf of others are called
intercessory prayers. And, while Im no expert on the subject, I am
a beneficiary of intercessory prayer. I confess that I do not understand
how or why God chooses to provide emotional and physical healing through
intercessory prayer. Neither do I understand why God does not provide healing
in all instances when Christians pray earnestly for one another. However,
I know what I felt in the days leading up to my surgery, and it was a sense
of peace, a belief that while many uncertain days lay ahead, the future looked
bright.
To be continued.
Complexions
By Sarah Carter Brown
Several years ago Uncle Lamar mentioned that he was serving on the board
of a dance company in New York. A few years later, he mentioned that he had
moved on to other things. I never knew the name of the company or much about
it until I was in Washington D. C. in October. Late one evening, he began
to talk about this graceful dancer with the company for which he had been
a board member. I listened as he talked about a lady named Sarita and a James
Brown number that he had seen.
This January, Uncle Lamar tried to let me know that Complexions, the dance
company, was going to be at Ole Miss in February. Barbara returned a call
to him because it is difficult to get in touch with me while I work two jobs.
Barbara told me that Uncle Lamar said he could get us tickets to the performance.
Barbara, Felicia, and Denise, my friend and boss from the hospital, planned
to attend, however Waynes post-op recuperation kept Barbara with him.
Felicia brought a friend, and Denise and I met them in Oxford.
Complexions Contemporary Ballet was founded in 1994 by Dwight Rhoden and
Desmond Richardson and has become well known for its performances. Sarita
Allen is the companys artist in residence. For a better understanding
of the mission and members of the company, the web site, complexionsdance.org
is a good place to start. The dance company has an impressive number of
performances worldwide. Complexions has been invited to appear at all of
the major European dance festivals. Recently the company has completed a
run of performances in Italy and Russia.
Felicia had been telling me about her friend from Tupelo, Roxie Thomas, getting
a part in an upcoming project. Felicia had mentioned that the choreographer
was from New York and that Roxie was excited about getting to work with such
a prestigious personality, but we did not put the choreographer and the visiting
performers together until Uncle Lamar told us about the New York dance
companys scheduled visit to Ole Miss. Six Ole Miss dancers were chosen
to participate in the performance. The performance was part of The Racial
Reconciliation Choreography Project: Before Now and After Then.
Denise and I were spellbound by the performance. I noted three standing ovations.
Sarita was tremendous and as graceful as Uncle Lamar had proclaimed. Denise
and I were particularly taken with Desmond Richardson. Of course, we could
only figure out the folks who had solo or partnered performances by the program
listings.
As Denise and I perused the program, we noted that Sarita began her career
with Agnes DeMille. Then she joined the Alvin Ailey American Dance Theater.
She has danced on numerous television programs and in the movies, The
Cotton Club, Angel Heart, and The Last Dragon. She recently appeared
as Bess in the first all-dance version of Porgy and Bess at the Kennedy
Center for the Gershwin Centennial and danced the role of Venus in the American
premiere of Venus and Adonis at the Santa Fe Operas summer festival.
After the performance, the four members of our group went backstage and met
Sarita. She was charming and all that we expected someone of her rank to
be. Its a small world.
Bodock Beau Best
Kept Secret
What with the Editor all wound up about his medical condition, I figure the
following observations might be appropriate.
Did you hear about the hospital that asked the doctors about a new building
project?
The Dermatologist said the move would be rash.
The Gastroenterologist (Stomach and Intestines) had a gut feeling that it
wouldnt work.
The Otolaryngologist (Ear, Nose, Throat) said, "I hear what you are saying,
but the cost would be hard to swallow and wed pay through the nose
for years."
The Neurologist thought the hospital had a lot of nerve.
The Allergist said, "Scratch it."
The Ophthalmologist said the idea was shortsighted.
The Orthopedist issued a joint resolution to prevent a knee-jerk reaction.
The Pathologist said, "Over my dead body."
The Pediatrician said, "Grow up, the notion is childish."
The Psychiatrist said, "In your dreams; you must be crazy."
The Cardiologist said the heart of the matter is cash flow.
The Obstetrician/ Gynecologist said, "Who conceived of this project? Its
premature and born to fail."
The Podiatrist just took it all in stride.
Contributed by Callie B. Young
Things For Which To Be Thankful
The spouse who complains when dinner is not on time because s/he is home
with me, not with someone else.
The teenager who is complaining about doing dishes because that means she
is at home and not the streets.
The mess to clean after a party because it means I have been surrounded by
friends.
The taxes I pay because it means that Im
employed.
The clothes that fit a little too snug because it means I have enough to
eat.
A lawn that needs mowing, windows that need cleaning and gutters that need
fixing because it means I have a home.
All the complaining I hear about our government
because it means we have freedom of speech.
The space I find at the far end of the parking lot because it means I am
capable of walking.
My huge heating bill because it means I am warm.
The lady behind me in church who sings off key because it means I can hear.
The piles of laundry and ironing because it means I have clothes to wear.
Weariness and aching muscles at the end of the day because it means I have
been productive.
The alarm that goes off in the early morning hours because it means that
Im alive.
Best Kept Secret
At a dinner party, several of the guests were arguing whether men or women
were trustworthier.
"No woman, "one man said scornfully, "can keep a secret."
"I dont know about that," huffily answered a woman guest. "Ive
kept my age a secret since I was twenty-one."
"Youll let it out one day," the man insisted.
"I hardly think so!" responded the lady. "When a woman has kept a secret
for twenty-seven years, she can keep it forever."
Selections contributed by Kim Goslin
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