I've resisted writing about this for awhile now. Partly out of fear, somewhat out of embarrassment but, most of all, out of uncertainty of how all of this will ultimately turn out. Well, this morning I received most of the news I've been waiting to hear... and things look good. So, with that, I feel I'm ready to share the following with all my friends, and the whole entire blogosphere.
I'll warn you now... the following is very personal and mildly graphic in parts. You may read Part One here.
The next several days passed by in a blur. I had a follow-up appointment with Dr. West Thursday morning, and I then spent the better part of the day at Trinity getting poked (blood screen), scanned (CT scan) and zapped (chest X-ray) to give the doctors, and me, an idea how much my cancer might have spread.
When I got home, Mom called to tell me she would be driving down to Dallas with Abby (the family schnauzer) that weekend. That's when I knew this was serious; Mom had last filled up a gas tank, by herself, sometime in the early 80s. And now she was driving 650 miles to stay with me.
Tuesday morning, January 31, 6 am. Check-in at day surgery at Trinity. Before they knock me out, Dr. West gives me some good news: the scans returned clear of any additional tumor growth. "Your blood test does show the marker for tumor growth, though," she said. "Which was expected. It means you either have cancer... or, you're pregnant." Turns out the same HCG marker shows up in a woman's blood when she's expecting. The things you learn.
In the days after learning I had cancer, there were several choices. Dr. West had asked if I wanted to talk to someone regarding the... well, loss... I would soon me experiencing. Although there is usually no (repeating, NO) significant aftereffects from losing a testicle - there's a reason guys have two (God bless the inherent redundancy of the human body) and the other one really does "step up" - it can cause a psychological impact. No, that's OK, I told her. I think I've made my peace with that.
She also asked me if I wanted to bank sperm, in case something DID happen that caused infertility. It's rare, but it does happen occasionally. I thought about that for awhile... and, well, I'll keep my decision on that to myself. Suffice to say, it's a choice I was comfortable making, and I still am.
Which is why, when the time came to go into surgery, I only really wanted one thing. "Please get this evil thing out of me," I told Dr. West. And that's pretty much all I remember.
I went home at 3 pm that afternoon I'm proud to say I walked out of the hospital by myself - no wheelchair - although it hurt like hell. Not as much as sitting down in the car did, though.
The pain eased quickly, though - thank you, Vicodin! - and I was able to walk well enough by Thursday (February 2nd) to go back for a follow-up appointment with Dr. West.
The news from the biopsy was good: it looked like it was "seminoma" cancer, the weakest kind, and light radiation usually kills any remnants left behind. She arranged an appointment for me with an oncologist, who would be handling the next stage of my treatment. Dr. Bhogaraju ("call him Dr. B.," West told me) came highly recommended, and she noted that he was known for being VERY thorough.
The appointment was for the following Monday. I spent the weekend regaining my ability to walk more-or-less normally, and I even started writing for ANN again Thursday night. By the weekend, I was working a full schedule; it was something to do, besides watching TV and dwelling on things.
One more thing about that weekend. Saturday morning, I started wearing a gold necklace my friend Jen had given me for Christmas two years ago. I'm not a bling-bling guy (MAJOR understatement, that) but I made it a point after she gave it to me to always wear it while I was flying. Call it superstition, but it's always protected me... and, to paraphrase Ray Kinsella in Field of Dreams, I needed all the karma I could get right now.
The necklace, 24-karat gold, has a small pendant at the center. "Our Lady of Loretto," it reads over an image of the Virgin Mary and Baby Jesus, "pray for us who fly."
I haven't taken it off since.
Monday morning, 8:30 am. Dr. B's office. I was feeling pretty good, actually; this appointment would set the course of events in motion to get the rest of this taken care of. To a degree, I was even looking forward to it. This was Day One of the recovery phase.
Well, it didn't go as smoothly as that. Here's the email I wrote to my family and friends after I got back from the appointment, while I was still a bit dazed from it:
Well, of course, this would have to be more fraught with drama than anticipated...
I had a very thorough discussion and exam this morning with my oncologist, who we'll call Dr. B (I honestly can't pronounce his last name.) He took some more blood, and scheduled me for another CT, this time for the chest area (the last was pelvic, with a chest X-ray) just to make absolutely sure there is nothing that's going to surprise us down the line.
There is one area of concern... although in his words, it's "nothing I should lose sleep over." One of my "markers" shows higher than usual for a straight seminoma. On a severity scale of 1-10, this is akin to going from a "3" to a high "4", as non-seminoma is unresponsive to radiation. Should it turn out to be non-seminoma, I would need some combination of chemo and/or surgery to make sure everything is removed. Dr. B also emphasized that the chance of complete curability remains at 97 percent, no matter what type it is.
There is a strong chance it IS "just" seminoma -- after all, two different doctors reached that conclusion last week. Dr. B also explained to me all about what the radiation treatments would entail, so that tells me that's the direction he's still leaning towards. Radiation would be a comparative cakewalk next to surgery... but if it's necessary, then OK.
He also noted there is an 85 percent chance that I am currently 100 percent tumor-free, and might just remain that way forever (although I will need to get checked regularly for the rest of my life.) The rub is, we'll know nothing for CERTAIN for another 10-14 days, as the pathology results make the rounds. These will be nerve-racking times...
After the appointment, I made the biggest mistake I could: I went to the online testicular cancer research page and read worst-case scenarios. The surgery option, called "nerve-sparing" RPLND (there's a reason for the modifier that I won't dwell on here) is intensive, painful, and has a long recovery period. And chemo is... well, chemo. Needless to say, I didn't like the uncertainty, but there was also nothing I could do about it.
Mom stayed for another week, before heading back to ABQ on Valentine's Day. She wanted to stay, but had to get back. There wasn't much point to her staying; by then, I was more or less back to maintaining a normal routine, even driving (took me 10 days to do it, though, before I felt comfortable again with a 5-speed.) And, really... I wanted my apartment back.
The 14th was also the day for my chest CT scan. It went much as the first one did, except this time I didn't have to drink a barium solution. Phew. The radiology tech - who was otherwise a very nice, talkative guy - pretty much harpooned my arm, though. It's a week later, and I still have a "track mark" on my left arm (just like a heroin addict!)
My follow-up with Dr. B was scheduled for Monday, the 20th. Not much else to do except work, and wait. In the afternoons, I went down to watch planes at Addison. Again, it was something to do... but it was also sad.
Flying means everything to me. Even when I'm not doing it, knowing it's there, knowing I can, gives me strength and hope. When would I be able to fly again?
Which brings us to today, Monday, the 20th. It's about 11:30 at night as I'm typing this out. It's been a very long day.
First of all, my appointment was canceled this morning, as the results from the pathology report Dr. B sent out for a second opinion still haven't come back. That means I'm still in limbo. I asked the nurse to have Dr. B call me with whatever news he DID have.
When I called my parents to let them know the news, they also told me my Grandpa Finfrock passed away yesterday. I wasn't very close to him, or to my dad's side of the family in general. I won't feel his loss as much as I felt the loss of Grandpa Sayers last November. But it still hurts... and worst of all, I knew it was one more thing causing my dad grief.
God... enough. When is this shit going to end?
Well, it hasn't ended... but about an hour later, I got a call from Dr. B.
OK. I just got off the phone with my oncologist, Dr. Bhogaraju (bo-gah-RAH-zhu) and he filled me in on what's going on. There's more GOOD news than bad.
But, there's some bad. While he's waiting for the Indiana University results to come back, he had Trinity take a closer look at the pathology reports, too. Upon closer observation, they found 1% of the tumor was embryonal carcinoma (not sure if that first part is 100% correct) -- a NON-seminoma form of cancer. That's what I was hoping to avoid, as it's not treatable with radiation.
Here's the good news, though. At this writing, I AM OFFICIALLY COMPLETELY FREE OF CANCER. My chest scan from last week came back normal, as did my bloodwork (I'm officially not pregnant.) My chances of remaining like this forever are 75%. Not as great as before (85 percent), but still a bet I'd take in Vegas (essentially, my odds of developing cancer again are the same as any of us have of developing it in the first place. See your doctors regularly, guys.)
Moreover... the preferred course now is observation. I've been freaking out about the possibility of a non-sem diagnosis because the treatment methods are a) chemo and b) surgery to remove the lymph nodes. Per Dr. B, neither is called for in this case. If something does show up again during the course of observation (belly CT scans & bloodwork, which will start out in one-month intervals and gradually lengthen as time goes on) then, depending on what shows up, chemo is usually the response... although surgery may be required then, too.
Still... for the first time since January 24... I'm breathing a sigh of relief today, and I don't think I'm tempting fate by doing so.
And that's where I am now. This isn't over. There is a 1-in-4 chance this will come back, someday, and I'll then have to undergo chemo (that's more likely at this point than the surgical option.)
But for now... I'm healthy. And there's a 3-in-4 chance I might never have to go through this again, either. The rest of my life will be a numbers game, though. The threat never really does go away... I'm only considered "cured" if I go 10 years without anything else developing.
Here's the thing, though. Even if it does come back, my chances of ultimately being cured completely are still absurdly high -- close to 98 percent. If you have to get cancer, TC is the "best" kind to get.
So... we'll see how this all plays out. There isn't anything else I can do. But really, as far as I know I'm cured, and I intend to live my life from this point on with that as resolute fact... praying every minute.