The Walnut-Sized Gland Step 2

I mentioned my prostate a few months ago—a walnut-sized gland, tucked under the male bladder. You’d think, by its choke-hold on your urethra, that it is hanging over empty space, like Luke desperately gripping the Cloud City maintenance walkway. It is not. It is packed in like an iPhone chip.

Sometimes that grip is the problem. Prostates get old, they get irritated, they swell. They wake old men up at night, unable to vent their bladder. But mostly they are very quiet. Even when they become cancerous. Prostate cancer arrives with no warnings, no symptoms. It is insidious enough to have become the leading solid organ cancer; insidious enough to become one of the leading causes of cancer deaths among men.

And that’s where packed in like an iPhone chip becomes a problem. Surgery is one way to fight back against a cancerous prostate. Think Darth deli slicing—and presumably cauterizing—Luke’s wrist. While Luke simply dropped away at the Bespin gravitational constant, the packed-in prostate only comes out with other stuff attached. Part of your urethra, for example. And a few key nerves. As you might guess from their neighborhood, these nerves control urinary continence and sexual response.

In fact, urinary incontinence is a common post-surgical complication with a radical prostatectomy. I was pretty lucky in that regard. I could almost whiz at will right off the bat. And any problems got rapidly better. Five months in, an occasional drop gets through the faucet. But, hey, at 61 I was headed toward some leaky plumbing anyway. So I can’t really complain.

The other common post-surgical complication is sex. More precisely, the inability to have it. And you’d think that might be from a lack of seminal fluid. In its quiet unassuming life under the bladder, the prostate produces seminal fluid, that protein that carries sperm down your urethra to form ejaculate. Gone now, and with the vas deferens also cut by the surgeon, there is no ejaculate. But that is not the problem. It is quite possible to have a dry orgasm.

No, the problem is in those key nerves that get cut. Some control blood flow into the corpora cavernosa. They are the last switch on the track that sends the erection locomotive into the station.

Nerve-sparing technology—especially when used with robotic laparoscopic surgery—is meant to leave some of these intact. But that is not always possible. Exactly where the nerves are located is one issue. But exactly how close the surgeon must cut to the margins of the prostate is another. In my case, the primary goal was being alive 15 years from now. The secondary goal was to be able to pee when I wanted. Sex was third. That might sound strange, I know. But, like I said, I’m 61. I only know one way to live. I know one way to pee. But when it comes to sex, I know more than one way to skin a cat.

So, my prostate came out in its entirety, like it never existed. With it came those key nerves. Now lost in a trance, my penis no longer pays any attention to the world around it.

Rooting the waltnut-sized gland out completely means it was also possible to completely dissect it. (Along with some of the lymph nodes in my groin.) The resulting chopping and grinding revealed that the cancer had not spread to the margins of the prostate. Which means it had most likely not spread.

That’s good news. Barring other cancers, car accidents, a massive stroke, stray bullets, ebola, pit bull attacks, a repeat of the Spanish influenza—or whatever ancient evil virus is being released from the melting permafrost—I might actually be alive 15 years from now. To be sure, I’ll get semi-annual PSA tests for a few years. And not just any PSA test. A normal PSA test looks for that prostate specific antigen in parts per milliliter. To get serious, they test me now in parts per nanoliter. I went back to the surgeon yesterday to hear the results of the first such test since surgery. Mine was a statistical zero. Not a trace of that antigen, peculiar to prostate cancer, was found in my blood. So, yay!

Me and the doctor are very happy with our primary goal. We are pretty happy with our secondary goal. My urinary control is not perfect. But it’s close enough.

The tertiary goal needs some tweaking. The problem with being 61 is that you are only 61. Not getting an erection at 81 might fall into the category of the coffee maker being on the fritz. At 61, you are not really ready to hang up your jersey. What to do? Sildenafil—or tadalafil, vardenafil, udenafil, and avanafil—only works if your nerves are able to signal for blood flow. With no blood flow at all, vasco dilators are out. We could simply wait for the nerves to regenerate. You know, skin the cat some other way for awhile. But nerves regrow slowly. It may take years after a radical prostatectomy to be able to have a spontaneous erection. The problem is, that after a protracted period without blood going into the erectile tissue, the tissue starts to deteriorate. The sponge gets less spongy. (Yes, wives, that nocturnal erection your husband gets isn’t just because he’s oversexed. It’s partly biological housekeeping.) Apparently this deterioration can happen in months let alone years. So waiting too long ensures some damage will be done.

So we’re off on a new adventure. The scars are healing. The plumbing is as tight as can be expected. My PSA level is exactly where I hoped it would be. Now, my wife and I get to select an ED treatment. It’s not exactly the stuff of dreams. But, it’s the next chapter in our little saga about a walnut-size gland.

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Cocoraque and a Blood Moon

This morning, the setting full moon is eclipsed by our planet’s shadow. A blood moon. It will rise tonight as a blue moon. And a super moon. Blood moons. Super moons. Blue moons. Snow moons. What does it all mean?

I don’t know. But it got me to thinking about a visit I made to the Cocoraque Petroglyphs. I avoided going there for over 25 years. But eventually, I needed to see for myself if these mysterious images are a collective enigmatic message. They are. And though many of the stones have been carted away wholesale, I think I pieced together an interpretation from what remains.

Seeing the glyphs surrounded by ironwood was vital to knowing what they say. Ironwood is an evergreen so long lived some individual trees survive for 40 human generations. Other plants seek the nitrogen around its roots. Entire life zones grow under an ironwood’s sheltering canopy. And… ironwood is a monotypic genus–the only one of its kind. Ageless, evergreen, nurturing and monotypic, of course ironwood represents divine female sexual energy: the Creator, the Life Giver.

Cocoraque itself is circular, another symbol of the eternal, save an anomalous lower secondary hill. So the dual peaks are a hierarchical life flow–from the sacred to the supplicant.

And the hundreds of, seemingly pluton, rocks? Born of earth and fire, exposed to wind and rain, they are elemental: the created. They are humans. They are eternal only as a group. Excepting those chosen as prophets they lack divine power or voice. But each rock with a glyph represents a message from a prophet, a manifestation of the divine voice.

So the relationship between the ironwoods around the circular Cocoraque and the glyphs on the individual stones reveals all. The message I have pieced together is this:

A people were here. Now they are gone. They took only what they needed. They did not build. They moved with the rains. But they are gone. Look and learn. The desert is eternal and you are nothing. Your technology will not sustain you. Only the earth will sustain you. Your contempt for her will be your undoing. Make peace with her. Know what is sacred and what is profane. Then live by what you know.

 

A Quiet Guy

One year ago today my father-in-law died unexpectedly at home. The circumstances were a little overwhelming, so I got no further than a Facebook post. In his memory, I am reposting that here today.

The idea that you can live a life of quiet strength is no longer in vogue. Now it’s about your calling, chasing your muse, living your dreams. All good things, of course. Except that often these things are simply thin veneers for self-indulgence.

John was far from self-indulgent. He just got things done. He didn’t need a stick figure sticker on his minivan for each of his kids—like some combat pilot who’d been shooting down Zeros—to prove he loved his family. He didn’t even need the minivan. He just made sure he paid the mortgage and bought the groceries and the shoes. If there was money left over from raising five kids on a steelworkers wages, it went into making Christmas full and festive or putting a pool in the yard in the summer.

He was a little gruff sometimes. He spoke loudly when he was right, and a little louder when he was wrong. But if you got past that, it was easy to see the twinkle in his eyes, and one corner of his mouth ready to turn up into a smile. Maybe he was a bit like the small house he lived in: a little rough on the exterior, but with a solid foundation and frame.

So he went quietly through life, a steel mill electrician. He’d pick up his lunch pail in the morning and head down the road no matter the weather. Rarely complaining, he slowly built his pension and savings for the day when the wheels of industry were ready to kick him to the curb. He readied himself to live independently when that day came. And that is exactly what he did to the moment he died. I think there is a lot to be said for that.

The great Christian writer Paul once opined that three main things should guide our lives: faith, hope, and love. I’m not sure that John could quote the first letter to the Corinthians. But that’s how he lived his life. Paul said the greatest of the three was love. And Paul was not talking about smothering people with wet kisses, or, as we see so often today, responding to a person’s problems with a smarmy “I’ll pray for you.” Paul was talking about the practical expression of love. I never heard John Kovach say, “I’ll pray for you.” Instead, he just came over to your house and helped you fix your toilet.

It’s shocking that John followed his wife of 63 years into death so soon. Death has been cruel to the Kovach/Adle clan—and especially this past month. I have had enough years on this planet to experience some heartbreak, but have never seen anything like this. But, I once said that good guys should die warm in their beds surrounded by people they love. John came pretty close. He died quickly and painlessly with Kelly’s hand on his shoulder and her looking into his eyes. Since I think she is the sweetest apple to fall from that family tree, I’d be okay with dying the same way.

Kelly overheard her dad praying just a few days before he died. He thanked God for all of the love shown to him these past few very trying months. He prayed to deserve it. And he prayed for the strength to be able to repay it. That’s how unassuming he was. He simply had no idea that he had already paid. He had paid it forward. It was love coming back to him from decades of doing thousands of simple things. We find it easy to see heroes in folks who sacrifice themselves for us all at once. It’s harder to see it in the ones that do it a little bit every single day. So, here’s to the quiet guys. Here’s to the guys who build the stage and then step aside to let the rest of us play on it. Here’s to just getting it done.

Godspeed, John.

Grand Canyon in 400,00 words

I’ve been kind of distracted when it comes to writing about our boat trip trough Grand Canyon. But, if a picture is worth a thousand words, here is a link to a video I made that should be worth about 400,000 words. Enjoy!

 

A Last Letter to Mimi

One year ago today my mother-in-law died. I had time—in the pause between when she resolutely faced her cancer until it claimed her—to write this letter. I post it here today in her memory.

Dear Mimi,

I’m not much for writing these days. My mind flits around like a feather in a breeze. Just when I think it will light down on a solid thought, it gets lift and is gone again. So I write things and then shovel the mashed up mess off to the side. But I feel like I should give this one more shot.

First, let me thank you for giving me the most wonderful gift anyone could want: your beautiful daughter Kelly. She is my light and my lodestar. Truly if there was ever a person with a heart of gold she is it. I am probably too much of a stoic for my own good. It makes it tough for me to let go and love people. But Kelly was always easy to love. I know she gets many of her loving ways—and that tiny little bit of enchanting free spirit she lets loose once in awhile—from you. So thank you. She has made all the difference in my life.

Thank you for all the time you spent with our children. Their happiness means everything to me. And you gave them a lot of happy moments. I’m not sure you ever gave a second thought to the time and expense of so many trips to Tucson. And I’m sure with it to do over you’d add even more. But I know that it took a lot. And I am thankful that you did it.

I worried sometimes that—with us marooning ourselves here in the desert—our kids might have tenuous family ties. Anthropologists know that humankind took a huge leap forward in progress about 15,000 years ago. They puzzled over that for awhile. Then they realized that leap came when humans had started living long enough for grandparents to influence child raising. So you see why I might have worried. But, thankfully, you were always there. I’m convinced that your many visits left them with a positive view of where they came from and who they are.

All of those happy arrivals did mean, of course, some sad departures. In the pre-9/11 days, it was always so exciting to stand at the top of the airplane ramp trying to be the first to spot Mimi. At the end of it, the final boarding call was always that strange mix of happiness and sadness; the joy of having seen you again, the sorrow of saying goodbye. I truly regret that I can’t be there for your final boarding call this time. But please know that as much as I might cry there will be that same mix of happiness. I will still have your amazing daughter by my side. And I will still see your influence in my children—your royal court. So, no matter where you fly off to this time, you will always be here with me, and I will always carry a little piece of you in my heart.

Godspeed on your travels.