Life comes with many aspects, some say challenges while opportunities.  When considering any part of life, any expectation, one thing remains consistent, one thing seems always ‘demanded’ of those of use facing some ominous disease, some life threatening condition, and that is hope.  I wonder if those professing this ‘hope’, this thing supposedly binding to life, this thing we must hold on to at all costs, really understand the impact of hope, including the trade-offs made when replacing ‘realistic’ with hope.  I wonder if, even in the least way, they have any concept of how hope, in itself, can destroy itself.

For those not afflicted with an omnipresent and life threatening condition, the idea of constantly harboring every once of hope one might muster, the belief something could come to change destiny, to save the afflicted person, seems rather straightforward.  I doubt most, at least in this is the case in my world, they comprehend the power of hope to do both good and, incomprehensibly, bad, when it comes to a person’s outlook. Fr me, I tend to live in an area, a region, of probabilities, rational and likely outcomes considering the data at hand.  I’ve found that with my condition this is a safe place, much in how I manage expectations in my business life, I find the same to apply with my disease.  By living within the probabilities, the realistic, I find things less turbulent, more balanced, with fewer downside surprises.

While living within the realm of the realistic appears to lack hope, it is, mostly about self-preservation, about preparation for the downside hits and the ability to enjoy the upside surprises.  For me, the data, and I do tend to be something more of a factual, data driven person, suggested the suppressive effects of Lupron would endure, at a minimum, for 2 years and likely more.  The rationale behind this is the data show Lupron effects, on average, last 2 years and in those cases where there is a dramatic response, the effects endure for some time afterward.  In my case, my PSA dropped dramatically, from 271 to the single digits with the first administration, by all accounts unexpected and on the extraordinary end of the response curve.  In my mind, based on these data, I began to readjust my expectations, recalibrate the length of my survival; I began thinking seeing my son obtain his Bachelors degree as a given and the likelihood of seeing him graduate from either law school or to obtain his MS, was a probability.  In short, the math, based on the probabilities, caused me to believe I had, at a minimum, 5 more years to live.  My ‘hope meter’ was thereby set, expectations established, to at least 5 years with the commensurate belief other options being forthcoming.

So here now I am, my projections for the lasting effects of Lupron recalibrated, actually established at 1 year, not the probable 2 and nowhere near the suggested 3 years.  To say the recent PSA rise was unexpected is an understatement, a massive miscalibration, at least in my mind, of nearly epic proportions.  The ramifications and probabilities reset from a likely life span of 5 years to a likely span of 2 years.  The supposition of seeing my son get his bachelors degree is now n question, his getting a higher degree now very unlikely.  In the end, and honestly, there is a measurable downside, a palpable sense of mortality and looming death becoming more real, this is, by all accounts, a major setback.

When talking with anyone involved in the healthcare field and for that matter most n everyday living, one becomes indoctrinated with the notion a positive attitude makes god things happen.  I’ve always concurred with this notion, finding god in even the most dire of situations, not the ‘what hurts you makes you stronger’ god, but things like with my cancer, I see my background and education surviving to challenge the standards and thus opening doors to fresh approaches to help others who follow.  I’ve seen my cancer as the impetus to seek my little sister with whom I’ve learned so much about, and, about myself.  I’ve looked at my cancer in many ways a blessing, a god thing that facilitated many positive things in ,y life as well as those of others.  I’ve always held cancer can kill in one or two ways, it takes our physical lives and, if we let it, it takes our real life, the non-physical, that encountered in everyday living.  I believe key to sustaining my attitude is regulation of expectations, to look at my physical life in increments, to limit distances envisioned, to manage ‘hope’.  In receiving the latest PSA number the paradigm shattered, the hope ‘set point’ destroyed and, from a practical perspective, my outlook took a major hit, all I previously thought true destroyed, hope destroyed, causing, at the expense of considerable energy to recalibrate, me to come back to manageable expectations.  I think, at least based on my reaction to the setback, hope, however well founded, damaged me, taking more than given and that, in my view, is the downside, the power, both constructive and destructive, of hope.

Happy reading, happy thoughts and happy trails.

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