For those who know me well they will, if asked, tell you I am quite the stoic person.  They will tell you of antics as a child where pain was not an issue and where I demonstrated an almost incomprehensible tolerance for pain.  They could tell you of the time when I was 15 years old, cut my finger and put in 4 stitches myself, of my daring, as a hockey goalie, players to see if they could hit my face.  Friends will also tell of all the times I challenged many things, many accompanied by pain, just to prove I could accomplish the whatever it was in my path.  However, they now see someone who appears soft, sometimes brought to tears by the constant and intense aches that are now mine.  They now see, as I am now experiencing, the pain of cancer.

Since my diagnosis first came over seven years ago, most looked at me, witnessing my level of activity and commented on how I didn’t look sick.  To me I wasn’t really sick, I had something threatening to kill me, but in my mind it was just something lingering in the background, something which I dealt with periodically.  The cancer, for the most part, proved an inconvenience to me more than anything.  Initially it involved daily trips to the ‘tanning salon’, the name I gave to the place I went for radiation treatments, doing drugs, aka chemotherapy, and the quarterly appointment with Paul, my hematology oncologist, among other things.  With time, and as the cancer advanced, it come to involve interstitial cystitis, a  bladder inflammation caused largely [in my case] by radiation poisoning, the inability t urinate normally tuning into the need to self-catheterized and then stents in my ureters where the cancer had spread and was threatening my kidney function and lastly, impaired bowel function requiring careful use of stool softeners to prevent gas and constipation.  With each progression, with each treatment and each side effect came some new annoyance, some little pain or procedure impacting my life.  The most prevalent of these being the bowel issues which, when gone awry, can impose constipation or gas and an accompanying somewhat intense pain from the stents.  In the end, all was manageable and none imposed limitations on my living life.  Enter bone metastases.

Until about two years ago my cancer was effectively ‘sequestered’, limited to those areas it already invaded and with little voice.  Until then, there were no treatments, no androgen deprivation, no chemotherapy and no radiation, life was good.  This all changed when the cancer once again became active as measured by a rising PSA.  We responded with chemotherapy dealing it a severe blow.  As measured by my PSA, the cancer retreated to less than half of its ‘former’ self and things looked good, but then my body decided it didn’t like the drugs making this known with a severe allergic reaction.  At this point the choice was clear, allow the cancer to grow or use one of the last arrows in the quiver, to return to androgen deprivation and with that I started back on Lupron.  The initial reaction was profound, dropping my PSA from over 270 to the single digits thus signaling a probable long-term effect of the treatment an effect that, in the end, was not realized.  My PSA began to rise last fall, doubling in just under three months, albeit remaining in the single digits.  Over the holidays life generally remained normal with a visit from my son and continued house showings.  Then in January I acquired a respiratory affliction, which, accompanied by a great deal of pain, and diagnosed as pneumonia.  Treated the pneumonia went away, but much of the pain remained.

Fast forward to February and my biannual ‘staging’, the time when I receive bone and Cat Scans to determine the extent to which the cancer invaded my body.  The results were sobering and suggested the reason for the persistent pain, metastases now littering my ribs and spine with several being quite prominent.  The source of the pain radiating from between my shoulders seems to derive from a spinal metastasis, something quite pronounced on my bone scan.  While originally I attributed the pain solely to the pneumonia and once gone it did diminish, I now find a new challenge, the challenge of managing that caused by the bone metastases, once masked by that associated with the pneumonia.  This challenge is interesting in its character because while most of that I previously dealt with was terminal, it would appear this is not, being instead a constant varying in intensity.  The thought is with the new medication, Zytiga, whose effects may last as long as one year, the metastases will shrink thus providing pain relief.  In the meantime I manage I with powerful pain medications which come with their own issues, not the least of which is constipation, which in turn impact the pain derived from the stents.  My goal now, at least short-term, is the building of a tolerance to whatever the cancer might cause, to ‘deal’ with the pain, to build a higher degree of mental toughness, to further temper my mettle in a way that allows me to continue to live and once again deny cancer’s ability to take my life.

Happy reading, happy thoughts and happy trails.

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