jazzoLOG: A Date With Surgery    
 A Date With Surgery29 comments
picture25 Mar 2004 @ 03:59, by Richard Carlson

...and he was almighty because he had wrenched from chaos the secret of its nothingness.

---Jean-Paul Sartre

When you get there, there isn't any there there.

---Gertrude Stein

God never appears to you in person but always in action.

---Mohandas K. Gandhi

Bernard Safran: A Surgeon Working
1982, 37" x 48", oil on masonite

In some ways this article will not be typical of my writing. In the first place I shall begin with a caution about reading it at all. The main information about what I'm doing and what is happening to me---hopefully in some kind of equal balance---is simple and I can tell you that right away. As a routine procedure for prostate cancer, which we have reason to believe I have in a very early stage, I received a total body bone scan last Friday. The results were shared yesterday and they were excellent. We see cancer has not moved into the bones...and there are not other marked abnormalities. It's time to take the next step and that is selection of treatment, and I have done that. We have a date for surgery to remove the entire prostate gland on May 3rd. My urologist, with whom I have been working for a year, will perform the operation.

Some may want or need to read no further. This situation is all about male anatomy of the most personal kind. Surgery is not the stuff for a morning read over your first coffee either...at least for most of us. I'm going to talk about the operation and why we selected this option. I'm going to write about the risks and what may happen to me. You may not be interested in knowing any of that. I certainly never wanted to...until my time came, as I guess in one way or another it comes to us all. I shall not be insulted in the slightest if you simply X out this item from your screen and move on to something you like better. You're now aware that from here until the operation I shall be preparing, and afterwards I'm going to be laid up for a few weeks. That may be enough of an alert. I would appreciate if someone would volunteer to Ming to, or if Ming himself would, edit the Logs for Front Page placement for a couple of months, beginning in May.

Many people have gone beyond filing away these pieces of info about me, and have replied with amazing advice and heartfelt support. All kinds of stories have been shared, sometimes publicly on the Web. We're still pioneers in very significant ways with this computer communication. I don't know if writing about my personal life to significant people in my life and to complete strangers all at the same time is a smart thing to do. However, all of us live in communities, and people want to know what is happening with the other members...and what has happened when someone comes up missing. It turns out a couple of the communities I live in are electronic and virtual, "where" I have certain responsibilities to take care of, just as I do at home and in my workworld. So it seems important to try to write.

A number of people have cautioned me about this surgery and the whole medical scene in the United States particularly. I welcome this controversy and hope the dialogue will go on with those who continue to read. The most important influence in my decision is my wife. We chose each other for a life journey, and it's at a time like this that a marriage means the most. Fortunately we seem to be agreeing about almost everything---although she always is able to find a few more things I can do to become a better man. After that come my doctors. I have chosen them carefully and nurtured our relationships. I feel that they know me and like me---which simple involvement I find important in being healthy and in healing. Maybe they have faults, but I do not think either has been brainwashed by the pharmaceutical companies or is ignorant of new research and alternative therapies. Both see me anytime I call and give me all the time I need during appointments. As usual I am not entirely happy with clerical communication between the offices, and I find I have to ride herd on that process much more than I'd like. But these physicians are understanding about those problems, and not overly defensive or frightened I'm going to sue them. In the past 10 years I'd had to get rid of a couple of doctors with whom I was not comfortable.

Next in influence come friends and family, church and colleagues, and the mountain of reading material you've recommended. I know some of you have disagreed with me about this option of treatment. Some of you have been through this yourselves and selected other methods. This is where this essay may start to get more sensitive. I have 5 1/2 weeks to change my mind, and if anybody wants to move me in another direction please try. Having the prostate out is not like removing the tonsils or appendix. This is major surgery and in a minute I'll review with you why. Some of you selected radiation instead when you were in my shoes, and it's still an option for me. Others have heard about chemo and hormone therapy. The importance of diet is undeniable...and I believe there is ample evidence to show that what I've eaten and drunk throughout my 64 years has contributed to my diagnosis. Many alternative therapies sound wonderful and I want to try them, but we've decided they should complement rather than replace our selection.

Much of what I'll say now is my understanding of things the urologist has told me and from a book he gave me entitled Prostate & Cancer by Dr. Sheldon Marks. My copy was revised in July 1999, and I've tried to supplement with more recent evidence and opinion; but I believe essentially the treatments have not changed since then although procedures hopefully have gotten better. It seems prostate cancer is particularly nasty because of how lethal is the spreading. The gland is nestled at the base of the spine and surrounded by the lymph system. That's where it goes. If it moves into either there are desperate problems for the patient. Therefore recommended treatment is radical and needs to be more aggressive than the cancer itself. Surgery has the best recovery rate of all the therapies...and that is because the cancer is gone from my body and in a jar in a pathologist's storeroom. That isn't to say we might not get it all or that some bad cell floating around might not bloom into another problem. The PSA level reveals if that is happening, and I'll have to have that test now the rest of my life---but all us guys have to do that starting at some age.

The point is that surgery is a window of opportunity available only now for me. Later I'll be too old to endure it. Radiation is my second choice, and if I'm bothered by this kind of cancer again (which is highly unlikely) that's what I'll do. I could take radiation now...and still elect surgery if the cancer reoccurs within 5 years. There is an uncomfortably high ratio of men who find the cancer back after 5 to 10 years following radiation. The problem I would face then is finding a surgeon willing to try it. The operation is called salvage prostatectomy. As Dr. Marks puts it, "Because all the tissues have been radiated, the normal layers between the tissues are usually gone, leaving the tissues all stuck together" (p. 271). The chances of error are enormous and a mistake in there is disastrous. People at Johns Hopkins are willing to try, but won't talk to you if you're over 70. So if I miss the boat of surgery now, it'll be gone for good.

Another advantage of the surgery is that some lymph nodes can be examined during the procedure to see if the cancer has spread to the lymph system. Given my genetic situation it may be vital to have that done, and radiation as an option does not provide it. Chemo and hormone therapies are used for men with prostate cancer as control and containment. In these cases because of age or severity, therapy to remove and cure is not possible. Guys have to come to this kind of acceptance eventually in one way or another.

I've also been advised toward radiation by friends because of the enormous risks and side effects of prostate surgery. Yes, I'm worried about all this. God in His Wisdom of Perfect Design and/or Nature in Her Sweet if Haphazard Evolution has set us up generally, male and female, so that stuff goes in at the top and comes out the bottom. Maybe gravity is to blame for this. I use the word "blame" because it always has been a bit awkward for me that sex and elimination are so close together. I'm sure we poets and artists could come up with some much better ideas for sexual pleasure and propagation than God did. I'll be careful about what I say since, if God is watching, I don't want to get Him mad at me right now. But I'm sorry, it's hard for me to consider semen and urine as equally sacred...although ultimately in some way I suppose they are. With removal of the prostate, it's good-bye to semen---and maybe hello to diapers. Here's the main reason men balk at the surgery...and why it is a major operation.

The urethra carries my urine from my bladder. This vital pipeline goes straight through the prostate gland. You can't just slide the gland off the urethra---which would be a really cool improvement. You have to cut it. Then it's stitched back onto the bladder, and I wear a catheter for a while as it heals. Incontinence can be a side effect for men if all this doesn't go perfectly. Furthermore there are significant nerve endings that will be disturbed in the operation...and they're the darlings that provide the mystery of the male erection. There's no way to predict what a guy will be like in this area after the voyage of surgery. You may have spent over 50 years trying to train the darn thing...and now there's a 50/50 chance you have to start over---and may not be able to do it. No more Viagra jokes please.

Well, if you've made it this far through the writing, you probably know more than you ever wanted to, both about me and about prostate cancer. But if you did, I'm sure you're one of those special people to whom I owe so much for your messages and your prayers. I know they will continue and they really mean a lot. I have been so surprised and encouraged at this important moment of my life with the thoughtfulness and caring of both friends and strangers. We live in such an amazing world---in which we are more isolated and yet more connected both at the same time. My father used to conclude his radio program every day with a quotation from Dickens...and I'd like to follow his example now. "And so, as Tiny Tim observed, God bless Us, Every One!"


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29 comments

25 Mar 2004 @ 04:16 by jstarrs : In the tantric...
...inner offering, the ordinary appearance of semen & urine (and the other bodily liquids, such as blood) are transformed into nectar.
In the least, I hope that you'll be able to transform the shit you're going through into a positive experience - (thanks for your frankness, I guess looking at the situation frankly & openly is the first step in being able to transform it).

^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^

I knew Jeff would top me in talk of the juices. Thanks man.
*****************
My honor, Jazz...I'm thinking that I'm seeing a fine supportive example of what can be done on the net, between people sharing their experiences. (thanks Kay, for the honest example & Shawa for keeping the passionate flame alive)  



25 Mar 2004 @ 04:56 by shawa : I think...
...Richard is well on the way to do that. Besides, there is more to a male human being than...oh! (as Martha says) never mind...

>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

And of course the boys soon find out there's more to the lady than the heady scent of camelias.  



25 Mar 2004 @ 05:09 by Kay @207.69.139.145 : I love you dearly
As you know Wayne and I have been through this very thing. He is finally on the mend but it has been a tough trip. Our relationship has deepened through all of this and I suspect that you and Dana will be fine. There are so many ways to espress love and devotion and sexuality than the typical penis vagina mode. There is so much more. Yeah I miss sex. True but what I have wound up with is very special. Communication has deepened on every front for us and we take time for long walks and bird watching and of course our web site which continues to grow and this we do together. We are also building a new center for multi purpose functions. Hey if you want to talk on the phone send me an email with your number or email me for mine. Also I send you one big cyber hug. love to all of you. Kay

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Newer members neverthless may have discovered already that Kay is among the most highly trusted people in this Network. For a few good reasons of her own she hasn't been around for a while, but it is always a thrill to hear from her.  



25 Mar 2004 @ 05:50 by Michael Jupin @63.155.184.157 : Richard:
I read your whole article and am very appreciative of all your wrote. It was not difficult for me to read although I sense it may have been difficult to write. And as I say I am grateful for both your straightforward and "feelingful" description of everything.

You, Dana, and all your family will be in my/our prayer this morning. I say "our." I am at the conference center with Bishop Thompson, archdeacon Hanisian, and seven other clergy for an overnight social/reflection/prayer time together. We wiill be having morning prayer in an hour and I will mention you all by name.

Every blessing and see you soon.

++++++++++++++++++++++++++++++++

Michael is the Episcopal interim priest at our church. In a short time he and his wife have become among our dearest friends. And yet he also is without doubt a supreme spiritual guide, in whose pastoral care I have grown immensely.  



25 Mar 2004 @ 07:41 by spiritseek : Stay true...
I found through all this, was that I had to decide what my body and soul wanted, and because of that decision healing in many ways improved. It is a true gift of unconditional love when we share these times, because in doing so we show that we care to help others enough to expose ourselves. May your life be filled with great blessings, love and healing. God speed in your recovery.

/////////////////////////////////////////////

Yes Marie, my secondary motivation is to inform others of what goes on at a time medical crisis, Stateside anyway. This Internet stuff still is pretty new, and it feels like pioneering to share this way---although some relatives are writing me privately begging for mercy on all the play-by-play. My primary thinking however is to let some folks know what's happening in case I drop out of sight---for a while at least. We all know, especially at NCN, how concerned we get when we don't see someone around for a while.  



25 Mar 2004 @ 07:42 by martha : oh richard
such a lovely honest story...hug and kiss...I wish all the love you are receiving could vanish your problem but alas please know you are loved and supported in your decision. I'll continue to send you energy every day and even after your surgery and shakti is right , you are so much more then...oh never mind!
(I did read all this before my morning coffee) (and I would be there to hold Dana's hand as you go through the surgery if you weren't so darn far away)

==============

You know Martha, we two families really should get together in person one day. I think we'll have a wonderful time.  



25 Mar 2004 @ 09:57 by swan : God Bless us everyone,
we write our personal stories not only to bring new understanding to ourselves but by chance maybe touch someone else who is in the same place. This is one of those pieces of writing. There is bravery in this writing and in your process. I trust your path and your choices because I know the kind of thought you put into things. All is right and perfect. Now, for the next 5 and a half weeks visualize that all the cancer is gone and you are in perfect health and surprise the doctors!

[[[[]]]]

Speaking of visualizing Katelyn, I just had a phone call from The Queens from a dear friend of 40 years, who's been struggling with the Big C herself. She won't bother with computers so she didn't know about all this with me---but she sensed something. (I had tried to phone her last week but she was down with a staph infection and couldn't talk.) We laughed and cheered each other up as we always have, but then she said she must tell her brother-in-law about me---and maybe get my reports and stuff faxed to him. He turns out to be the head of the Board of Medical Examiners in a certain state, and an expert on my kind of problem. Wow, what a second opinion that'll be!  



25 Mar 2004 @ 10:59 by jazzolog : Wondrous
These have been terrific comments this morning and I'm shouting my Thank You! We're going to get out of town for an overnight trip up to Akron, where there is an exhibit of the Dead Sea Scrolls and early Biblical art as well http://www.thescrolls.com/ . Then we'll spend some time in Amish country before rolling home tomorrow night. I'll check in with you again then.  


25 Mar 2004 @ 13:09 by vibrani : Richard
you'll do fine - think positively. My dad had the surgery and he was also fine - no side effects. When I had my c-section my doctor said that it would take at least a week for the staples and sutures to heal and he kept indicating that it wasn't an easy thing. Well, did I surprise him. I came prepared to heal quickly, and there was never any thought, no doubt, in me that said I wouldn't heal quickly and perfectly. And I did - in one day. The doctor was stunned and asked me how I did that. I told him how I did my metaphysical work and he said he'd recommend it to anyone after seeing what it did for me. You can do it, too, Richard.

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Thank you for your confidence Nora. Of course I'm not at the height and depth of metaphysical work that you are and so I expect I'll have a more average recovery. I'm aiming at some postoperative astonishment though.  



25 Mar 2004 @ 13:18 by skookum : I will
send a request for my second level reiki group to give you energy. You are such a terrific person and my greatest wish of my heart is for your speedy and complete recovery. May you be blessed in every way. My prayers are also with you and your family.

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I'll definitely tune myself in for those powerful Reiki vibes! Thank you Marissa.  



28 Mar 2004 @ 19:05 by magical_melody : Sending our prayers and healing from
the South Pacific. Richard, thanks for sharing your story with all of us here in NCN. As Max and I witness you embracing this experience, we understand the deepening process that opens akin to many of life's initiations. Experiences such as these take us through profound pains and blessings simultaneously as life and death come to meet in the very center of our being. Initiations have a way of opening new windows and doors of opportunity while sometimes (even abruptly) closing other doors. We pray that all the best resources and supports come to you, and that you continue to be guided in all of your affairs and relationships. Please keep us posted about your process. Blessings, Alana

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As if by magical melody, some new process that I hope is healthy growth is happening---and I invite you to look into the new entry here...just above. Thank you for this wonderful comment. It feels so good just to read it.  



16 Apr 2004 @ 03:57 by jazzolog : UPDATE: My Medical Situation
Well dear friends, I've been meaning to let you know how things are going with me personally---but I don't seem to be using my computer time (obviously) that way. There seem to be so many urgent social issues with which I want to bother you! I'm sorry, that's just the way I am---and I guess the way I have built myself over the years. Some of you even have written to say, "Look! Never mind about all the political stuff just now. Are you alive or dead?"

OK, OK, so what have I been up to, how am I doing, and are things on schedule? Wednesday Dana and I met with Dr. Batten in Logan, Ohio, and I signed papers consenting to surgery and whatever they want to do with the pieces they take out of me. (In case someone is reading this who's unaware of what I'm talking about, I am facing prostatectomy on May 3rd.) I guess that makes things official...and now the hospital and insurance and all that get set up. My employer is in on it, and apparently someone will be doing my work during the last month of school. I have been donating and will continue to donate my own blood for the procedure, but since I have to travel an hour north to Lancaster to do it it's meant more time off from work. (I hate to see Athens, Ohio, so out of the loop in so many ways.)

Thanks to MH teacher Joyce for covering for me during those times. There is much going on at that job right now that seem impossible for me to abandon. I'll not list them all, but I think you see that part of the difficulty of this kind of thing is letting go of one's ongoing. Anyone who has had to drop out for a month or 2 or longer in bed knows what I'm talking about, but I never have before and I'm learning about the personal toll. I'm not being grandiose or anything, but what I do does affect a few people and I'm grateful to them but regretful at the same time.

Regret and feeling bad about needing surgery is tough, and folks at home and on the Internet have been great in working with me on this. There's a fight with depression that has been taking place, and all the uncertainty of what could go wrong only adds to the stress. My wife Dana has been a rock of understanding, love and care---and I know she will continue to watch over the whole process, especially when I get out of touch. I'm stabilizing emotionally now I think, and on target for the final preparations.

I can't begin to list all the people who have sent messages---or lately even come up to me and grabbed me by the shirt---with advice and spiritual energy. I really appreciate it all...and knowing about the care and prayer you folks are doing truly is amazing in carrying me on. I have resisted adding myself to our church's prayer list until I actually am absent from the congregation---but Father Michael urges, "It doesn't hurt to get a head start!" Well, maybe Sunday after next I'll ask for it. That Sunday, coincidentally, our Bishop will visit and bless Dana, Ilona and me as we confirm membership at Good Shepherd. I told Dr. Batten I was being blessed hands-on by a bishop the day before the surgery he will do, and he looked a little taken-aback. I said, "Don't worry, I'm not expecting an immaculate incision here."

My best buddy Don is a master researcher at the Medical Library of the University of Maryland. He has kept me up to date on the latest stuff---even within the last couple weeks---so I feel I know the latest statistics and therapy choices and so on. This is important here, because 20 years ago we men didn't know much about this cancer. Now, more and more, I hear guys in the US say, "If I live long enough I'm going to get it." While I'm not sure that's true, it does show that research is continuing and vital in these procedures.

Another good friend in New York referred me to her brother-in-law, Dr. Strax, who is on the Board of Medical Examiners in Texas, and as well an officer of the Texas Radiological Society, and possibly still the chief of staff at Houston's Christus St. Joseph's Hospital. I wrote him my whole story, and he contacted colleagues and got confirmation that what we're doing is on the right path, in their opinions. It was a tremendous relief to get that email, and I slept better that night than I had in a month!

So I would say we are doing well and already into recovery, in a way. In another couple weeks it will be over, and I will have learned more about this wonderful life. God's Peace to all this day!  



16 Apr 2004 @ 07:44 by martha : thanks again Jazzy
for sharing your thoughts. A big decision in your life and I'm not surprised that you have been looking into all the approaches. And yes depression is a large area of concern. I wish i could give you the magic pill of comfort but as usually you need to look inside at you your heart and find the love. Best to you and Dana...  


19 Apr 2004 @ 00:59 by R Strax @63.155.184.32 : A Difficult Time
Thank you so much for including me in the distribution (and content) of this
most personal e-mail message, which I imagine was intended for your family
and close friends. I suppose this puts me in that category, even though we
may or may not have ever actually met.
I know that this is a most difficult time for you to go through, but perhaps
when it is all behind you and life is calm and normal again, we can get to
know more about each other. I look forward to that very much, and feel
certain that time will be here before we know it.
My best wishes and prayers for a speedy recovery,
--Richard Strax  



19 Apr 2004 @ 02:24 by jazzolog : The Times On Health Care
The New York Times Magazine featured health care yesterday. For a while the contents are available online. I especially recommend the slide show of Lynn Redgrave's recent treatment for breast cancer. There are astonishingly intimate and moving photographs taken by her daughter. The world is so indebted to the ongoing courage of that remarkable family!

http://www.nytimes.com/pages/magazine/index.html?th

There is brief, free registration necessary. I've never detected any spam as a result.  



26 Apr 2004 @ 10:34 by ming : Front Page Logs
I'll take care of the front page logs while you're out of service here, don't worry.

All the best with everything!  



26 Apr 2004 @ 13:18 by jazzolog : Thanks Ming
My last day of service splashing about among the floating Logs will be Sunday, May 2nd probably. Then I shall visualize computers as motivation to try to walk, which certainly will be a major goal. I'll raise a high sign when finally I can get to you folks.  


8 May 2004 @ 09:31 by jazzolog : Image Of The Day

http://lava.nationalgeographic.com/pod/pictures/sm_wallpaper/NGM2003_09p52-3.jpg

Here we see a father, just home from the hospital, giving to his family new commands of priority appropriate to the occasion.

(More later...when hopefully I can feel the tips of my fingers better~~~)  



8 May 2004 @ 10:12 by martha : hahahahaha
get well quickly Jazzy...we miss you...yes sir you tell those women around you. (how many are listening?)  


8 May 2004 @ 12:06 by swan : Fast recovery to you,
elephants...interesting....  


8 May 2004 @ 12:19 by martha : elephants
Yes one could spend hours analyzing why he picked that pic but since he is recovering I'll save my brain thinking of all the insights that I could offer...hahahaha

Oh dear I best not get him laughing cause he might pop a stitch and then I'll be accused of torture. (though laughter is the best medicine)  



8 May 2004 @ 14:48 by jazzolog : The Real Truth
The one sniffing the air is actually a female though. Heh...  


8 May 2004 @ 14:58 by martha : no doubt
the male is leading...  


8 May 2004 @ 15:02 by vibrani : right into a trap
because they didn't ask for directions. Richard - how are you? Hope you have a quick and easy recovery. I didn't know you were asking for help with the front page postings. I would have volunteered (and still do if you need help).  


8 May 2004 @ 16:22 by martha : hey Jazzy
do you stop and ask directions when you get lost?...what's that you say, you never get lost!

Actually this is probably a question for Dana but she is too busy running around taking care of...never mind.  



9 May 2004 @ 03:34 by jazzolog : Getting Lost
I prefer to find my way myself I must admit. I love maps---although we have been led mightily astray by those we've generated via computer for vacations. Dana's usually the one to urge the asking of a passerby, and then I'll slow down. Since the passenger is closer to the curb she usually does the asking, but we both listen---and later express the stress by arguing over what he actually said. If you have a choice in your passerby, would you prefer directions from a man or a woman? Anyway Martha, it's best not to rile up the poor convalescent.  


9 May 2004 @ 05:02 by spiritseek : Recover quickly...
Richard and continue with a new outlook in life and a new jest. I know I appreciate life more.  


9 May 2004 @ 07:58 by martha : What - me rile you up!
Hard to believe! LOL
I'd ask a woman for directions over a man!  



6 Jun 2004 @ 14:04 by jazzolog : Thanks To Ming
for covering the Logs for Front Page placement this last month. We've agreed I'll slip behind the editor's desk again as of today. However, complaints can go to either of us. :-)  


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