Well, It's getting that time again. I am about two weeks out of my next PSA test. Time to renew my three month lease, and see what changes were made to the contract. I find myself doing the same thing that I have done on all the previous times, almost like some sort of bizarre ritual. I pull up all of my pathology reports and read them once again, because maybe - just maybe- I missed something all the countless times before that I read them. When I am done with that, I turn to google, and run different variations of the basic searches that I have always done. "prostate + cancer + ductal", or "ductal + adenocarcinoma". Sometimes I add the word metastasis just for some added fun. Then I re-arrange the order of the search words and repeat. But regardless, the same old hits appear that always have. So I read them all again. One always hits close to home. it involves a case study of a gentleman that required a urinary diversion surgery (ileal conduit) when his PC spread into his bladder. My father had to have that surgery when his cancer hit his bladder. He passed soon after. That was 2008.
Once I have exhausted all of that, satisfied that there are in fact no new nuggets of information, I start playing the what-if scenarios through my mind. What if it goes in my favor - or - what if it doesn't? I wish that I had the mental fortitude to not put myself though this again, having done it so many times before. But this test is different. Then again, aren't they all? There is the first test after surgery - or the first since starting hormones - or the first after finishing radiation - or the first after the radiation has done all it's going to do. Maybe one day, they will be routine. I sure hope so. Not this one. This one is most definitely different. I have been off all treatments since December. I took my last 4 month lupron shot in August. I am actually starting to feel a hint of normalcy. I am not tired all of the time. The brain fog has lifted, and my stamina is returning. I am starting to enjoy things again, instead of just going through the motions. I sure hope that I don't have to go back. My wife and I are going on our first cruise in June. Then I am going to hike the Camino De Santiago with my daughter in 2018. I want to be able to truly enjoy those experiences without the mental and physical veil of hormones. It all hinges on this test. Yea, this one is different. For sure.
So back to my teeth. Yesterday was my six month appointment with my dental hygienist and check up with my dentist. You know the deal with getting your teeth cleaned. About a half an hour of probing, the ultrasonic water needle that winds up hurting my ear from the pitch more than my gum line, all the while staring at a light of sun like intensity. Meanwhile, the suction device is stuck, leech-like, to the inside of my cheek, and Barry Manilow is crooning in the background through the scratchy overhead speaker.
With the scene properly set, I can tell you the the cleaning went pretty smoothly. I have been pretty consistent with my daily brushing and flossing, so there was no need for Beverly, my hygienist, to turn the cavitron up to eleven. In fact, a couple of times, I began to doze off in the chair while she was working. (It's a trick I learned in the Navy many years ago - never miss an opportunity to take a nap). She finished up a couple of minutes early, so we chatted a bit while waiting on the doctor. It gave me an opportunity to respond to some of the things she asked me about while I had a mouthful of dental instruments and fingers.
Enter, the dentist! (insert theatrical soundtrack here). Actually, my dentist is pretty cool. As a result of my RP surgery, I had to have an emergency root canal attempt that eventually became an extraction. As it turns out, some people bite down really hard while under general anesthesia. I am apparently one of those, and I guess the mouth wedge became dislodged during surgery and I clamped down really hard on the intubation tube and cracked a tooth. (that explains why my jaw seemed so sore after surgery). About a week or so before I was due to start radiation, it abscessed. She took lead on making sure that the endodonics group took care of me prior to radiation treatments. She even called me at home on a Sunday afternoon to make sure all went as planned and wished me luck on my treatments. I really appreciated that.
Anyway, back to the present. she began doing a through oral evaluation - which including messing with my neck (I hate that), while I open and close my mouth. Then she began a visual inspection of my gums for general health and any sign of oral cancer. That is when a "thing" caught her attention. On my gums behind my back top tooth, she saw what she described as a "small brown flat freckle". She finished the rest of her evaluation and then went back to it. "It is probably nothing, but let's get the camera in there, take a picture of it and keep an eye on it on your next visit, just to make sure it is nothing more." Well, shit. As a practical matter, it is probably indeed nothing, and most people wouldn't give it a second thought. But I am not most people. I am a guy that has spent the past couple of years fighting a particularly aggressive form of prostate cancer. So yea, my mind went there immediately. In a New York minute. As did Dr. Google, as soon as I got back to the office.
The Doctor finished up and left, as I kept studying the picture of my gum freckle - now displayed on the computer screen. Beverly saw my concern, and tried to reassure me. "Don't worry about that thing!. To me, it looks like you bruised it eating some sort of crunchy food or nuts. " OK. fine. I'm sure that's all it is. Nothing more. Right? Right.
As she started scheduling my next appointment for September, she told me that it wouldn't be her. She will be retiring in July. What? She has been my hygienist since around 2000. Now, there are many things much more pleasant than getting your teeth cleaned, But it was nice to have a consistently friendly and professional person there that really seemed to care. Someone who took the extra time to get to know her patients.
Thank you, Beverly, for all of your efforts. Enjoy your retirement. I am not looking forward to getting accustomed to a new hygienist, but change is inevitable, I guess.
Walking back to my office, I couldn't help but notice how beautiful the day was. It had been cold that morning (In Florida terms). About 28F. It was now noon, and had warmed up to the 50s with a nice breeze that felt invigorating. Perfect clear blue sky. The birds were very active, perhaps due to the weather. I decided to take the long way back, so that I could take it all in. All in all, I feel good. Once again, I feel reminded to appreciate every day for what it is, and the people around you for who they are. Because change will happen. It is inevitable. Meanwhile, it is great to just be alive.
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