Investing In Our Relationship

Taking time to celebrate us and our “woness” is something we live to do. So yesterday, we had an opportunity for an outing and we took advantage of it.

We really didn’t make any plans and neither of us were feeling something extravagant, so we just went on an impromptu lunch date.

Great company, fun conversation and time in each other’s gaze was all we needed to invest in our relationship bank.

My beautiful lunch date ❤️

You’re All I Want

As I was sitting contemplating about some things that were stressing me out, I was somewhat oblivious to my surroundings. I was so deep entrenched in my anxious thoughts, that I didn’t realize that my wife, had called my name three times.

She then asked me what was wrong but I told her nothing. Now, I don’t know if it’s because we’ve been married 24 years, but she knew I was lying! So she asked me again, and again I just kind of shrugged off the question.
She then turned back to her book and became quiet.

This quietness lasted for most of the night and then she simply got up and went to the bedroom. I thought she’d be back in a few minutes but after about twenty minutes I was still alone in the living room. This sometimes happens when we’ve had a disagreement. But I knew this was different.

So I make my way to the bedroom thinking about whether I should just leave it alone or ask her what was up? Clearing my throat, I asked her why didn’t she tell me she was going to bed as she usually does. Her response was that she felt that I did not want to be bothered.

I then felt compelled to share some of my anxieties and concerns. She let me know that in all that time that I was concerned and worried about things which were temporal, I deprived her of the thing that she looks forward the most. And in a clueless manner, I asked her what was that? She proceeded to tell me “You!” Wow! She was right.

Although as men, we are supposed to be protectors and providers, as husbands we must never forget that our first priority is to love our spouse. And in loving, all the other areas of “woness” will never be sacrificed.

Out With The Old, In With The New

It is common to think about resolutions as we celebrate a new year. Whether it’s a new diet, a work out program, an organization plan for our hones or a goal for work, we often usher in the new year with such promises. Some people also purge old clothes from their closets.

However, as 2020 ended, resolutions were probably not on high list of priorities as much as just a simple wish for a better year!

Nevertheless, in light of a new year, I wondered whether married couples use this concept to improve their “woness.” And honestly, if we really think hard, we can all work on throwing away some things that don’t really serve to strengthen a marriage. Things like pride, sarcasm and anger. And as we turn our backs on different degrees of these old ways, let’s ring in a new year by allowing our interactions with our loved one be characterized by grace, humbleness, gentleness and patience.

Spend intentional time together discussing how to make your “woness” better.

What are some new things that you could do to improve and strengthen your marriage?

Prostate Surgery and Beyond

In my last post, I had mentioned that after considering our options, we decided that surgery was the best choice for us. We researched and read in order to prepare ourselves for the big day. Sure, we both had some deep concerns regarding what the pathology report would read and what the next steps would be. But we prayed and left all those anxieties and worries at the foot of the cross.

On a partly cloudy day on September 20th, as sat as a family in the waiting room, I almost forgot why we were at the hospital. However, I was quickly reminded when my name was called and a nice lady applied a bracelet to my wrist. Things were starting to get more real. But I was ready! I was also hungry… I mean, I’m a breakfast man so… I’m just saying… When my name was called again, it was for real. It was time for me to take the long road to the pre operative area.

I was given a gown to change into. The anesthesiologist then came to the room. He was a rather quiet, stoic man. He asked me if I needed anything, to which I responded, “how about two shots of Jack Daniels?” Unimpressed by my response, he said, “well, we’ve got some medications that…blah blah.” “Could you just humor me,” I thought to myself. But the anesthesiologist went about his business. The nurse who was completing my pre-op papers kind of chucked at the exchange. Much to my surprise, I got a visit from my pastor and one of our elders who said a quick prayer and wished me well.

After an IV was started in my arm, I was wheeled to the cold operating room. The only thing I remember was seeing a large piece of equipment in the center of the room. This was the robotic machine used for the prostatectomy. After that, all I remember was waking up in the recovery room with a catheter. I was then transferred to a hospital room where I stayed two nights.

It was nice to come home to my own bed. I’m not the greatest of patients but the recovery was not too bad. I had a lot of help and mother-in-law even came down, and she was great!

Fast forward to eight months after surgery and I’m doing great! My latest PSA was still undetectable and I’m officially cancer free. I will still have my three month checks for two years. I continue to thank God for the medical team that treated me, for all the prayers and support from friends and of course for my family. I especially thank my one, my only, my forever partner, my love, mon cherie, my ride or die. My wife of 23 years has a been my rock, my unwavering support, my nurse and my best friend! I couldn’t have gotten this far without her.

I can officially say that I’m a survivor!

Staying Close During Social Distancing

People who know us well, know that I’m an extrovert and my wife is an introvert. I require longer periods of socializing whereas my dear wife, contrary to popular belief, does like social interaction, but has to have it in spurts and needs time to decompress after long periods of socializing.
So how do we, as polar opposites on the socializing scale, make our marriage work during this time of quarantine? This also applies to couples who don’t normally spend a great part of their day together. I offer a few suggestions:

Love our walks together!
  1. Respect Each Other’s Differences

Respecting one another’s differences is important at any time but when you’re in lockdown mode it’s extremely important. I have to be aware of not “suffocating” my spouse and she in turn connects with me after she’s had her alone times. 

  1. Be Willing To Communicate 

In times of a quarantine when social interaction is limited, it’s important not to isolate yourselves further.  It’s vitally important for us to communicate with one another if we need hugs, space, kisses or conversation.   

  1. Be Attentive To Your Spouse

No matter how much “alone time” a person enjoys, we all need some amount of socializing. When this is not possible, feelings of isolation, anxiety and fear can squeeze like a vice grip.  So it’s up to each spouse to be attentive to each other’s needs.

  1. Be Patient With Each Other 

Being around each other more can feel like your spouse is in front of you every turn you take.  This can feel a little like deja vu.  It’s important to be patient with one another and try to somehow have fun with these situations.

  1. Say I Love You

The most important way to survive a time of social distancing is to tell each other “I love you” often. These three words can never be said enough and are the foundation to Twobecomingwon!

What are other ways for a marriage to survive an increased time together?

ANOTHER ROLLER COASTER RIDE

I have been quite for a while as I recover. But I wanted to continue my story…

As we met with the oncologist, he thoroughly described my staging and reviewed the NCCN Guidelines.  According to the Gleason score and high percentage volume involvement, of at least two specimens, my prostate cancer staging, according to the American Joint Committee on Cancer was the following:  

pT2b or PT2c with most likely no node involvement (NO). 

If this sounds confusing, it’s really not as long as you have a legend to follow.  For reference, you can follow the attached diagram.  But just as a quick explanation, the “p” along with the “T” refer to the pathologic staging of the primary tumor and how much of the organ is involved.  This is designated with the prefix pT2-4 referring to the extent of the prostate gland involvement (minimal, one lobe, two lobes, whole organ and surrounding tissues). 

The other letters refer to lymph nodes and distant metastasis, N and M, respectively. The N is staged from X-1, ranging from no lymph node sampling to node metastasis. The M is staged from 0-1C, indicating no metastasis to bone involvement.

As we heard about the staging, we felt some optimism.  But then the doctor described percent success rates with and without androgen deprivation therapy. Wait, what?  I had already decided on a course of treatment that I wanted. What was happening?  Furthermore, I was now told that I would first have the radioactive pellets placed in the prostate and then four weeks later I’d have the external beam treatment.  

We were also told about the precautions I would need to take with having the pellets in terms of holding babies.  Mind you, I have a baby grandson (nine months old during this occurrence).  When he told us that the pellets never stop giving off radiation, I was paralyzed.  Although I had read that the pellets would not be a danger in terms of holding a baby, the radiation oncologist said that holding the baby on my lap for a long period would not be advisable for three to six months.  To say I was shocked would be an understatement!

Then came the other bomb.  We were told that because of the enlarged size of my prostate, it would be highly recommended that I have ADT first to decrease the size to allow for safer placement of the pellets.  Now I became numb.  How did I go from having a choice on the ADT to now it almost being required?  Not only that, the percent survival at later years were also improved when adding this therapy.  As with any treatment, there were several possible listed side effects from radiation and ADT. 

My world was absolutely rocked!  I felt like someone had pulled the carpet from underneath me!  What I thought was an appointment to go over the treatment protocol and start scheduling sessions, became a bombardment of information that was overwhelming and surprising! However, given the intermediate, unfavorable category of my prostate cancer, made sense.  It was just unexpected.

Well, the other option, which I had totally ruled out before this visit was surgery. However, we were told that obviously, we would have to make that decision.  And obviously, there were also some side effects discussed with the surgery.  We were told that although no medical professional could force me in any certain direction, given my age, surgery could be a viable option.  I left this appointment with totally dejected.  Needless to say, it was a very long night!

To be continued…

CONFUSION ABOUNDED

So we thought we were ready to embark on the radiation pathway. Yep, I thought a one time procedure of pellet implantation was very desirable over 40 external beam treatments. This would be much less disruptive to my schedule.

Furthermore, I had a conversation with at least two people who either had external beam or pellets with external beam. But before I committed to any type of treatment, I was still confused about what I had heard at one of my urologist appointments regarding my Gleason 7 score. This was confusing to me. But after doing some research, it seems that even if most of the core specimens are 3+3 and only one is staged at 3+4=7, the person is staged according to the higher number.

So the Gleason system is based on the assumption that the higher number is representative of what’s actually occurring. Here I am thinking that sine most of the core biopsies were a Gleason 6, that’s what was representative of the cancer. Oops, I guess NOT!

Oh well. I had to stay on track. I had to keep moving forward. So next stop on this train was an appointment with the oncologist at the cancer center. I was ready. My wife and I had discussed this and made up our minds on the treatment plan and was ready to go and get this radiation thing scheduled and started. But I could not have been less prepared for what came next.

Continued….

THE RECONNAISSANCE MISSION

After having heard about my treatment options, I was determined to speak to someone who had been through radiation. However, my quest was more specific than just anyone. I was on a mission to hear from someone around my own age who had been through radiation treatment.

So through a friend, I was able to speak to a gentleman who had a history a higher Gleason score and went through both brachytherapy and external beam treatment. And he was doing well with minor side effects. So after this conversation I was encouraged and ready to go forward. So I thought.

After this conversation, my wife and I met a couple who were nutritional vendors promoting a vegan lifestyle. The gentleman had a significant history of prostate cancer, however, his had metastasized. He underwent both surgery, testosterone suppression therapy and radiation. He shared research information about how a diet free of animal products and low in saturated fats, was known to protect against prostate cancer and actually reverse the process.

The name that stuck out the most during our conversation was Dr. Dean Ornish. He authored a study in the Journal of Urology, which detailed the effects of an “intensive lifestyle change” on men with early, low grade prostate cancer. The study showed that the PSA revealed a 4% decrease on the experimental group versus a 6% increase in the control group. Furthermore, there was an decrease in the growth of cancer cells of up to 8 times as much in the control group.

This sounded groundbreaking! But was it truly real science? This may not be mainstream, I thought, but certainly worth some attention. Furthermore, Dr. Ornish may not be a cardiologist or nutritionist, but even the American Cancer Society recommends a reduction of saturated fats and reducing red meats.

Although this gentleman had some side effects, his claim was that they were improved with a vegan diet. Although I was not totally ready to bet the farm on these claims, it was clear that there were at least anecdotal evidence. So we did research on a vegan diet and decided to adopt this practice. I had nothing to lose. And my wife, in a demonstration of love and support, decided to adopt this lifestyle with me. (Mostly because she’d be doing the cooking anyway. LOL)

Our hope and prayer was that God would use this change in diet in conjunction with the upcoming radiation treatments to give me good outcomes. But wasn’t totally sure if this was my treatment option for sure. I still had a consult with the Cancer Center.

THE GLEASON GRADING SYSTEM

Remember the numbers associated with my biopsy specimens? Let’s get back to those. During my phone conversation with the urologist before my vacation, I was told I had a “Gleason 6” staging. Or maybe I understood that in my mind. Remember this, it will be important later in the journey.

Normally the pathology report will list each specimen or “core” (named such because it’s a “core needle biopsy”) separately by a number assigned to it by the pathologist, with each core, having its own diagnosis. The cores are listed separately because If cancer is found, it’s often not in every core, so the each core has to be examined separately to accurately make a diagnosis.

Pathologists grade prostate cancers using numbers 3 or higher based on how much the cells in the specimens look like normal prostate tissue under the microscope. Grades 1 and 2 are not used. Instead, if the core sample present with cells that look normal, it is designated as “benign.” This is called the Gleason System. Most biopsy samples are grade 3 or higher.

Since prostate cancer specimens can often have areas with different grades, a grade is assigned to the two areas that make up most of the cancer. These two grades are then added together to give the Gleason Score. In this system the higher the number, the more likely the probability of spread and thus the higher stage the cancer. The highest a Gleason sum can be is 10. Recall that the numbers are designated as a sum: 3+3, 3+4 or 4+3. The first number assigned is the grade that is most common in the specimen. For example, if the Gleason score is written as 3+4=7, it means most of the tumor is grade 3 and less of it is grade 4, and they are added for a Gleason score of 7. This sum can also be designated as 4+3=7. Although this is the same Gleason score, most of the cancer is grade 4, which is obviously higher. If a tumor is all the same grade (for example, grade 3), then the Gleason score is reported as 3+3=6.

Although most often the Gleason score is based on the two areas that make up most of the specimen, when a core sample has either a lot of high-grade cancer or there are three different grades including high-grade cancer, a higher score is determined to reflect the aggressive nature of the cancer.

The other significant part of the pathology report, besides the Gleason score is the volume of each specimen. This basically refers to the percentage involvement that each specimen is affected by cancer. For instance, one of my specimens, the one graded at 3+4, had 50% volume. And one of the 3 + 3 specimens had 40% volume. These are consistent with a possible greater involvement of the prostate gland and a greater possibility of spread.

This certainly was a cause for concern. However, I already knew from the scans that there was no spread. Next stop: Treatment Plan.

As we continue to raise awareness for prostate cancer, please remember men: Although there may not be a hard rule for screening, talk to your doctor about a PSA test if you’re between 45 and 55 years old. Screening should be done at 40-45 years of age for African Americans, Latinos or if there’s a strong family history.

THE SCANS

So what’s it like to hear you have cancer right before a vacation? Well, let’s just say that it wasn’t in my bucket list.

After our vacation, came the follow up visit. As it had already been related to me, I would need some diagnostic studies to rule out any spread. Oh yeah, I guess this is a good time to say that I’m a doctor and I was very familiar with all these steps. Familiarity, however, didn’t add any level of comfort. It did however, allow me to cut out the middle man and schedule my own tests! In my sense of losing control I needed to feel like I still had some, even if it was in my own head.

As I laid motionless on the hard, cool table for the bone scans, I could see my images on the screen and immediately knew there was no spread. I guess my knowledge was helpful in this case. But I also knew that the next step involved a discussion of treatments. And I knew that I was facing radiation or surgery. However, I thought for a moment how someone in my shoes would feel if they didn’t have the medical knowledge that I did. Would they feel lost, out of control and helpless? I think they would. Because in a way, so did I.

I guess I also have to share at this point the fact that my darling bride of 23 years was with me during these visits. It was very reassuring to know that I had her support. I told her she didn’t have to go with me but in a very assertive way, with a not so nice look she said, “shut up!” That made me happy.

To be continued…