We're Going On A Mission

We have planned on serving a mission for a long time and things have come together to make it a reality. We filled out all the required papers, got the physical exams and had interviews with our Bishop and Stake President

 

We were recruited by a friend and business acquaintance, Stephen Mecham, who is the President of the Micronesia Guam Mission, so we weren't surprised when the call came to serve there.  Or perhaps we could say we recruited him.

 

We received our call on Friday, June 29th.We will be serving for 18 months, working primarily in the Mission Office taking care of finances, vehicles, housing, travel, records and correspondence.

 

We have a lot to do to get ready such as immunizations, photos, shopping for clothing and supplies and getting the house and farm closed up.

 

We are really excited for this opportunity to serve our Heavenly Father and the people of Micronesia.Our responsibilities in the Mission Office will be our primary focus, and we look forward to doing all we can to make the work run smoothly for the President, his staff and all the missionaries.We also hope we have the opportunity to work in a local ward and get to know the people on a personal level.

 

Of course before leaving we had to have a few family gatherings.  the hard part was it seemed like we had to say goodbye every time we saw them.

Prostate Cancer III

I had my three month and six month cancer check-up and so far everything seems okay.  My PSA at there months was down to 1.6 and at six months it was down to 1.5.  We would all like to see it lower, and it may continue to decrease but maybe not.

I was not the least bit impressed with my urologist and the three month check-up.  He couldn't find the results of the PSA test so he asked me what it was.  I had been on the website so I knew and told him and that was about it.  He didn't examine anything, ask me how I was feeling or anything.  He did ask if I had any questions so I asked him if some of the conditions I was experiencing were permanent.  His reply was "well, they pretty much fried your prostate so you have to expect that".  I can't help but think he is a little put off that we didn't accept his offer to surgically remove it.

I was cleared to procedde with submitting papers to serve a mission, so we made appointments to have our mission physicals and begin that process.

At six months I saw Dr. Richards, the radiation oncologist.  He was very concerned, friendly and I really felt like I had been to the doctor when we were finished.  We told him we had a mission call and he was happy for us and gave me the paper work I would need to get PSA tests done in Guam.

I guess there is not any way to know if your cancer is cured other than the test of time.  If the PSA remains low then the cancer is in remission.  If it starts to climb then they didn't get it all.  You just have to monitor that level fairly closely for a while and see what happens.  Dr. richards seens quite confident that the treatments have done their job and I can only hope he is right. 

Recovery, Treatment and More

Prostate Cancer Part III

Recovery comes in stages, because thats how treatment comes. After each treatment you have two weeks to recover, then they do it all again. Two more times.

Considering what I had been through I was feeling pretty good when we left the surgical center that Thursday evening. Prior to leaving Dr. Richards asked how I was doing and I challenged him to a race across the parking lot. Of course he wisely declined. I talked Ellie into stopping at Nielson's Frozen Custard and we had a treat to enjoy on the trip home.

As directed I took it easy for a couple of days, reading, resting, watching tv and playing computer games. I had no swelling and no bleeding from the prostate catheters, and very little pain. The moist severe pain was from the bladder catheter. Urinating after its removal was excruciating! It felt like you were eliminating hydrocloric acid! That persisted for a few days, but gradually the pain subsided. Saturday we went to town and I got a haircut and we ran some ereands. By Sunday I was feeling good enough to attend to my church responsibilities, and Monday I went to work outside. There was some fatigue, I didn't have the stamina to work too long, but it felt food to get out and try. I gradually got stronger each day and by the time my two weeks ended I was ready for round two.

The second treatment was on Thursday, February 2nd. Things went much the same as the first and I was soon home recovering again. This time the pain from the bladder catheter was not quite as bad, but I really suffered from hemmoroids. It felt like instead of a nice smooth ultrasound probe they had used a very large dry corncob! It gave a whole new meaning to the Johnny Cash song 'Ring of Fire". It seemed like just as I started to get some relief I would have a bowel movement and the pain would start all over again. It wasn't a totally debilitating pain, but just the same you didn't really feel like doing much of anything. At the same time it seemed to help to do something to get your mind off the pain. I spent a lot of time sitting on an ice bag, and was just starting to get some relief whan treatment three rolled around.

Treatment three was on Thursday, February 16th. I was dreading it this time, yet at the same time wanted to get it over so I could start to heal premanttly. They moved our starting time back an hour, so we arrived at 7:00am and it all started again. I had a little talk to the doctors about being a little more careful when inserting foreign objects into my body,. Otherwise the procedure was a repaet of the two previous ones, with the exception that this time I knew I didn't have to come back.

During the five hour recovery period we talked to the other couple sharing the room and discovered that he was the brother of a missionary I knew 40+ years ago in Australia from Burley Idaho. He got right on the phone and called him and even got through but by the time he did I was in for the next session.

Recovery this time was more like the first treatment.  I'm not sure why the second was so bad but if they had all been like that one I wouldn't have survived.  Healing takes a while, and three months after you have recovered from most of the temporary effects, some seem to be more lasting and may never go away.  Nonetheless youare greatful for good Doctors and modern medicine.

Brachytherapy

Prostate Cancer Part II

Brachytherapy (pronounced by most as 'brakie-therapy'),is a high dose targeted internal radiation. This type of treatment is used for several other cancer types as well, including breast, lung, cervical, but I will confine my discussion to the treatment of prostate cancer.

I was given the option of several different treatment types, including (1) prostatectomy, which is the surgical removal of the prostate and associated tissues, (2) external beam radiation, where low dose radiation is targeted at the cancer from the outside, which is less invasive but requires as many as 40 or more treatments, (3) hormonal, which involves the injection of certain drugs into your system to suppress the growth of male hormones that speed the cancer's growth , and (4) brachytherapy.

I chose brachytherepy for several reasons. First, it involves three treatment days separated by two week recovery periods and you are done; second, it leaves all your organs in place so at least you have a chance of them healing and resuming normal function; third, it is very targeted and specific, involving minimal damage to surrounding tissues and organs; fourth, Dr. Ray Richards comes very highly recommended by others who have had the treatment; and fifth, it just seemed like the right thing to do.

Dr. Ray Richards, Radiation Oncologist

My treatments began on January 19th with a 6:00am arrival at the Coral Desert Surgical Center in St. George. Starting about 24 hours prior you have to go through a prep procedure which involves taking a stool softener in the morning, then after a normal lunch begin fasting. You are allowed clear liquids until midnight and after that only a sip of water to take any required meds. Before bed you take two Imodium and a fleets enema. First thing next morning two more Imodium. This prepares your bowels by basically stopping them so that they don't interfere with the procedure the next day.

After checking in at the surgical center you are taken to the prep area where you remove clothing and put on a gown and elastic stockings. They give you some nausea medicine, take your vitals, have you sign consent forms, put in an IV and then wait.

the 'prep' room

Around 7:00am you are taken into surgery, where you are moved onto the surgical table where you sit up while they give you a local anesthetic to numb things a little before giving you the shot in the spine to deaden your lower body. As you feel your feet start to tingle and numbness spread they lay you down and put your feet is stirrup-like apparatus so you are basically in the birthing position. To guide them in what is to follow, they put in a catheter through your penis into your bladder, position a fluoroscope over your abdomen and insert an ultrasound probe into your rectum.

I can see the ultrasound monitor as I lay there listening to the doctors plotting the procedure. The team consists of Dr. Ray Richards, radiation oncologist, Dr Greg Taylor, urologist, a couple of nurses and of course the Anesthesiologist. You know they are doing things to you but it is rather detached, almost like it is someone else because you can feel nothing. It is a little errie watching the monitor and seeing the catheters slowly being inserted, knowing that they are invading your body. It is good that you are convinced it will help, but just the same there is nothing you can do except perhaps scream. Instead I tell the doctors I am doing fine.

They place a template on the perineum between your scrotum and anus. Through this template they insert 18 thin plastic catheters into the prostate gland as pre-determined by computer analysis using the biopsy to determine where to place each one. When this is done a CAT scan assures that they are in the correct position, and you are ready to be 'illuminated'.

the afterloader

nurse Tyler connecting the afterloader

After a short wait you are wheeled into the lead-lined room, and connected to a machine called an afterloader. Each of the 18 catheters is connected to a corresponding port on the afterloader. This machine contains a single highly radioactive iridium pellet at the end of a wire. The pellet is pushed into each of the catheters one by one under computer control. The computer controls how long the pellet stays in each catheter (dwell time), and where along the catheter it should pause to release its radiation (dwell positions). This very precise treatment takes around 20 minutes, after which you are taken to a recovery room for a five hour wait.

During the five hour recovery you can read, watch dvds, visit eat or sleep. After the rest they take you back and hook you to the afterloader again and repeat the treatment. When this is finished they remove the 18 catheters from your prostate and the one from your bladder. They make sure that you are passing urine and that there are no blood clots, and that the bleeding has stopped, then put a diaper on you and help you get dressed. Then they walk you to your vehicle and send you home. The entire event has lasted between eight and nine hours.

Join The Club

I recently joined a new club. It isn't all that exclusive, in fact membership is in the millions worldwide. It isn't even a club that one seeks to join, but rather would avoid. Even so, membership isn't free, in fact is is rather costly. Sometimes it costs your life. Obviously I didn't join voluntarily, rather I was inducted.

If you haven't guessed by now, the club is called The Cancer Club. So you now see why it is not a coveted nor sought after membership. I belong to the Prostate Cancer Chapter. I didn't want to join, and now my main membership goal is to get the certification as "Survivor". I have been reading some statistics which may be of interest:

• About 11.7 Million Americans currently have or have had cancer (does not include skin cancer and other basil or squamous cell types)
• About 1.5 million cases were reported in 2011, not including the above exclusions
• Approximately 572,000 people died of cancer in 2011, 0r about 1500 per day, accounting for about 1 of every 4 deaths in the US, and exceed only by heart disease.
• Death rates for common types of cancer in the us in 2003-7 per 100,000 were: All types-380.8; Lung/bronchus-101.4; Colon/rectal-36.1; Prostate-24.7; Breast-24; Pancreas-21.7; Non Hodgkin's Lymphoma-14.2; Leukemia-10; Liver-9; stomach-5.
• Survival rate for all types was up from 50% from 1975-77 to 68% from 1999-2006
• The National Institutes of Health estimates overall costs of cancer in 2010 at $263.8 billion
• 2011 US estimates for prostate cancer, 240,540 new cases, 33,720 deaths
• Prostate cancer is the most frequently diagnosed cancer in men and the second leading cause of cancer death
• Relative survival rates for treated Prostate Cancer: 5 year 99.6%; 10 year 95%; 15 year 82%.

So you see from these statistics that it is a large, expensive club. My chapter has good survival rates but because there are so many cases there is still a fairly high death rate. You also see I have a pretty good chance of surviving for at least 15 more years and by then other risk factors will probably be at least as significant.

My cancer was detected pretty early. I have been having yearly PSA blood screenings done for the past 10+ years, which showed only a gradual yearly increase until this past year where it spiked 1.4 points. Anything over an annual spike of 1.0 is a danger sign. Combined with other risk factors (family history) and symptoms the urologist recommended a biopsy. The biopsy performed in December revealed a malignancy in 6 out of 11 samples taken, with a Gleason score of 6/7. The Gleason score ranges from 2 to 10, 2 being non-aggressive and 10 being very aggressive.

Because of my Dad's experience with prostate surgery, I rejected that option outright and after further consultation decided on brachytherepy, which is a high dose radiation treatment delivered via radioactive wire inserted in needles directly to the prostate. My next blog will describe my treatments, which may be rather graphic and not suitable for women and children so beware!

The Trail Cam 1

Bobcat

Around Christmas 2011 I had the trail cam set up about a quarter mile south of my home. I captured the following video, which I think is quite remarkable as I don't think bobcats travel in pairs too often nor is it common to see them in the daytime.

Coyote

I also caught a coyote, though not as amazing it is still interesting to catch wild critters in the act of being themselves without the interfering with their natural behavior.

Out With The Old and In With The New

A common phrase for the new year, right? Well, this is even a little more literal. I finally got the new barn built and am in the process of tearing down the old one. Would it be prober to call it "De-constructing"?

I designed the barn last spring and had the plans made into construction prints. I decided I probably wouldn't live long enouth to build it myself, so I hired SMJ Homes to build it. Sounds kind of funny, but it is a home for our three horses. I think they did a great job and even ame in under budget!

After the barn was finished I started on attached corrals using old pipe that Dad had collected. I got enough done to put the horses in just in time to start feeding them around the first of December. There is still quite a bit to do on the corrals, but it can wait for spring.

My good friend Norm Kroh has joined the wrecking crew, and his wife has even helped out. They are new to this valley, they recently purchased Mervin's home and moved here from Idaho. They are great people and a good fit here I think, and they seem to like it so far.

I have to admit that this is all a little nostalgic, because I helped Dad build that barn when I was about ten I think. That would have been around 1957 0r 58. All the while I am working I wonder what Dad would have to say about the 'improvements'. I'm sure when he was a few years younger he would have loved it, but as he got older he really resisted change. I suppose that just goes with the territory.