Wednesday, October 31, 2018

Cancer Patients Need Their Sleep

I can't count the number of sleepless nights I've experienced since I was diagnosed with prostate cancer. There are so many phases of this journey where I've faced hours, days, and sometimes weeks of poor sleep. Here's a few places in my journey. You probably have others you can add.

My sleep troubles began after I went in to my Urologist for a prescription refill. My physician insisted on performing a DRE.

My world was turned upside down when he said he felt a "suspicious lump" which he wanted to biopsy. This was the event, one of many to come, which caused a significant amount of sleep deprivation.

When I went to the front desk to make an appointment for my biopsy I was told the earliest time available was in a month. They scheduled a second appointment two weeks later to discuss my biopsy results. I drove home in a daze. My world was turned upside down. I had a "suspicious lump" on my prostate which could be prostate cancer.

After my first sleepless night, I realized there's no way I'd survive four weeks of waiting for a biopsy, and two weeks after that to receive my biopsy results. Two things become my top priority in life. Getting a biopsy and biopsy results as quick as possible.

I reasoned that if my cancer was large enough to feel, I might be facing a life threatening disease. I wanted to receive a sand begin treatment yesterday, rather than many weeks from today. A night spent awake worrying increased my resolve to receive a diagnosis and treatment immediately. I felt certain my survival depended on this.

Night after sleepless night I imagined thousands of prostate cancer cells with razor sharp teeth, chomping away at the lining of my prostate looking to create a microscopic hole, so they could escape my prostate in order to kill me.

With that imagery in mind, I was more than willing to leave the Urologist who cared for me for more than two decades in order to find another Urologist who could get me tested, diagnosed, and treated, as soon as possible. I found one in a different city, who could get me tested and have the results in less than three weeks. I canceled my original appointments and scheduled a biopsy in another office.

I lost a lot of sleep in the weeks prior to my biopsy, the week waiting for the results, and countless hours of sleep after I was told I had prostate cancer with a Gleason Score of  4+3=7.  This was the beginning of a series of stressful events which resulted in loss of sleep.

Below is a list of events occurring days, weeks, months, and years, after my initial diagnosis which were highly stressful resulting in significant sleep loss.
1. Waiting for my bone scan
2. Waiting for the results of my bone scan
3. Waiting to discuss treatment options after bone scan results came back negative.
4. Time spent researching pros and cons of various treatments.
5. Waiting for appointment at a treatment center
6. Waiting for a pre-surgery exam
7. Waiting for surgery, a minimum of six weeks after a biopsy.
8. Waiting for a post-surgery biopsy
9. Living in diapers waiting to see if urinary control comes back
10. Waiting for the return of erectile functioning
11. Waiting for an appointment for penile rehab
12. Waiting to find an appropriate treatment for ED
13. Waiting for my marriage to return to a familiar place
14. Waiting for PSA testing  results every three minths
15. Coping with the fear of reoccurance.
16. Waiting for penile implant surgery
16. Waiting for intense penile implant surgery pain to end
17. Waiting for penile implant activation 

This is a partial list of the events in my journey with prostate cancer that resulted in significant sleep deprivation .

Given the inevitably, and harmful effects of sleep deprivation, which most cancer patients (and their caregivers experience). I believe assessing the frequency and duration of sleep deprivation is anessential part of treating all forms of cancer.

Sadly, the issue of sleep deprivation is seldom discussed and goes untreated. Most cancer patients and their caregivers suffer through long bouts of sleep deprivation without any assistance.

If sleep deprivation is a problem for you, meet with your physician to discuss the various ways to treat your sleep deprivation.
Rick Redner and his wife Brenda Redner wrote two award winning books. The first:
provides men and couples with information and support before, during and after prostate surgery.

Their second book was written for couples living with!erectile dysfunction. After living with  erectile dysfunction for four years, Rick chose penile implant surgery. The couple share how implant surgery changed their lives and relationship.
The title of their book is:

Monday, August 6, 2018

I Hate Waiting For Test Results

Common sense leads me to assume the more you do something the easier it becomes. Why after eight years have passed since I was diagnosed with prostate cancer, I've discovered that it's more stressful waiting for my yearly PSA test results?

This was the first year I put off my PSA check. For seven consecutive years I've had my test in April. This year I put off testing until July.

According to an article in Zero The End of Prostate Cancer "Fortunately the five year survival rate for men with localized prostate cancer is nearly 100 percent. Although up to 40 percent of men will experience a recurrence so it is important to understand your risk for recurrence as well as live your life after cancer."

Is it wrong to assume the longer you live with prostate cancer the greater the odds of experiencing a reoccurance? There's no doubt other factors are involved in addition to the passage of time. Whether your cancer was contained within your prostate, and the stage of your cancer when you were intitally diagnosed impacts the odds of a reoccurance.

In addition to the clinical reasons for a reoccurance, almost all cancer patients have a universal fear of cancer returning. According to an article in Cancer.Net the fear of reoccurance is higher in the first year. I found the opposite is true for me. The longer I remain cancer free, the greater I think my odds are for a reoccurance!

Every day my mailbox does not contain the results of my lab tests, I'm thankful for another day to live in ignorance. 

Unfortunately, I'm also stressed. If there's one thing I've learned about prostate cancer is this, the earlier it's discovered, the better the odds for a successful treatment. I assume this is true about a reoccurance as well.

This year brings a new fear and other diagnosis I wish to avoid. Last year my blood tests revealed I was borderline diabetic. According to Healthline "If you have prediabetes, you should know you’re not alone. In 2015, it was estimated that 84.1 million Americans age 18 and older had the condition. That’s 1 in 3 Americans.Having prediabetes doesn’t mean you’ll definitely develop diabetes. It’s a warning of what could lie ahead"

Due to chronic back pain, I had three spinal injections of cortisone. One of the dangers of  cortisone is this:
"People on steroids who are already at a higher risk of type 2 diabetes or those who need to take steroids for longer periods of time are the most susceptible to developing steroid induced diabetes."

So you treat one disease only to risk developing another. I don't want bad news. I just retired a few weeks ago. There's a part of me that wants one year of my retirement without any news of a disease old or new that will impact my life. I'd like to live my first year of retirement in ignorant bliss.

What I'd like, conflicts with what I know to be true. Early detection of any disease is better than late detection when damage is done. I compromised with myself. I put off my yearly physical and tests by a few months. Now I'm waiting to receive my lab results. I feel an obligation to my wife, children, and grandchildren to take care of the most precious asset I possess, my health. 

There'll be no riding off into the sunset in my RV, in ignorant bliss. I'm going to face and if necessary treat any issues discovered in my lab tests. If I didn't do that, the lessons I've learned as an eight year prostate cancer survivor would be wasted.
This poll on my Facebook page was answered by twenty folks. It isn't a scientific poll, but it does show I'm not alone in finding that waiting for test results gets more difficult with the passage of time. 

My advice is don't let difficulty, stress, or fear, stop you from doing what you know needs to be done

The question was does waiting for test results get easier or more difficult with the passage of time. Here are the results.

Rick Redner and his wife Brenda Redner wrote two award winning books. The first:
I Left My Prostate in San Francisco-Where's Yours?
provides men and couples with information and support before, during and after prostate surgery.

Their second book was written for couples living with!erectile dysfunction. After living with  erectile dysfunction for four years, Rick chose penile implant surgery. The couple share how implant surgery changed their lives and relationship.
The title of their book is:
Everything You Never Wanted to Know About Erectile Dysfunction and Penile Implants.

Thursday, June 21, 2018

Together in Sickness and in Health

On June 7 2017, my wife and I celebrated our 37th anniversary. For six of those years, we’ve been coping with the quality of life issues associated with my prostatectomy. For many years, these issues had a negative impact on my self-esteem and our marriage. In order to preserve our marriage, we sought professional counseling. 

Every year since my prostate surgery, it seems I’ve had a new health crisis or surgery. Here’s a few of those medical challenges. I suffered lots of wrist pain for a long time.

 Finally, I went in for an exam. I was told that I needed surgery for carpel tunnel syndrome.

Sometime after that surgery, I tripped over my dog, fell, and injured my shoulder. I was in constant pain and unable to sleep well. It took almost a year to get a diagnosis and finally have a rotator cuff repair. After surgery, I spent almost two months in a sling, then three months in physical therapy.
Each year, a new health crisis has a negative impact on the quality of my life and the ability to enjoy time with my wife. For these reasons, I wrote my wife the following on her anniversary card:
“Today we celebrate our 37th anniversary. I’m not sure whether our best days are behind us or whether our best days are yet to come. Either way, I’m blessed to journey through life with you.” 
Shortly after I wrote that note, I received the unexpected news I need surgery to have my gall bladder removed. My wife and I stopped counting the number of surgeries I’ve had after I reached my tenth surgery.
All of these storms, unwanted changes, sleepless nights, months of chronic pain, multiple surgeries, physical therapy, and illness have taken a huge toll on me, my capacity to function, my ability to enjoy life, my energy level, and my capacity to love my wife.
I have no idea whether we will get a break from health challenges or whether this is the new normal for me and for us as a couple.
If this is our new reality, I believe the best is behind us, rather than yet to come. This is certainly not how I hoped to spend my “golden years.” There’s one thing that has been a blessing through all of these trials.
Thirty-seven years ago, my wife and I made a vow to each other before our friends, family, and God. We promised to stay together in “sickness and in health.” In our youth, and in good health, we had no idea how difficult and challenging keeping that vow would be.
For many years after my prostate surgery, I was convinced  my wife would be better off without me, rather than with me. I’m blessed beyond measure that I'm married to a woman who is committed to keeping her wedding vows.
How you treat your partner as they recover from an illness or surgery can affect how quickly they heal. A recent study found that patients whose partners displayed empathetic behaviors like emotional support, affection, and attention showed improved physical function over time.
There’s a reason your marriage vows included the promise to stay together in sickness and in health. We need each other, and we are more likely to successfully navigate through the storms of life as a team.
I pray those couples tempted to break your wedding vows will reconsider and get help in order to preserve your marriage and keep the marriage vows you made to one another.
It’s my prayer that couples facing the challenges of coping with the unwanted changes brought about by cancer and/or the quality of life issues couples face after treatment, will enable you to grow closer together, rather than further apart.
If your partner made a difference (positive or negative) in the way you coped with cancer, I hope you’ll share your story so other couples can learn from your experiences.

Rick Redner and his wife Brenda Redner wrote two award winning books. The first:
I Left My Prostate in San Francisco-Where's Yours? provides men and couples with information and support before, during and after prostate surgery.

Their second book was written for couples living with erectile dysfunction. After living with erectile dysfunction for four years, Rick chose penile implant surgery. The couple share how implant surgery changed their lives and relationship.
The title of their book is:

This article was reprinted with the permission of Prostate Cancer News Today 

Saturday, June 16, 2018

Fathers Day Thoughts From a Prostate Cancer Survivor

As a prostate cancer survivor of seven years, I don’t take reaching any milestone or holiday for granted.Therefore, my first thought and feeling is a profound sense of gratitude that I’m alive to celebrate another Father's Day. Prior to my diagnosis of prostate cancer, I never considered living to celebrate another Father's Day was an achievement to celebrate.

As a dad, whether I like it or not, I've influenced my children in both positive and negative ways. From my perspective, one of the worst things I've passed on to my sons is a greater likelihood they'll one day hear the awful news they have prostate cancer.

I don't know why, but on Father's Day this reality becomes a heavier burden:
"Family history is the strongest risk factor for prostate cancer. A man with one close relative with prostate cancer – for example, a father or a brother – is twice as likely to develop prostate cancer as a man with no family history of the disease."

No father wants his son(s) diagnosed with prostate cancer. I deal with my greatest fear with useless worry. I worry whether my sons will insist on prostate cancer screening on a regular basis. I worry whether their physicians will take their increased risk seriously enough to insist on regular screening. I could write pages about the futility of worry, but thousands of articles are available to address this issue. 

When I get stuck in the worry muck, I turn to two Bible Verses. In the first Bible verse Jesus asks:
Who of you by worrying can add a single hour to your life? (Luke 12:25)

It's a powerful question and a good reminder that all my time spent worrying is a waste of time. So if worry is a waste of time what do I do with the very real concerns I have? The second Bible verse gives me a positive alternative to worry:
"Be anxious for nothing, but in everything by prayer and supplication, with thanksgiving, let your requests be made known to God; and the peace of God, which surpasses all understanding, will guard your hearts and minds through Christ Jesus." (Philippines 4:6-7)

An important aspect of my Father's Day is spending time praying for each of my four children, their wives, and my grandchildren.

Prayer is a wonderful reminder I'm not the only Father involved in the life of my children. They have a Heavenly Father who loves them more than me! As I grab hold of that reality, my worry fades away. This enables me to enjoy the day with a heart filled with gratitude that I'm alive to celebrate another Father's Day.

There's one more prayer that's easily neglected or forgotten. I pray that my wife and I, two broken and imperfect parents, receive wisdom from above to become the best parents we can be. We rely on this amazing promise:
"If any of you lacks wisdom, let him ask God, who gives generously to all without reproach, and it will be given to him." (James 1:5)
I shutter to think of my parenting without wisdom from above.

There's one more important Father's Day reflection. I think back to my dad. I sort out the positive memories and experiencs and the negative ones as well. There are valuable life lessons contained in these memoires. Joyful things to do and share, as well as very negative, careless and abusive things I want to avoid, rather than pass on to my family.

If there's conflict and divisiveness, Father's Day is a reminder to do everything possible to be a peacemaker in order to resolve family tensions. The Bible says this about those efforts:
Blessed are the peacemakers, for they will be called children of God.(Mathew 5:9)

I wish everyone who is a father, or who had a father, a Happy Father's Day. Whether  your father was absent or present, kind and loving, or abusive, alive or dead, there are important life lessons for you to know and grow.

For those who long for a Father's love, you have a Heavenly Father who promises never to forget, leave, or forsake you. It's my prayer you'll experience your Heavenly Father's love for you this Father's Day weekend.

Rick Redner and his wife Brenda Redner wrote two award winning books. The first:
provides men and couples with information and support before, during and after prostate surgery.

Their second book was written for couples living with!erectile dysfunction. After living with erectile dysfunction for four years, Rick chose penile implant surgery. The couple share how implant surgery changed their lives and relationship.
The title of their book is:

Tuesday, May 15, 2018

Cancer Survivorship Can Wear You Down

I was diagnosed with prostate cancer when I was fifty-seven years young. I believed a diagnosis of any form of cancer was a death sentence. Imagine my pleasant shock and surprise when at age sixty-six I was alive and well when my first Social Security check arrived.

The next day I went for an eye exam. I was certain I needed a stronger prescription. I wasn't seeing words clearly with my left eye. I knew bad news was coming my way when my Optometrist said "I can't get your vision in your left eye better than 20-50. We need to find out why.

I was terrified I could be moments away from receiving a diagnosis of macular degeneration. I breathed a deep sigh of relief when I received the news I needed cataract surgery.

My relief, gratitude, and celebratory attitude  over the fact I wasn't going blind, ended abruptly. Soon I found myself feeling miserable about growing old. I'd just finished my third spinal injection for severe back pain few days prior to receiving the news I needed cataract surgery.

My wife who is the keeper of our family history informs me that every year since my diagnosis of prostate cancer, I've experienced some medical emergency or crisis. I know this has taken its toll on me, my wife, and our marriage. I'm a seasoned veteran when it  to surgery. Over the course of my lifetime this will be surgery number sixteen. I'm not the least bit worried about the outcome of cataract surgery.

The success rate for cataract surgery is above ninety-eight percent. The recovery time is short. I was surprised that my level of despair was much greater than the medical challenge before me. I tried a number of ways to talk myself out of my despair.

                     Positive Self Talk Does Squat

According to the literature positive self talk has these benefits:
 "People are becoming more aware that positive self-talk is a powerful tool for increasing your self-confidence and curbing negative emotions." 

I needed to curb my negative emotions so I said to myself:

1. This is a piece of cake compared to prostate or penile implant surgery. If I made it through those and fourteen other surgeries, I've got this.

2. The benefits to this surgery is immediate within a few weeks I'll notice vastly imported eye site.

3. Cataract surgery is as risk free as can be. It's not like prostate surgery where I faced life long consequences.

4. I am grateful that I live in a country and a city where a skilled doctor will restore your vision.

This is the one I expected would turn things around:

5. Diagnosed with prostate cancer at age fifty-seven, I'm grateful that I lived long enough as a prostate cancer survivor to need cataract surgery.

I wish I was feeling greatful. I thought I should be feeling grateful, but I wasn't. I'm feeling overwhelmed and frightened. For the last seven years I've been falling apart piece by piece, at a rapid pace. Every year it's been a new medical challenge, a new surgery, months of chronic pain, and dozens of sleepless nights. My ability to bounce back is rapidly declining. I can't get a break from falling apart piece by piece.

I've  learned a valuable lesson. Sometimes you won't get to where you want to be until you deal with where you are. Whenever you are overreacting to a situation or circumstance, something else, most likely from your past is triggered.

In my situation, I needed to grieve and say goodbye to my expectations regarding retirement. I expected to reach retirement age in good health. I didn't expect I'd be living without a gallbladder, appendix, or a prostate. I never considered the possibility I'd have a penile implant, or I'd be living with chronic back pain. This isn't  my season for positive thinking and gratitude. It  a season for mourning. I can be grateful and sad at the same time.

It's ironic that on the one hand cancer survivorship has made me stronger. On the other hand it's also made me more vulnerable. I feel worn out. I'm emotionally and physically drained, and that's OK as long as I don't get stuck there

We are capable of experiencing more than one emotion, so that I'm capable of feeling greatful and sad at the same time. My plans and expectations for retirement was not how I planned it.

Monday, April 2, 2018

Acknowledging Cancer Anniversary Dates

On March 17, my wife said "Happy Anniversary." For a moment I panicked. I thought I'd forgotten our thirty-eighth wedding anniversary. I breathed a sigh of relief when I did a calendar check in my mind. Since it was March rather than June, I hadn't missed our anniversary.

Puzzled by. my wife's remark I asked what exactly is this anniversary. She explained that seven years ago I had my prostate surgery at UCSF. I've been living without my prostate and cancer free for seven years. It was a happy anniversary!

I don't pay much attention to dates, so I had no idea this was my seventh anniversary. I wondered if my wife kept track of the anniversary date of my penile implant surgery.

I wondered if cancer survivors keep track of anniversary dates of cancer's devestating, life changing events. Do folks keep track of dates so they can say this the anniversary date of my first hot flash, the day I stopped wearing diapers, my first post op erection.

I'm glad I don't pay attention to anniversary dates, but I'm not sure why. Maybe keeping track of those  life changing milestones are days is a worthwhile endeavor. You add events in your life for celeb or mourning.

Keeping this possibility in mind, I imagine throwing a one year post surgery celebration thankful that I graduated from diapers to pads during that first year. I'm not that creative or extroverted to throw a "Goodbye to Diapers, Hello to Pad Party."

I can't decide whether acknowledging anniversary dates is a valuable and important way to cope or whether it makes little or no difference.

According to an article in Cancer.netPreparing yourself for anniversary dates and honoring them in ways that are meaningful to you may help you sort through complex emotions and reflect on your experiences.

That maybe true for some folks, but I'll pass and continue to ignore anniversary dates related to treating prostate cancer.

What about you?

Rick Redner and his wife Brenda Redner wrote two award winning books. The first:
provides men and couples with information and support before, during and after prostate surgery.

Their second book was written for couples living with!erectile dysfunction. After living with erectile dysfunction for four years, Rick chose penile implant surgery. The couple share how implant surgery changed their lives and relationship.
The title of their book is:

Saturday, March 17, 2018

Is the Medical Profession Failing Men with Prostate Cancer?

Diagnosed at age 57, I was shocked when, in 2011, the U.S. Preventive Services Task Force recommended against routinely screening for prostate cancer in all men.

Even more shocking is how many doctors stopped screening for prostate cancer. A 2016 study published in JAMA Internal Medicine found that prostate-specific antigen (PSA) testing — a blood test used to screen for prostate cancer — decreased from 2010 to 2012. Testing fell from about 36 percent to 16 percent among primary care physician visits and from about 39 percent to 35 percent among urologist visits.

When you read between the lines, only 16 percent of primary care physicians routinely screen for prostate cancer. This leaves 84 percent of men going to their primary doctor without prostate cancer screening.

The odds for screening aren't much better when seeing a urologist. Approximately 35 percent of urologists screen for prostate cancer. This leaves 65 percent of men who visit a urologist untested for prostate cancer.

Here's the prostate cancer trend among younger men:
The number of younger men diagnosed with prostate cancer has increased nearly sixfold in the last 20 years, and the disease is more likely to be aggressive in young men, according to a 2014 analysis by researchers at the University of Michigan's Comprehensive Cancer Center.

Here's the trend for older men:
According to an article in the Cornell Chronicle, investigators examined data from the Surveillance, Epidemiology and End Results Program, a National Cancer Institute database that tracks cancer incidence rates. They found that the decline in PSA screening has significantly altered the way prostate cancer is now seen: 12 percent of men over 75 were diagnosed with metastatic prostate cancer in 2013, compared with 7.8 percent in 2011. And the proportion of men diagnosed with aggressive cancer increased from 69 percent to 72 percent during the same period.

In other words, the number of older men presenting with aggressive prostate cancer has increased.

I understand the good intentions behind the effort to save men from choosing unnecessary and aggressive prostate cancer treatment. No one wants to ruin the quality of a man's life if aggressive treatment of prostate cancer is unnecessary.
It's the underlying assumption I take issue with. Men are fully capable of making the correct treatment decision based on their diagnosis when someone takes the time to address their previous experiences with cancer and the fear that arises when you hear the dreaded words: “You have prostate cancer."

Upon receiving the news that I had cancer, three words came to mind: pain, suffering, and death. I wasn't capable at the time of diagnosis to make a rational treatment decision. I think that's true for the majority of those who receive a diagnosis of cancer.
Men need time to decompress. They need time to sort out their personal experiences with friends and family they've known with cancer.

Then, they need time to receive their own specific diagnosis without the filters of fear and their past experiences with folks who've died from any form of cancer.
When information, rather than fear, drives a treatment decision, you get more appropriate treatment decisions.

The proof of this is the increase in the number of men choosing active surveillance.
The New York Times reported that 10-15 percent of early-stage prostate cancer patients were treated by active surveillance several years ago. Now, national data from three independent sources show that 40-50 percent of them are making that choice.
In other words, the data suggest that men are capable of making a treatment decision based on their diagnosis, rather than their fear.

It's always heartbreaking when I hear from a son or daughter who's lost their father, or from a partner who's lost the love of their life because they were never screened for prostate cancer.
It’s possible that your primary physician or urologist is among the group of physicians no longer screening for prostate cancer.

I'm not a doctor, which means I don't give medical advice. I'm a prostate cancer patient advocate with strong opinions about the need to resume prostate cancer screening.

Here are my opinions:
•Familiarize yourself with the various tests available to detect prostate cancer. A new 
urine test may replace the need for a prostate biopsy.

•If prostate cancer runs in your family, I suggest getting your first screening a decade earlier than recommended, at age 30. You are at a higher risk for prostate cancer.

•If you are African-American, get your first screening at age 30. You are at a higher risk for prostate cancer.

•All men should have at least one screening by the time you reach 40.

Men, given where we are with the politics and policies with prostate cancer screening, your life may depend on you taking control of this piece of your medical care.
For your sake and for the sake of those who love you, you can't assume that you don't have prostate cancer because your physician didn't screen or test you.

Note: This article appeared in Prostate Cancer News Today 

Rick Redner and his wife Brenda Redner wrote two award winning books. The first:
provides men and couples with information and support before, during and after prostate surgery.

Their second book was written for couples living with!erectile dysfunction. After living with erectile dysfunction for four years, Rick chose penile implant surgery. The couple share how implant surgery changed their lives and relationship.
The title of their book is: