Life after treatment - Going it alone

Going for treaments unaccompanied

The radiation oncology office seemed to be a very busy place this morning. As always, I showed up unaccompanied, arriving about ten minutes early to fill out the usual pre-consultation questionnaire regarding my general physical and emotional health and those issues specifically relating to my cancer treatments. A couple, a man and a woman, presumably husband and wife, exited the consultation room and waited patiently behind me to schedule his next visit before leaving.

Post treatment appointment

We stood waiting several minutes for the receptionist to show up at her desk. "They must be very busy this morning," I thought to myself. Once checked in and my pre-consultation questionnaire was filled out the RN called me back right on time at 10:00 AM to weigh me in and take my vitals. After entering my vitals and completing updates to my medication list, she left me alone in the room with my thoughts. I didn't have long to wait before the Nurse Practitioner knocked and entered.

My first consultation with her today, nineteen months post-treatment was fairly routine in nature. We reviewed my PSA and testosterone history since completing radiation and hormone treatments. She indicated my most recent PSA results were satisfactory even though the latest one was a bit higher than the last. She emphasized some variability was to be expected, and she pointed to my continued rise in testosterone as a positive. Although on the rise, my "T" was still below the level considered hypogonadism in males.

Testosterone and erectile dysfunction after prostate cancer

“I would like to see it rise more quickly, but it is what it is” I complained. "I can certainly understand that" she consoled. We never actually got around to discussing my ED, even though I had answered “no” to the question on the questionnaire, which she had on the desk in front of her. “Can you get an erection sufficient to allow penetration?” it had asked.

I guess that is almost a given for a man my age with low testosterone coming off ADT. The ability to achieve penetration is a moot point anyway, since I am widowed, and have no partner as of now. Still, though I may be old, I'm not dead yet. Desire still lives in me. Is there still hope for the future? Perhaps the problem would be something more appropriately discussed with my urologist anyway when I see him in April.

Post treatment interview continued

She continued with the interview, asking if I’d had any problems with constipation or diarrhea. I responded that I have frequent diarrhea, but I am not sure how much of that is a side effect of my diabetes medication and how much may be a result of something else, radiation for example. She stressed I should further discuss it with my new primary care doctor when I meet with him in February. (This is yet another changing of the guard on my healthcare team.)

“Have you been keeping up with regular colonoscopies?” she inquired. I had to confess I have not had a colonoscopy for many years and that during the only one I’d had they had found one polyp which was removed and confirmed to be benign. She encouraged me to follow up on it, saying “You’ve already had one cancer…” She left the rest of the thought unspoken but certainly understood.

We discussed my history of DVT and PEs, and she asked if that was the reason for my warfarin regimen. I explained the PE that had broken away from DVT in my left calf nine years ago was small and asymptomatic, but my primary care doctor had suggested at the time I might want to remain on a blood thinner for life.

Cardiac arrhythmia problems from ADT

I made it a point to mention my cardiac arrhythmia problems; Which had been brought on by my ADT treatments. I explained that happily, the cardiac ablation I'd undergone in June has so far worked well to resolve them. She indicated my former radiation oncologist had filled her in about my cardiac issues before our session today. I felt comforted to know they had communicated and discussed my case in some detail before we met today.

I had further indicated on my preliminary questionnaire I was concerned about having no caregiver at home. I suspect that’s why she made it a point to ask about my family before we ended our session. I told her I have two children, but they live out of state, one in Colorado and one in Arizona. I asked her to indulge me while I took out my phone to proudly show her the picture of the view out my son’s front window in Sedona. She remarked how beautiful it was.

Feeling good after doctors appointment

My visit was not at all rushed, and I estimate by the time our session was complete we must have spent twenty minutes or more in conversation. Before leaving she took time to listen to my lungs and heart and apparently heard nothing of concern. A six-month follow-up will be scheduled, and she told me to call if I needed anything in the interim. The receptionist promised she would call tomorrow with the date and time of the appointment after she’d had time to “get caught up.” Six months seems a long time between visits, but I will be seeing my urologist for four months hence for a follow-up with him.

Feelings of loneliness

On the way home after a trip through Walmart, I stopped at Burger King and ate a solitary lunch. I noticed everyone else in the place was eating with someone, a wife, a husband, a co-worker, or some other companion. I recalled the many times Rosie and I had stopped there for lunch while we were in town. That was before her pancreatic cancer was discovered, and prostate cancer was still the furthest thing from my mind. My feeling of loneliness grew as I ate my meal alone looking down at my smartphone checking my home security cameras or scrolling through Facebook.

Now back home with groceries put away I sit here alone communing with myself in my journal with nowhere to go, nothing in particular to do, and nothing, in particular, to look forward to in the near future. Somehow, I feel a bit like the weather outside my window looks today – flat and gray with no color or excitement. It will pass as it always does. I just hate December in Indiana.