Morphing in Small Steps

Two weeks in the rear view mirror for surgery, and it has gone as well as hoped for. I am in no danger of going postal as this disgruntled patient recently did. Thanks to my buddy Chris for the link. Tragic. In the work up towards surgery, the care team set the bar low for expectations. They were deliberate about discussing complications and very conservative when talking about timelines for recovery. So much of recovery is about one's mental state. Especially when talking about that side effect of prostatectomy that we won't mention for the benefit of my kids, and those who would be shocked to hear that it is still important to a 59 year old guy. My point being that managing expectations is key to an optimistic outlook. Set the expectations at a level most will attain with many considerably exceeding, and you will have a happy patient cohort. It works. I'm making my way back and in a good frame of mind.

Here's a little memory from the radical prostatectomy road trip. Skip down a few paragraphs if you don't enjoy sensitive topics. In fact, if you want to avoid lots of talk about guy parts and function, now would be a good time for you to find something else to read. No offense taken.

When discussing the side effects of surgery, Dr. Knoedler got around to discussing how separating nerves from the surface of the prostate subjects them to a post-traumatic stress like syndrome. They shut down along with anything they are connected to. Follow me? In time they usually regenerate and heal, but it can take awhile. Dr. K matter-of-factly stated, "Don't worry about it. There is always something we can do to fix that." Don't worry about it? As a male, my raison d'etre is to couple with a female to perpetuate the species. I have fulfilled my purpose 4X with 2 daughters and 2 sons and the remainder of my life is only a meaningless existence occupying space and resources from the anthropological standpoint. But hey, if you're just killing time, that whole procreating act thing isn't a bad way to go once in awhile, especially when it is in no danger of adding more mouths to feed. Give me something to work with Doc!

The armamentarium available for dealing with the subject we aren't talking about is impressive. There are pills that are the focus of those ubiquitous, hokey ads on TV. Drug companies are making a fortune. Remember the teenage days when you were watching TV in the basement with your sweetie  and they had just started advertising feminine hygiene products. Embarrassing? Uh-huh. What do kids do now?

Circa the Rolling Stones, should the pills be called Daddy's Little Helper or Mommy's Little Helper?  They've already got one affectionately known as the Weekender. Take 'em on Friday for supper and you're good to go for 36+ hours. And now they are coming out with a super pill. Even longer lasting. A recent regimen suggests a lower dose taken daily so said male is always warmed up and ready to pitch. These drugs were initially developed as blood pressure lowering meds. Men can get that added side effect.

On the extreme end, there are implantable medical devices. I was an implantable device rep on the cardiovascular and neurology side. I'm not ready to embrace the thought. Less so, but still extreme in my book are external devices. Look it up on the internet. I'm not ready to describe them either. And there are externally applied potions.

There is also what I refer to as "The Shot". Have you seen the movie Pulp Fiction? Uma Thurman OD's on cocaine and goes into cardiac arrest at a drug dealer's house. John Travolta enlists the assistance of the dealer who happens to have a kit with a large needled syringe full of adrenaline. Kneeling over her, Travolta rares back and plunges the needle into Uma's chest presumably finding her heart. He shoves the plunger down dispensing the medication directly and waits. In seconds Uma is shocked back to life.

This is the picture that came to mind when Dr. K talked about "The Shot". Apparently the end of the schwanz (w sounds like a v) has more nerve endings per area than just about any other place in the body and is very sensitive. Uh-huh. We know. But the base of the schwanz has little in the way of nerve endings and is a suitable place to administer The Shot without undue pain. A doctor acquaintance who wrote a book on his prostatectomy experience noted that the operative word there is undue. When you are on a mission, sometimes pain is relative. To paraphrase his words, "The Shot will give a dead man the hard-on of an 18 year old." The reaction can vary and sometimes the result can be prolonged and uncomfortable. I am not sure what that means. His doctor suggested that since neither of them wanted to end up in the ER in the middle of the night coaxing his schwanz back to normal, the first occasion for use would best be a morning or early afternoon interlude.

The question I am left to ponder is how nice would it have been to have this stuff in days gone by? I saw a Viagra ad several years ago with a baseball player in his 30's touting the benefits. I wondered what he was doing. He was too young to have ED. Plus he went on to be accused of steroid use. Then it hit me. Duh! Performance enhancement. A doctor was telling me that when he gives physicals to men, the number one question he gets in guys over 25 is, "Can I get some Viagra?" They don't need it. They're doping up like Lance Armstrong and living large on their own Tour de France! Ooh la la!

While I find humor in the topic, I will take a moment to send the message to my contemporaries and their partners. Nobody is saying you have to want or enjoy sex. If you do however, life's too short to struggle needlessly. See your doctor and they'll straighten you out. That didn't sound right. Get you pointed in the right direction. Not much better. You catch my drift.  

And one final thought as we are talking about the subject that we aren't really talking about, I feel the need to interject a brief observation. Any of you under 40 something's can focus your attention elsewhere for a few moments. This is a little secret I want to share with my middle age contemporaries. Romance is wasted on the young! Don't tell 'em. They'd never believe it. That's all I'm saying for now.

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It's no secret that I can be slow to move. Not always. And not when activity is necessary. There is a time tested adage: "Don't just sit there! Do something!" The yang to that yin is "Don't just do something! Sit there!" Life is certainly spinning at a furious pace but somehow I have managed to put myself in a place where I can find time to just sit peacefully and let life reveal itself. And it does. I like that aphorism, "Don't confuse action with progress." Sometimes one just has to sit, think and observe to find answers and move forward.

The original title for my post was "On Starting Over", but in very few ways am I starting from scratch. I'm morphing into a new phase of life. It is exciting although there have been a few restarts. One could look back to JoAnne's memorial service as a marker for closure and new beginnings, although in truth, grief does not end overnight. Planning a wedding for Wade & Sarah occupied much of the fall. The holidays and their attendant activities claimed the rest of November and December. Surgery and recovery occupied most of January, if not physically, certainly emotionally. And then Miriam headed out on a 2 week trip to China that she had planned prior to our meeting last summer.

There are always things on the calendar. We have a new grandchild due in April. But for the first time in................forever, now that I think of it, my life can be about me for awhile. There is some selfishness in that statement, but I've earned it. And once the scales come back into balance, I'll be back to feeling generous with my time and energy.

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Somewhere in the Bible, Jesus was described as being gentle, humble in heart and unselfish. Those traits have always appealed to me. Unfortunately, the crush of life often got the better hand. I often could not find enough strength or security to stay the course. Daily challenges would trigger the instinctive fight or flight response, sometimes for extended periods of time. Gentleness, humility and generosity were rarely my best qualities. I'm human. I'm learning. In the remaining days of my life (may they be many :-)) it would be nice to embrace those Jesus-like qualities more boldly. A worthy purpose in my mind.

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I like words. Every once in awhile a phrase or word crosses my path that is fun to say. I especially like words with a V in them such as Avalon or Avignon.  Perhaps it is wired into me via the Kevin moniker. Ginkgo biloba! How can one not enjoy saying that? Or baba ganouche? I go to a Mediterranean restaurant just to hear myself order it. During JoAnne's treatments, she received a relatively new monoclonal antibody, ofatumumab. Few in the hospital and clinic knew how to pronounce it so we enjoyed teaching them. OAF-a-too-moo-MAB. And then there is ruminate and of course, who doesn't enjoy saying raconteur?

We've talked about this before. Beauty and the Beast can be no more. Beauty has left us behind for a far better place. We need a new name. I ran across the word quinquagenarian, defined as a person in the 50-59 year age group. I like the word and the way it rolls of the tongue and over the lips. At age 59, I am actually in my 60th year so that presents a truth in advertising quandary. I looked up the like minded term for 60-69 year olds. Sexagenerarian. Really? Sounds too much like a porn site. Maybe I'll just stop counting at age 59. Quinquagenaria it is. KWIN-kwa-gen-AIR-ee-a.

In closing, please don't take any of my observations or descriptions, medical or otherwise as gospel. Every individual is different. See your doctor or provider. 

And the Beast Goes On