Where Meaning Dwells

“One in six men will get prostate cancer in their lifetime. Most of them will die of something else before the prostate cancer would have killed them.” The urologist sat on a swivel stool and looked at my husband, who was perched on the edge of the examination table.  “But here is where it gets tricky,” Dr. G. continued. “How long are you going to live?” He glanced over at me, flashed his steel-blue eyes. I felt like he was gauging my reaction to see how open he could be, whether I would get up and run out of the room. He looked back at Buck. “Because that’s a big factor in determining how, or whether, we treat it.”

Buck doesn’t have prostate cancer, or at least if he does we don’t know about it. Yet. But his Prostate Specific Antigen (PSA) numbers have turned erratic. A chart he and I made last night from 2008 to December of 2013 looks like a nascent Bull stock market beginning to make a run. And the doctor’s question goes to Buck’s age. “You’re an unusually healthy guy for 76,” he said. “Extremely fit. No meds. Most likely good for what? Ten to twelve years? Maybe more?”

My ears began to buzz, and I had to concentrate on breathing to keep my hands from clenching the chair arms, to keep my face impassive when I wanted to scream. I felt like an atomic clock was in the room with us, counting down seconds.

Buck laughed easily. “Oh, more, I think. Maybe a lot more.”

We talk about death sometimes, and he makes me swear to stay healthy and safe. I swear. I make him swear to live forever. He promises to try.

The urologist explains to us that Buck’s PSA numbers aren’t alarming in isolation, but have begun to show a certain velocity that can be a danger sign. He wants to be sure if there are any cancer cells present, he knows which type they are. Apparently some are quite aggressive and some are not. The doc recommends an ultrasound examination and biopsy. Buck agrees and a time is set for next Wednesday.

We’re back home now. It’s raining and dark, with deep, nearly continuous rumbles of thunder. Buck is downstairs in a room we call “The Lodge,” writing away on the revision of a book he has just completed. I’m upstairs in an open area we dubbed “The Treehouse,” drinking spiced Chai and writing too many words in a bright circle of light. The curtain of rain outside the windows when it hits the concrete patio below makes a sound like tin foil crinkling.

A woman acquaintance warned me once that I was unwise to be so close to my husband; that in time it would bring me grief. Can you believe that? Foolish woman.

Besides, grief has been my close companion since I was 13, and I am unafraid of it. It is like that inner part of a ripe tomato skin, the part I call the velvet, the part where meaning dwells. You can only get to it by dropping the ripe tomato into boiling water for thirty seconds and then lifting it out with a slotted spoon. The peel slips off, revealing the gem-like velvet. Grief is always in the room with us. Grief, I think, is also the kernel of love.

A happy postscript: Dr. G’s nurse, Patty, called Friday morning, to advise us there were no aggressive cancer cells, no passive cancer cells, not even any passive-aggressive cancer cells, none at all. When I looked at Buck, he suddenly seemed years younger. When I caught my own eye in a mirror later in the day, so did I.

ReSound Alera: The Little Black Dress of Hearing Aids

Buck has been driving us toward North Carolina for the last three hours. We just made the big turn north on I-85 at Montgomery, Alabama toward Atlanta. Pensacola had a near-record 13.11 inch rainfall last night with more falling today. A persistent, heavy rain has been with us since we picked up our soggy Sunday newspaper at the gate and linked up with I-65 to Montgomery.

It’s not so bad for me, since I am in the passenger seat. Our laptop is a great knee warmer, and I’ve got it tethered to my Droid phone for high-speed internet.

Buck is road-testing a brand new pair of hearing aids on this trip. His old pair of Phonak BTE’s (behind the ear) are still working reasonably well, but hearing aids reputedly have a “life” of five to six years. Buck’s Phonaks are six now, and so when his audiologist let him know about a special 60-day trial promotion on new hearing aids, he decided to take advantage of it.

Dr. Jennifer Reeves LaBorde, Audiologist at The Hearing Center, Pensacola, Florida

Buck has seen Jennifer for about 12 years. She is Dr. LaBorde, a Ph. D. Audiologist, but to us, she’s also our trusted good friend, Jennifer. Buck promised her that he would check out all the bells and whistles on his new ReSound Alera BTE hearing aids on our trip to Maggie Valley. We’ll be in a variety of situations involving road noise, restaurants, and visits with friends that should provide all the elements for a good test.

Buck left Jennifer’s office with a chic black shopping bag full of gee-whiz gizmos. The hearing aids themselves are sleek matte black and silver units. The accessories are where things have the potential to get fun. These hearing aids are blue-tooth equipped, which opens up a world of potential enhancements. One is a phone clip, a unit that wirelessly pairs with Buck’s cell phone and then allows him to hear cell phone calls directly into both ears via the hearing aids. We haven’t tried that one yet. The other accessory is called a mini-mic. It’s a chic little black and silver number that I can wear clipped on to my t-shirt or blouse. When wirelessly paired with Buck’s hearing aids, my voice goes directly into his ears. What spouse wouldn’t love that?

We tried the mini-mic at home first, and then at a noisy restaurant. The mini-mic is fantastic. Buck could hear background sound all around our table at the restaurant, but when I spoke in a very soft voice, that is the sound he heard intimately and clear. It dampened and took precedence over all the other sounds. Buck had to remind me a time or two not to speak so loudly. Amazing. We were able to enjoy a relaxed meal and conversation in that noisy space without resorting to lip and/or mind reading.

And so, we have the black “Hearing Center” bag full of goodies and battery chargers to play with in Maggie Valley.

Buck says that so far he doesn’t feel like he is hearing any better with these new aids, however he notes that the TV volume on his small office set has come all the way down to 20, from a setting of 32, so something is clearly going on. Jennifer explained that brains need a period of adjustment to get used to a new assistive device.

Another cool thing is that the hearing aids make a record when Buck adjusts the volume up or down so that when he goes back for a follow-up with Jennifer, her computer can communicate with them and see how and when the units have been adjusted. This will give valuable feedback as she  fine-tunes the units.

Far out, don’t you think?

National Bladder Cancer Awareness Day July 17

This time last year, bladder cancer was not a phrase that had ever crossed my lips. I knew it existed, but thought it was one of those rare cancers that few people get. I couldn't have been more wrong. Bladder cancer is the fifth most commonly diagnosed cancer in the United States. Surprised? So was I.

According to the Bladder Cancer Advocacy Network, more than 70,000 people in the United States were diagnosed with bladder cancer last year, and more than 14,000 died from it. Because bladder cancer has a recurrence rate of 50-80%, it requires life-long surveillance. The cost of keeping this disease at bay makes it the most expensive cancer to treat on a per patient basis. Nearly $3 billion is spent in the US alone each year on treatment of bladder cancer.

By the time my younger brother, Steve, was diagnosed late last year, he had been having symptoms for months: blood in his urine, frequent urinary tract infections, frequent urination, painful urination, back aches, abdominal pain and weight loss. If you or someone you know has any of these symptoms, call your doctor for referral to a urologist immediately.

As with most cancers, early detection may save not only your life, but preserve your quality of life.  Mayo Clinic is a trustworthy website for health information. Click here to see their page on bladder cancer symptoms.

The Bladder Cancer Advocacy Network is sponsoring the first National Bladder Cancer Awareness Day on July 17 to heighten public awareness of this disease. Research dollars have been disproportionately lacking for this cancer, which has surely contributed to the relatively slow progress of treatment alternatives over the past twenty years.

National Bladder Cancer Awareness Day events are being held all over the country not only to raise awareness, but to celebrate with survivors, their families and friends, to remember the lost, and to share inspiration and encouragement. 

To find a National Bladder Cancer Awareness Day event near you, contact BCAN at BCday@bcan.org or 888-901-BCAN.


Personal update:  As many of you know, Steve was diagnosed with Stage 2 invasive bladder cancer and had surgery to remove his bladder on February 23.  The neobladder that was crafted for him developed a rare complication which caused an enteric fistula. Steve has spent most of the last 3 1/2 months in the hospital because of this.  Yesterday, June 14, he underwent successful surgery to remove the neobladder, repair the fistula, and craft an ileal conduit. We are hopeful and guardedly optimistic that Steve will be able to recover now, to regain some of the 35 pounds he has lost in the last few months, and to once again hike, garden, eat (real food, not TPN), and enjoy sunsets on the beach.

Together we're better Our whole family is enormously grateful to readers of my blog, other friends, and especially the BCAN  On-Line Support Community for your prayers, resources, visits (thank you, Al), and other expressions of support. The BCAN On-Line Support Community has been there to help me in trying to learn about this awful disease and to offer support to Steve since the first day I went to the site looking for information. You can read my journals and the community's responses on the BCAN web site. My "handle" is Pinewoodswriter.


Non Sequitur

There are all kinds of big deals on the table from the minute we are born. Two of the trickiest are the urge to merge and the desire for immortal life. Our separate bodies preclude actual merger, but oh, we try, how we try. As for immortality, we learn,usually as children, that we won't live forever. But that doesn't stop us from trying, inventing subterfuges or taking great huge leaps-before-we-look of faith.

The bongo drum of the beat poet begins to play in earnest when we hit our mid-fifties and watch as our older friends and relatives begin to drop like marionettes whose strings have been unexpectedly cut. The merry-go-round plays herky-jerky music, and we try our best to waltz gracefully despite the stutter-step accompaniment that distracts and dismays.

It's been a hell of a week with a heaven of an outcome.

I'm too tired and wrung out from a week of travel and fret to go on with an explanation, plus there are privacy issues involved. Suffice it to say the person I love most in the world and I had a scare. Turned out to be a non-issue. He is well and oh-so-fine. And when I get one more full night's sleep, I'll be fine, too.

Bluetooth Rocks!

Like most long-married folks, Buck and I have little jokes together. One of ours is that since I can't see and he can't hear, it's a good thing we found each other. Actually, I can see up close okay, but you wouldn't want to be on the same highway with me if I was driving without my glasses. I'm quite near-sighted, plus I have this weird astigmatism that makes it difficult for me to tell which lane oncoming vehicles are in.  Just imagine if you saw a driver lower their window, cover up one eye and inch slowly into the road. . . . yep. Other drivers get out of my way.

Buck's hearing impairment has worsened steadily over the years. He's a scary-good lip reader, but we are always on the look-out for new technologies that will give him bionic ears. He wears high-tech silver and black behind-the-ear digital hearing aids made by Phonac. We have a conference-style phone at home that makes it possible for him to have a comfortable conversation, but cell phones continue to be frustrating. Most cell phones these days are  "hearing aid compatible," but in our experience, that hasn't meant much.

The newest, "bleeding edge," hearing aids can now be bought with built-in Bluetooth capabilities that can enable wearers to connect to cell phones, IPods, televisions, and other wireless devices. Hearing aids are very expensive, however, and so we were hopeful of finding a device to improve Buck's cell phone experience and "bridge" him over for another year or so while the latest greatest technology gets even better. As the huge baby boomer cohort enters the age of diminished natural hearing. . . well, you can assume the problem is going to get solved a lot faster. Suddenly, hearing aids aren't just for Granddad anymore. Plus, these days, almost everyone is wearing something on their ears. Hearing aids come in sexy colors now, too, just like Bluetooth headsets.

Buck's audiologist, Dr. Jennifer Reeves Sylvester, did some research for us. Enter the Artone Bluetooth Loopset, made by Westone. It's a nifty looking black and silver Bluetooth pendant on a black cord that can be worn over or under a person's shirt. It pairs with a cell phone, and the audio goes straight into the hearing aid wearer's ears, in stereo. And, at $167, it's a real bargain.

We were skeptical, but it works! So, today, we went out to Best Buy and bought a Plantronics Voyager Pro headset for me. I've never used a Bluetooth ear piece with my cell phone before. I am surprised how much I like it. Best of all, my voice is delivered via Bluetooth through Buck's hearing aids with perfect clarity. It's exhilarating to whisper to each other into the air and have the endearments arrive clear as pillow talk.

We hung out for awhile at Best Buy looking at gizmos. Now that we have the Bluetooth loopset template, we are looking at all sorts of wireless devices in a new way, with an eye toward using them to extend and enhance quality of life and independence. We even began to "blue sky" ideas for a new, smaller house that is truly a gee-whiz electronic cottage, with acoustics, lighting and computer design tailored to keep us plugged into this remarkable world until the day we matriculate to some other form of energy.

Calling Brother Al

There haven't been any posts over at The Longleaf Bar and Grill lately. Perhaps it's a natural asceticism that follows the richness of holiday foods, a leaning toward the dry after a season of juice. I have always been a carnivorous woman, but lately, the smell of steak or rare roast tenderloin makes me nauseous, and therefore, it has disappeared from our plates. Pork, long a staple, has, at least temporarily, lost its sensual allure. Chicken, too, seems just too much. This won't last, of course. It's not a political statement, and I am personally healthy as a young horse. Meanwhile, writing about food is temporarily – excuse the expression – off the table, too.

I'm not wasting away either, so I must be eating something. Oh, yes, I am, and well. Muesli with soy milk, sesame ginger tempeh on baby salad greens, veggie pizza with red and yellow peppers, onion and shitaki mushrooms, roasted beets. Oh, lots and lots of roasted beets, my new love. Oranges, so fragrant I cry at their beauty. I stand at the cutting board and inhale. Deep breathing over a fresh cut orange is the way to go. Trust me on this.

Coffee is still king in my kitchen, but Japanese green tea has become queen. And my treadmill, walking and free weight work has become more routine and more rigorous. Are you sensing a theme here?

I know we will all die – oops, sorry, there I go again talking about that – so avoiding death isn't the point. But it sure would be nice to live to be very, very old and not be sick and then just die. With a younger brother on the ailing list, and our annual physicals fast approaching, I have found diet and exercise religion again, as I do over and over again. They say some preachers are especially good at talking about sin because they know so much about it. That's me.

When I was a child, there either was or I imagined, a radio evangelist named "Brother Al." He preached purple prose over the air waves. His voice would rise to a hysterical high, thin screech, and then drop theatrically way down into a low, growly whisper. Fabulous stuff. He was a master. At the finale, he would tell the audience to put their hand on the radio, pray about what was worrying them, and then send Brother Al a dollar and their prayers would be answered.

Brother Al, old buddy. Call me if you read this. Maybe we can make a deal.

Striped Parasol

No hurricanes. Rather, monsoon season with occasional steam-sucking sunshine so far this verdigris September.

Yesterday afternoon found me reclining on a deep burgundy faux leather examination chair while my young, skinny surfer doc stuck a long needle between the third and fourth metatarsals of my right foot. Dr. E's eyebrows were upside-down v-shaped fuzzy caterpillars, strange counterpoint to gelled-up black hair spiking in modish points.  Not a stud muffin, exactly, but cute. At least, I tried to think so as he delivered the long, slow stick of cortisone  into the top of my tender foot. It wasn't a sharp pain. More what I imagine siphoning bone marrow might feel like.

Unlike me, most of Dr. E's patients are elderly diabetics. Shortly after I arrived, his nurse settled me into an exam room. Walls are thin in such places. I hear well and am an experienced doc-talk translator. Between weather talk and asides to his nurse, Dr. E race-walked in no-sox worn out jogging shoes between patients as he dressed wounds, ordered x-rays, advised patients on the special care needed for their legs and feet due to the diabetes, and — bless his heart — he listened, he comforted. Out in the hall, a nurse called for him as a patient came in trailing blood spots from her shoe as she was led to an examination room. I heard the patient talking to the nurse. "Oh, I'm so sorry to be messing up your floor."

When my turn came, he said my x-ray looked "really very good." Upon seeing the pinkish swollen oval area on my foot, he frowned and spoke to the nurse, who disappeared and reappeared fast as a cartoon superhero, needle and accoutrement in hand. Dr. E was moving too fast for me. I leaned forward. "If there's no fracture, what's wrong?"

"Most likely," (that great equivocating phrase), "the nerves or tendons are inflamed," he said.

"And will that shot of cortisone solve the problem?"

"You'll know within 48 hours."

"And if it doesn't?"

"Then we go to an MRI and keep looking," he said, nodding to the nurse to move into position to spray my foot with an anesthetic before plunging in the needle.

"Doctor," I said, moving closer to hold his attention. "I understand that most of your patients are older folks, many of them quite ill. I am very healthy, and very lucky. But this foot problem is messing with my program, and we've got to find out what's wrong and fix it, so I can continue to stay fit. Diabetes is a wonderful disease not to have."

Dr. E stopped, needle in mid-air, and looked me in the eye. Ah, contact. You know it when you see it. He nodded. Message received. He bent to his work, apologizing all the way for the discomfort he was delivering along with the medicine.

On the way out, he stopped at the door, turned around to look at me again, and spoke softly, "You're right. Diabetes really is a wonderful disease not to have."

I rode the elevator alone back to the clinic lobby. It was 3:30 and raining sideways, so I stopped off at the walk-up cafe window for a latte and a chocolate chip cookie, found a comfortable chair and people-watched. Some were in wheelchairs, some on crutches or limping, young women with downy soft hair on their sleek skulls, crying babies and exhausted-looking caregivers, all making their way in and out of the storm. Two men stood on either side of the automated doors with industrial mops. They handed out plastic umbrella bags to everyone trudging in with their dripping bumper-shooters.

My coffee cup was empty. The cookie was gone. I missed Buck and Maggie, dry at home, awaiting my arrival.  My foot was not in good running condition, and I hated the thought of getting soaked to the skin walking to the car. Umbrellas. Ha! I was sitting directly across from the clinic's pharmacy. They had three packable-style umbrellas: one black, one blue, and one a cheerful stripe, more like a parasol.

IMG_2830 The heavy rain stopped had stopped by the time I reached our gate. I pulled into the car port as a copper sun was setting. Maggie and Buck met me at the door.