"Bravery..."

A few weeks ago, our family was having dinner at our regular Sunday waterfront dining restaurant.  Our waiter appeared to be pre-occupied, so I asked if he was feeling OK...

He said that his 35 year old girlfriend, a single mother with an eight year old, was having a tough time.  A year before before, she had a double mastectomy for diagnosed breast cancer.  She had been told that it had been successful surgery, but then was told that it had spread to some other lymph node sites, so she underwent intense chemotherapy, during which she experienced nausea and her hair loss, but she had remained in good spirits, to be nearly thru the regimen.  A few months later  she had been informed that it had spread to her bones and blood.  

 

 

This week, I was sitting in a waiting room, while the third set of new tires was being installed in my three-year old, 65,000 mile vehicle.  Two young men were sitting across from me and one was in a uniform.  Questioned, I discovered that he was home from Afghanistan on a medical leave, and was about to return to a domestic air force base.  He had jumped from a plane overseas and his parachute had tangled and did not open.  He free  fell with such speed that he couldn't execute his trained emergency shoulder roll", and had landed headfirst.  He survived and after recovery time in a hospital, had been released.  He returned to the States.  One night he said from the experience gained from surviving eight concussions during his "extreme sports years", he knew that he wasn't better.  He started bleeding thru his nose and ears and went to an emergency room to be diagnosed with internal brain bleeding.  He had just been released from surgery from this.  I thanked him for serving and asked how old he was?  "Nineteen".


The July 2012 Summer Olympics from London have been wonderful to watch.  I had never watched cycle distance  road races before.  It is amazing how much is involved in negotiating these courses, while riding sometimes in excess of 60 mile per hour in groups of cyclists with no separated distance.  Near the end of the mens' 152-mile race, the favored winner came to a ninety degree road turn, and was unable to negotiate the turn, and crashed headfirst into the fence.  Bleeding, he got back up, hopped on his cycle and finished the race.  The sportscaster revealed that three months before this 39-year old had crashed and had broken his collarbone in four locations!

"Tuesday Evening Observations..."

As I only had a half hour before an evening Village Council meeting, I stopped in a local sub shop for a quick dinner on the go.   I was the only customer there...

"Is anything on "special" tonight?"  "Just the printed daily sub, drink, side (chips or cookie) combo."  "How was your day?"  "I have been swamped since I arrived at  9am (it's 6:30 pm now).  I apologize for my snappy attitude!  The other day shift employee quit because of our pay.  Then our evening replacement called in sick, so I'm doing a double shift.  I earn just above the $7.50 minimum wage and I pay a home sitter $15 per hour for my baby, but that increases to $30 per hour for overtime after 8 hours!  I'm only in my my early twenty's so I live at my parents' home a 45 minute drive away, with my boyfriend.  He commutes 1.5 hours to his job because he earns more money. Gas is expensive!   Normally I make $60 in a day and pay my sitter $120, but today I'll make $180 and will pay the sitter $360.  Day care out west runs $200 per day and it  ain't very good!  I wouldn't leave my child there!"  "Do you get health coverage with this job for your baby and you?"  "Nope...we're on my parents' policy, but it ain't very good either.  It has high "co-pays" that I can't afford, so if me and my baby get sick we go to the emergency room and say we ain't got any insurance so we don't have to pay! Do you want some Parmesan cheese on your sub?  Is this for here or take-out?"   I paid my bill, and got my cup of water, and sat in the dining room at one of the numerous tables covered with crumbs on the floor also covered with crumbs.  Meanwhile, The employee was in the back room talking on her I-phone..."Yeah, I got double duty here tonight..."  "Good night...I hope your evening turns out better than your day..."  On the exit door was a sign..."Rate your experience with us.  Take an online survey and receive a coupon for a free cookie for yur next visit!"...WOW!

I left and went to the Council meeting where despite a room full of fellow neighbors and two of the three  Council members objecting to the proposal, after two hours discussion they unanimously passed building a 10,000 SF industrial maintenance building directly across from my home!  In order to do it, the petitioner had to have the zoning changed, and close a major area traffic relief road also in front of my home!  How did it pass?  Why wasn't a vote delayed to a future meeting after the neighbors' concerns could be addressed? I left the meeting dumb-founded and drove along two major roads where people were standing along their edges, with billboards advertising..."Eat here"..."Yup, we're open so buy your mattress here"...and the best...a man dressed as a Dalmatian costume..."Stop here...new pet store has opened for all of your pets' needs!"  And who says there aren't lots of local alternative jobs available? 

As I drove, I looked out at the billowing clouds in the sky, contrasted against the silhouettes of palm trees, toward another magnificent Florida sunset...

"The Prostate..."

Between the Wednesday 6:30 PM and Friday scheduled return to the urologist,  after getting over the normal reaction of hearing the "C" word, I started to research the topic.

What became very apparent is that there is lots of controversial discrepancies as to what would be done. 

This time my appointment was scheduled 45 minutes later  at 4:45 PM, so I had less of a wait.  The nurse came in with her blood pressure testing apparatus, saw that it was me, and turned around to leave!  The doctor entered at 6:00..."I'm sorry about.."  I cut him short..."Doctor I'm used to the waiting game...it's modern medicine as usual!" 

"As promised, I have your image and data printout from the your biopsy.  Your "Gleason Score" is six...three plus three.  This along with your (9.7) under 10 PSA result indicates VERY early cancer.  It appeared as a left base 1.2 mm (10% of the tissue) and 0.7 mm (5% of the tissue) two spots out of 12 cores taken in the biopsy.  This is prostate cancer in its very early stage and is slow-growing.  You have a choice of treatment to make based on your personal "comfort level" with one over the other. I would not recommend the first, "watchful waiting", because of your relatively young age, general healthy lifestyle and great physical condition; and due to your early detection.  You can take action now that will reduce you having to deal with a larger problem in the future. Hormonal modification that curtails your testosterone  production is not recommended at this stage.   I am a surgical urologist by training so I would lean toward that method of treatment.  Traditional surgery uses a long incision in the front of your torso, and has possible complications that have been reduced by the robotic procedures.  Of these, the urologist who is one of the top in the country for successfully completed procedures using the DaVinci system, in a relatively short operation time (less time under anesthesia) with a short hospital stay (overnight), and quick recovery, and a record of less complications (incontinence, lack erection ability, etc) is a doctor who works out of Celebrations Hospital in Orlando.  Although I do the DaVinci procedure, I take 6 hours while he takes 1.5 hours and I would use him!   Radioactive seed implants into your prostate is a choice that I would recommend for patients older, and external radiation is another choice to investigate.  Take some time to research the alternatives...you really can take 6 months before deciding with hardly any risk for the spread of the cancer..."

This was a lot to absorb in one meeting, so I left with the mindset to talk to many people, and to continue to read about, and research the topic online...