Prostate Cancer Journal: The Waiting is the Hardest Part

universal-no-symbolThis will be an intensely personal post. If you came to this blog expecting something else, you might want to take a break from reading this now, head over to the archives, and wait until the more characteristic posts make a comeback.

This week I have been doing a lot of waiting. I no longer know what to do with myself.

Carly Simon’s lyrics are so overdone that they have become trite (except for Heinz, I guess), but they are running around in my head abreast with Psalm 130:

We can never know about the days to come
But we think about them anyway….

Anticipation, anticipation
Is making me late
Is keeping me waiting.

Anticipation, Carly Simon

Out of the depths I cry to you, O Lord!
O Lord, hear my voice!
Let your ears be attentive
to the voice of my pleas for mercy!

If you, O Lord, should mark iniquities,
O Lord, who could stand?
But with you there is forgiveness,
that you may be feared.

I wait for the Lord, my soul waits,
and in his word I hope;
my soul waits for the Lord
more than watchmen for the morning,
more than watchmen for the morning.

O Israel, hope in the Lord!
For with the Lord there is steadfast love,
and with him is plentiful redemption.

And he will redeem Israel
from all his iniquities.

Psalm 130


I'm a Cubs fan. I know about waiting.

In Spring 2002 suddenly appearing “liver spots” (actually petechiae bruising) had been met with curiosity on Thursday. I rarely show bruises, much to my wife’s dismay as she seems to share a genetic link with bananas when it comes to bruising; so I didn’t make much of them. Dad had liver spots, so probably would I. On Saturday a couple bruises, startling purple and red explosions, appeared over a very short period of time. I called my GP’s exchange. Interrupting his golf game, he likely saved my life. Instead of saying “come and see me on Monday,” instead he said “hang up the phone and go to the emergency room. Now.” He said he would meet me there. That didn’t sink in.

When I got to the emergency room they were expecting me. That didn’t sink in either. After exchanging my clothes for theirs, a blood sample was taken, and a physical exam was conducted. I became a bit of a curiosity as seemingly random medical personnel would knock on the door and ask if they could examine me. By now I knew the “liver spots” were actually petechiae, that is pinpoint bruises, and they were showing up everywhere. If you are old enough to remember the water-color books for children that had the pictures filled with dots—a child paints with a dampened brush that releases the color in each dot—well, that is what I had come to resemble, especially on my arms and legs. But they didn’t hurt. No one said any different. And it didn’t really sink in.

I had been left to myself in the exam room for over an hour, and I was bored silly. Fearing that some trauma may have come in to the emergency room (and that I had been forgotten behind my closed door), I finally went and opened it, made eye contact with one of the medical staff, and said I was just going to leave the door open, if that was okay. Back to the exam table to wait. Another blood draw and another hour. I must have dozed.

I heard some activity at the ER desk and padded over to the door where an ER doctor noticed me. “We’re going to be taking you up to a room real soon,” he said, “sorry for the wait. A nurse will be in in a minute to start an IV.” A room? That was the first I had heard. Okay, let’s try a reasonable question: “If I am going to be staying, can you tell me what’s wrong?” “We don’t know,” says the doctor, “but we do know its not leukemia.” Leukemia! You were looking for leukemia? I didn’t know what “it” was, but “it” started to sink in.


Idiopathic thrombocytopenic purpura

Later I learned the diagnosis; I had ITP—idiopathic thrombocytopenic purpura. For no known cause (idiopathic = “we don’t know why”) my immune system started to destroy my platelets faster than my bones could manufacture them. The average healthy adult has a platelet count in the range of 150,000-400,000 per cubic millimeter of blood. My first blood test indicated a platelet count of about 16K. The second blood test the count was even lower. By Sunday morning the count was below 10K—and this was with having received blood products to fortify what my own body was creating. Sunday afternoon I was shuttled around. I had an ultrasound done and they were monitoring me closely for bleeding gums and hematomas in my mouth. Great bags of fluid were constantly directed into my IV. Not only was I continuously receiving platelets, they were trying to suppress my immune system with immunoglobulin to slow if not stop the spleen’s destruction of the platelets I desperately needed. As my platelet count dropped past 6K the bruising was showing up internally as well. The blood—my blood—no longer constrained by the platelets, was leaking out of the capillaries and pooling just under the surface, not only under the surface of my outer skin, but also that of my internal organs. Dr. Derderian and the medical staff were keeping me close to the equipment that could quickly determine if the event of bleeding in the brain or in my gut—but the doctors were grim, because if I would begin to bleed internally they would have to operate—causing more bleeding—to get to and try and repair any hemorrhage.

Harrowing as those seven days were, they did not affect me emotionally or spiritually as much as has this whole prostate biopsy journey. I was a leaky capillary away from an aneurism; I was an it-can-fail-any-moment-blood-vessel, or a surgical-knife-cut, away from death by exsanguination. And yet I was calm, cool, and trusting to the point of frustration to my wife and friends. I know that caught early (before there are symptoms), prostate cancer has a >90% cure rate and that there is really no threat of dying from it as there was even 10 years ago, and certainly 16 years ago as did my father. But my fear, my fear of no knowing, is almost unbridled. I put it again and again in the hands of God, and there still seems to be a portion that is held back—it seems to have a home nestled deep in my gut, in my heart, and in my head.

About eight months after the onset of ITP, my hematologist, Dr. Paul Derderian, announced that I was in full remission. He, in all honesty, said he could explain my remission no better than he could explain what brought about the ITP in the first place. I had spent a lot of time with Dr. Derderian over those months, and had come to know he was baptized Lutheran. When I thanked him for all that  he had done, this great and knowledgeable man brushed it easily aside and said he only assisted, that I had obviously been healed by the Great Physician, because my health and remission was certainly beyond his comprehension.

Jesus, the Great Physician of both our bodies and our souls knows our every need, our every malady. He puts into His service all manner of people and technology for our care. Had my GP not interrupted his golf game to answer his page, or had not had a previous experience that had trained him to respond with his definitive charge for me to “go to the emergency room,” I would likely have died sometime in the course of the days before the next available office visit appointment. Of this I have absolutely no doubt. I also do not doubt that my Lord and Savior will carry me through today and whatever is yet to come in those days yet to come—and that along the way He will bless me in ways I can not imagine. Of this too, I have absolutely now doubt.

A friend just sent this to me: “Thinking about you and praying for you Psalm 56:3 ‘When I am afraid, I will trust in you.'”


Now if Dr. de la Paz would just call…

Other  posts in the Prostate Cancer Journal can be found under Categories in the sidebar of this blog.

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