Diagnosis Day

Adenocarcinoma.  Fuck.  It was Wednesday, April 10.  I was on my way from Missoula to Lewiston, ID, where I was working as a travel nurse.  I stopped in Kooskia, ID to check MyChart for biopsy results since it was the first place I could get cell service after a beautiful drive along the Lochsa River.  Fuck. Adenocarcinoma.  Adenocarcinoma.  Adenocarcinoma.  Adenocarcinoma.  Adenocarcinoma.  I read it five more times, not because I wanted to make sure I was reading it correctly, but because it was present in all 6 biopsy samples they took.  Fuck.   My mind was racing and I didn’t quite know what to think.  I started breaking the word down in my head. A-den-o-car-ci-no-ma.  A den-that’s where a bear sleeps; no-red circle with a slash; car-I pictured a small green sedan; ci or “si”-Spanish for yes or a picture of an eye if it was a rebus puzzle on the underside of a beer cap; another circle with a slash; ma-mama, I just killed a man…  Fuck.  I’m 43.  That’s too young for prostate cancer.  I’m supposed to work tonight.  How can I focus on work.  I can barely focus on what my phone feels like in my hand.   I walked down to the river and sat there for a few minutes to try to get my bearings.  The icy water on my bare feet helped clear my head a bit and I made it the rest of the way to Lewiston.  I spent the rest of the drive soaking in and appreciating the glorious spring sunshine and the road winding through the rapidly greening hills along the Clearwater River.  After unpacking and getting some things sorted out, I sat in the sun on the tailgate of my truck and made a few calls.  I needed to get some of my news off my chest and get a bit of perspective from heads that were a bit more level than mine at that point.  

 The last couple of weeks have been a rollercoaster of emotions.  Emyr and I had spent the last weekend of March in Calgary for a Noah Kahan concert and had a blast.  Ikea, manicures, pierced ears, delicious curry, and the concert were just a few highlights.  Most of all, just getting some one-on-one time with one of my favorite people in the world.  I had scheduled an appointment with my doctor for April 1, the day after we got back, to get a few things checked on.  One of the things I’d wanted to talk about was a change in my urination patterns over the last 6-9 months and notably worsening in the past 3 months.  Even though I’m relatively young, there is a family history of prostate cancer, so we decided to check my PSA (prostate specific antigen).  I drove back to Lewiston that afternoon and when I got back, I was able to look at my lab results.  My PSA level was 44 ng/mL.  Apparently, the normal range for PSA is less than 4 ng/mL.  Great, I’m above average.  My doctor recommended starting on some antibiotics, since it was most likely prostatitis (inflammation) caused by a low-grade infection, but also recommended following up with a urologist.  I was going to be back in Missoula in a couple of days to watch Mack in the Hellgate High School production of Mean Girls (which was fucking awesome!!!), so I was able to get in to see a urologist on Friday, April 5.  Based on that exam, they were concerned enough that they scheduled me for an ultrasound and biopsy on Monday, April 8.  Looking at the ultrasound images, I was not reassured.  I’m not a radiologist, but I’ve looked at a lot of ultrasound images.  Things didn’t look quite right.  I was still hopeful.  The next couple of days were filled with all sorts of emotions.  I was hopeful, but scared.  I was anxious to get the results of the biopsy and checked MyChart multiple times each day.  Which led me to sitting in my truck, in a parking lot, in Kooskia, ID staring at the screen on my phone.  Adenocarcinoma.  Six times.  

 I’m trying to wait until I have more information before I completely freak out.  It’s easier said than done.  My head definitely has played through all sorts of scenarios.  What if it’s metastasized all over the place?   What do I do then?  I’m not excited at the prospect of a bunch of chemo.  I’m not excited about any of this shit.  Has it spread at all?  Will it be easy to treat?  They say prostate cancer is “highly treatable”.  What the fuck does that mean?  What are the side effects of each of those treatments?  Will this kill me?  I’m not feeling particularly ready to die yet.  What about Mack and Emyr?  What about the rest of my family?  Fuck.  I try to put forward the version of me that’s calm, logical, and rational about all of this.  Compartmentalize.  I generally do it well.  “It is what it is” on the outside.  On the inside though, I’m coming a bit unraveled.  I feel like I’ve dealt with enough bullshit lately.  I’d like to order less bullshit, please.  And could I also get a side of good stuff?  Thanks.  Things happen.  They’re not necessarily good or bad things.  They’re just happen.  And it’s up to us to decide how we react and respond.  And for right now, I’m choosing to wait until I have more information.  One bit of information at a time, one decision at a time.  At least that’s what I keep telling myself.  And what I try to model.  And even if that’s what it looks like on the outside, that might not be the case under the surface.  

 Waiting is the hardest part.  Despite working in healthcare, and knowing “how these things go”, I want all the information and I want it now.  I am scheduled for some additional scans and tests on Wednesday, April 17.  Then an appointment with the urologist on Wednesday, April 24 to discuss treatment options and a plan going forward.  It’s been two weeks since the wheels started coming off the bus.  It’ll be another week and a half until I feel like I’ll have more of a roadmap for moving forward.    Once I have more information, the next hard thing will be talking to the kids.  I want to have as much information as possible when I talk to Mack and Emyr so I can answer as many of their questions as possible.  As much as I’m scared for myself, I’m more afraid for them.  And I want to have as much information as possible before I tell anyone else. 

 By the time anyone else is reading this, I will have had my follow up appointment.  I will have talked to my kids.  I’ll have that roadmap, wherever that might lead.  I’ll have a better idea of what I need from folks.  Or don’t need, for that matter.  And I’ll have posted at least one more update.  I plan to keep writing in this space.  If for no other reason than to give me a singular platform from which to share updates with people.  Some of the updates might be more polished.  Some might be more raw and unfiltered, giving me a chance to let you into my head a bit so you know more about where I am and how I’m processing all of this.  There might be days I feel like talking about it.  There will probably be days I don’t want to talk about any of it.  But you can still get an idea of what’s going on.