6: The sentencing

A week passes and now its the first full week in February. The week is filled with mostly good days with good control over the pain. I know this seems like a great thing, which it was, but it had the opposite effect emotionally. We didn't have any appointments in between so it was like Claire and I could live a normal life for the first time since the fall, where the symptoms didn't really dictate what we could and couldn't do. We got back to us. We hiked, went out to eat, hung out with friends, we talked about something other than stupid cancer for a minute, because once you find out, it consumes you. It was awesome. What wasn't however, was the realization that we haven't been "us" since last fall, and this little glimpse back into normalcy made me realize it. I was crushed, sad, angry, I felt as if I had robbed Claire of the guy she fell in love with and made her love this cancer because it was a part of me, and she loves unconditionally. I cant put into words how upsetting this is, because I also cant put into words how deeply I care for that girl. But more on that sob story later, on to the sentencing.

Claire accompanies me to the appointment. We check in, the waiting room is full. I am keeping it together on the outside but internally its like everything is firing at once. After about 20 minutes in the waiting room, we get called in, a quick set of vitals taken and into my consultation room. We meet with Heather, the NP working with Dr Hogan today. She takes my history for the millionth time, does a quick physical exam and she exits the room. Next, My surgeon and Urologist, Dr Salkini comes in to do the follow up from the orchiectomy preformed 3 weeks ago. He says everything from the surgery looks good. The results of my CT are finally back and more bad news, the cancer has spread up into my retroperitoneal area of my abdomen and is sitting on top of a kidney and adrenal gland. There is more than one, 5-6 maybe, but the largest is big enough to impede blood flow and return to my kidney. At least this answered the back pain question. He leaves only for Dr Hogan to walk in behind him. This was our first time meeting Dr Hogan personally. My Mom and Claire have researched this man thoroughly before this appointment and had nothing but positive things to report. In walks a taller, older gentleman, he sits at the computer and dives right in. Late stage cancer, its spread, at least into the abdomen. For some reason, my insurance WILL NOT approve an upper chest CT, to see if the cancer has spread any further north, and neither of my doctors can believe it, but promise a fight to get it approved. Thanks Obama. Then comes the sentencing. 3 to 4, 21 day cycles of intense chemo. They run 5 straight days of chemo, 3 days off, back for a day, 6 days off, back for a day, 5 days off, then you start all over. Hogan described it as riding a wave, highs and lows followed by more highs and lows. He explains on a scale of 1-10 this will suck about 7-8. Side effects to prepare for, Insomnia, weight loss, ototoxcicity ( heariing loss ) , Fibrosis of the lungs, fatigue, nausea, vomiting and hair loss. I knew that this was all coming but it doesnt make it any easier to hear. We finish up talking about the treatment plan with Hogan which includes scheduling a port placement to administer the chemo through. Last is our Patient advocate meeting, this person is our mediator between us and the hospital, we can tell her whats going on and what we need, and she bypasses the 10 layers of red tape you would normally have to struggle through navigating yourself and gets things done. Luckily for us, our advocate happens to be a friend of Claires, a sweet older woman with years of experience. She gives us a Cancer Binder with literature for the patient and the care giver, some other resources and then we get to talking about infection control. Something that becomes paramount once you start loosing the white blood cells. Its not uncommon for you to reach 0. She asked about our daily habits and hand washing. Like I had mentioned before, Claire already has a relationship with this woman, and Im a pretty laid back guy, so when the next sentence was uttered by our liaison what Claire and I heard was NOT what she had said. What we heard was " Have you guys Banged yet?" ... I looked at Claire, She looked at me, and it was like we both just vomited vowels as we tried to somehow answer that question. Our advocate then clarified and asked if we had "banked any sperm" which caused Claire and I to belly laugh, it felt good. Once we got that situation all figured out, we took a trip down to the infusion center where i'll be spending at least 150 hours over the next 65 days or so. Its an ok facility, 3 different tiers of rooms, like a good, better, best set up, they give snacks, its a free roam area, so you can take your tree and do hot laps, make friends, or sequester in your room until its over.

We head home, its been a long afternoon of appointments. We have been there from 1-4 with a quick stop at my accountant before that. I cant wait to get home, the dogs will be so excited to see us, they dont know that Claire and I came home with way more baggage than we left with. They'll help unpack it, they always do.