Just Minding My Own Business

Transcription

1 Just Minding My Own Business My Experience with Prostate Cancer Paul R. McGraw Copyright 2008, Paul R. McGraw

2 page 2 This is my story about my experience with prostate cancer (PCa). Before going into all the details let me cut to the chase and give you the real short version. The story began in November, 2006 with a routine insurance physical leading to the diagnosis. I elected to have surgery to remove my prostate which turned out to be successful. Based on the pathology report my surgeon told me I was cured. 15 months later my PSA is still zero, which is a good thing when you don t have a prostate any more. I have been blessed with virtually no negative side effects from the surgery and my life is normal in every way. I know there are guys whose PCa story is not nearly as positive as mine and my heart goes out to them. If you are one of those guys please know that I am not suggesting in any way that my good experience is because of anything I did and that your tough times are in any way your fault. It s just the hands we were dealt. My reason for writing all this is to encourage guys who end up in the same boat I was in. I m not a doctor. I m not claiming to have all the answers and certainly am not recommending any particular course of treatment. If somebody can learn anything from my experience that makes their journey easier that s a bonus. You will hear about guys who have had lots of problems, side effects, recurrences and long term treatments but usually PCa gets cured and all goes well. My case is one of the latter. It has taken me a long time to finally write this because I wasn t sure how much to include. Ultimately I decided to just put it all down because I wasn t smart enough to figure out what to leave out. I am also writing this because I want to tell about how God was with me every step of the way. As a follower of Jesus Christ I can t tell my PCa story without talking about Him because his hand is all over it. Because of my cancer He is more real to me than at any other time in my life. So here s my story. Just minding my own business When all this happened I was just minding my own business. My kids were grown, life with my wife Janet was good, things were fairly normal and all was well. Trying not to bother anybody and not let anybody bother me, as they say. I was literally minding my own business too. I had spent the last six years of my life starting and growing Hope Industrial Systems, a manufacturer of industrial monitors and touchscreens for use on factory floors. As every entrepreneur knows, that is a full-time effort. Up to this time health had never been an issue in my life. I was 58 and rarely had to see any doctor except Dr. Alexander, my orthopedic surgeon, who treated me for things like a broken bone from playing basketball, a separated shoulder I got by stupidly trying to tackle my 16 year old son, a dislocated shoulder from falling on a waterfall and a couple knee surgeries to fix

3 page 3 damage caused during my running years. I like to call those my sports injuries, being the jock that I am. As far as I knew everything was working just fine down there in man-land. I had no symptoms at all. I never thought about PSA except that it was normal on the physicals I had gotten over the years. The only time I ever thought about my prostate was when the doctor would do that routine digital exam, but I never felt like asking him exactly what he was looking for. If I hadn t applied for a new life insurance policy I might not even know to this day that I had PCa. They sent the nurse out to my office just before Thanksgiving of 2006 and he took blood. After about three weeks I was curious about why I hadn t heard from the insurance company so I started calling them. Finally they told me that my PSA was a little elevated (4.0) and that I would have to get an evaluation by a urologist at my own expense. In the meantime my application would be put on hold. I quickly went to the web and found out that 4.0 used to be considered normal but that now normal is only 3.5. So I figured that this was just another one of those false alarms. But then I looked up a blood test from a couple years prior when my PSA was only 2.4, so it had gone up quite a bit. But then, maybe the 4.0 wasn t a good test, I hoped. So I called Dr. Alexander who recommended his urologist, Dr. Green, who turned out to be a really good doctor. I found out later that my internist brought his father up from Florida to be treated by Dr. Green for PCa. He has had lots of experience with PCa and has performed hundreds of surgeries. Dr. Green did another one of those digital exams and didn t feel anything out of the ordinary. He took blood and this time my PSA was 4.58 with a really low free ratio (4.8%), which wasn t good. (PSA should be low and free ratio needs to be over 10.) I got this news on December 27 th. Merry Christmas. He said there was a chance I had cancer and that the only way we would satisfy the insurance company would be to do a biopsy. Of course I m wondering how they do that! All of a sudden people are going to be doing a lot of messing around in man-land. This MIGHT BE serious I began to get a sense of foreboding. In my daily Bible study I came across passages that talked about the brevity of life. Then I learned of the death from cancer of a 49 year old technology business leader in Atlanta. I also had done quite a bit of research by this time and began to conclude that there was a pretty good chance I had cancer. I found out I had a high PSA velocity, i.e. my PSA had increased by 1 ng/ml per year. My Free PSA was a lot lower than it should have been. And we had ruled out prostatitis because my prostate was not enlarged so I couldn t figure out what else might be going on other than cancer.

4 page 4 We did the biopsy on January 4, Happy New Year! Dr. Green took 10 samples. And by the way, it wasn t all that bad; not nearly what everybody told me it would be like. Maybe it was Dr. Green s skill that made the difference, I don t know. It was the idea of what he was doing was the worst part of it. The actuality was pretty much painless and lasted only a few minutes. Afterward there was a little discomfort and a little blood but that didn t last long. I have a lot more fear of sitting in a dentist s chair than I would about getting another prostate biopsy. But I guess that s easy for me to say now that I don t have a prostate. After the biopsy I asked Dr. Green what the chance was that I had cancer and he said 25%. I figured he might have said that so I wouldn t worry and because we would know for sure in a couple days anyway, so odds didn t really matter. The diagnosis: This IS Serious Dr. Green called me on January 9 th while I was in my monthly meeting with my BBL Group, a group of Christian business owners. When I heard his voice and not his nurse I figured something was up. He told me that the biopsy found some cancer. He said it was a small amount, we found it early and it was very treatable. The Gleason score was mostly 6 but there was some 7. When I got a copy of the report I saw that some of it was 4+3, which meant it was aggressive. He told me to schedule an appointment when I could be his last of the day and he would stay and talk with me for as long as I had questions. I was in shock. I had never thought about the C word in the first person before. I have cancer. I went back into the room and gathered up my things. Our leader, John R, walked out with me and prayed for me before I left. As I drove up GA 400 toward home I just started talking out loud with God. I found myself telling him something I hadn t thought about before. I said that I would of course learn all I can about the cancer; after all, that s my nature anyway. But I vowed to seek God first and foremost. Throughout the journey ahead, I would look first to him. He would be my final source of truth. I would spend as much or more time seeking Him as I would learning about the cancer. That afternoon and evening I just processed it, alone and with Janet. I didn t have any big emotions; no fear, anger or panic. Just generally in shock. I can t believe this. The journey begins After talking a little with Janet about it I decided that I didn t care who knew about my cancer and I m glad I did. A lot of people would later go out of their way to encourage me; it meant a lot to know they cared. Others told friends who had been through it who called with offers to support me and share their experiences.

5 page 5 The next day I decided to go into the office, get a few things done and take the afternoon off to get alone with the Lord. The first thing I did was sit down with my three sons who all work in the business. I shouldn t have been, but was surprised at how they took the news; they were really concerned for me. I felt bad, like maybe I told them in the wrong way or something. I also told Jeff who has headed up engineering from the beginning of our company and who is a committed Christian. At this early stage God began showing me he was with me in this. Just before leaving the office John called to encourage me. He mentioned that a guy named John Piper wrote about his own prostate cancer experience and he would me a link. Less than a minute after I hung up Jeff walked into my office and handed me a copy of an article titled Don t Waste Your Cancer, written by John Piper. I decided I would strongly consider what Piper had to say, that it may be from God, and took it with me. (Later, after reading and praying through it, I decided to take it to heart. I went hiking with my dog on the Benton Mackaye trail in north Georgia, reading my Bible as I walked. As usual, I was just picking up in various parts of the Bible from where I left off the previous day, and God spoke to me. o Suffering is part of the deal. It comes with life. (Psalm 44:22) o But suffering is not necessarily a result of my sin (Psalm 44:17-18) This is a natural response when we find out something bad has happened to us and I was no different. It had been on my mind. Was it my poor diet? Could it have been my lack of exercise in recent years? Did I do something to cause it? When I read this verse I decided that if the Holy Spirit wouldn t convict me of anything then I would let it go. I would not convict myself. He never did and neither did I, to this day. o Cancer can not separate me from God. Nothing can. (Romans 8:35-39) o Go to Jesus with my illness. Jesus has power sufficient to heal me, whether it is through doctors or supernaturally. (Mark 5:21+) I felt like God was saying to me, Have faith in me. Do not fear. Trust in my timing. My understanding of your situation is perfect. You can trust me. o Obey me (Jeremiah 35) o Hold onto your faith and belief (Hebrews 3). Rely on Me. Cling to Me. Trust Me. Keep your confidence in Me. Don t let up even to the end. Over the next three days God continued speaking in the same way.

6 page 6 o From Psalm 46 o Do not fear, though the earth give way and the mountains fall into the heart of the sea o Be still and know that I am God. o I am your refuge. o I am your strength. o I am always present with you. o I will always help you in times of trouble. o From Mark 6:5 o Believe that I can do miracles in your life. I didn t know that would happen but God was making it clear to me that I was not alone in this. He was right there with me. He was as close as my next breath. As serious as death? I suppose it is natural, when you find out you have cancer, to start thinking about the idea it might kill you. I was no exception; in spite of the fact that Dr. Green had said it was early and very treatable. But some things happened that got me thinking about death even more. The next weekend Janet and I decided to get away to the Balsam Inn in North Carolina. It s a quiet place where we like to go just to relax. On Sunday the preacher in the local church spent his entire sermon on the subject of death and whether we immediately get a new body or become a disembodied spirit for a period of time. Normally I would have found the subject intellectually interesting but not this time. I found myself asking, Lord are you telling me something? Then that evening as I was sitting in the library of the inn reading about PCa some random guy walked in and started talking about four of his family members who died of cancer! (He had no idea what I was reading.) Janet was getting upset. I could tell she was anxious about the whole thing. She said she wondered if God was telling her she was going to lose me. To this day I don t know why the above happened. I never seriously thought the cancer would kill me. But I know it could have. Enjoying the attention This part is a little embarrassing to write about because it makes me look like a real jerk. But it needs to be said. Once the word got out that I had cancer I began to get a lot of attention; from Janet, my family, friends, co-workers, everybody. And I was enjoying it.

7 page 7 I didn t realize how much I was enjoying it until God spoke to me at the Balsam Inn about it. By the way, I already mentioned that Janet was getting anxious about the cancer. I came to realize along the way that sometimes it is harder on those close to you than it is to yourself. After all, I was engaged; reading, studying, thinking about it, making plans, soaking in the love. The activity was keeping me busy. Janet and those close to me didn t have the benefit of all that. Another reason Janet was getting anxious about it was that I kept talking about it. Every time I learned something new I would tell her about it, especially if it was something bad. Of course she wanted to be supporting and understanding and patiently listened. But I didn t let up and it was getting to her. Anyway, at the Balsam Inn I began to sense, with God s help, that something in me wanted the cancer to be bad, something that did not want to hear good news. On January 15 th I wrote in my prayer journal, WHAT IS THAT? There is something in me that doesn t want to put the minds of others at ease. Do I like the attention I am getting? Do I not want to lose it? THAT IS SICK! So, given this deplorable thing inside me, Lord, what should I do? I wish I could have just left this section out. Anyway, as I sat there praying, I wrote down the following which I sensed was coming from the Lord. o Confess it and ask forgiveness. Ask God to cleanse me of it. (I did) o Resolve to encourage Janet, my family and others o Speak positively and optimistically o Don t talk about bad stuff that may not even be relevant to me, like how much farther it may have gone in my body. o Don t keep peppering Janet with it. If something needs to be said, say it only once. Limit the frequency! Don t remind her of my cancer every five minutes. o Minister to Janet and my family. Tell them what they need to know and don t dwell on it. o Be upbeat! Then God confirmed it when I opened my Bible and read the next Psalm (15). o The tongue of the wise commands knowledge. o The tongue that brings healing is a tree of life o A happy heart makes the face cheerful o A cheerful look brings joy to the heart, and good news health to the bones Then I wrote these words which would govern how I treated my family from that day forward: Stop focusing on all the bad possibilities and minister confidence, healing and joy to Janet and all those around you.

8 page 8 First meeting with Dr. Green Janet and I met with Dr. Green on January 16 th, and I was ready. I had read everything I could get my hands on and had a long list of questions. It was 4:00 and he said he was available for as long as we wanted to talk. He gave me his permission to use a tape recorder. It was helpful to listen back later but if I had to do it again I would probably want him to feel more relaxed and not make it seem so official. Dr. Green was really upbeat and encouraging. He repeated that we found it early and it was very treatable. He said the odds were very good that it was localized in the prostate. (I had already found some tables developed by Dr. Partin at Johns Hopkins, the Partin Tables, which help to quantify the chances that the cancer has spread outside the prostate.) He said that at my age the chances are very good that there would be no adverse side effects. He said we would treat it and I wouldn t have to worry about prostate cancer again. But how to treat it? The good news is that there are very effective methods for treating prostate cancer, especially when it is early and limited to the prostate. The bummer is that they won t tell you which one you should choose. They leave it up to you. At least that was the case with me. Dr. Green explained that there were two routes that I could take. He was careful to explain that because he is a surgeon he has a bias toward surgery and recommended I talk to specialists in the other methods. He also told me that he always thinks it is a good idea to get a 2nd opinion and that wouldn t be a problem with him. 1. Radical prostatectomy they surgically take out the prostate (and the cancer). He explained that the surgery was nerve-sparing and could be done one of two ways. a. Conventional the surgeon makes a 3 to 4 long incision just below the belly button. Even though the prostate is more toward your back I guess that s the easiest way to get to it. At first I imagined them cutting through stomach muscles but they have a way of separating them while they are in there. In Dr. Green s opinion a big advantage of the conventional method is that the surgeon has tactile feedback as he is removing the prostate so he is operating not only by sight but by feel too. Another advantage is that they have been doing it for over 20 years since it was initially developed by Dr. Patrick Walsh at Johns Hopkins in Baltimore. I would be in the hospital 2-3 days and out of work for 2 to 3 weeks. b. Robotic in this case they just make a small incision. The surgeon sits in a booth nearby watching a video display with remote control devices in his hands that he uses to control the robot.

9 page 9 The advantages of robotic would be a smaller incision, potentially less blood loss and less time out of work. But robotic was newer and not nearly as many had been performed. 2. Radiation Treatment this would be a two-step process. First would be 40 days of radiation beam treatment followed by brachytherapy where they put about 100 rice-sized pellets into your prostate that over time kills your prostate cells as well as any cancer cells that are in it. a. Advantages o You don t have to be cut open (other than the procedure to insert the seeds which I think is similar to the biopsy procedure) o You don t have to miss work o There happens to be a really good clinic in Atlanta and patients travel from across the nation to get treated there b. Disadvantages o Scar tissue develops making it virtually impossible to do surgery later o You never get to do a pathology report because nothing gets removed Dr. Green was professional and caring and Janet and I both left that meeting encouraged and confident about the future. He told us to take a couple months if we needed to, that there was no hurry. He said we shouldn t take more time than that and mentioned that one guy didn t call him back for five years and he didn t know why. I do. The only question I had was, how am I ever going to figure out what treatment to get? Let s go to Baltimore I decided to take Dr. Green s advice and get second opinions about the biopsy reading, the diagnosis and recommended treatment. Of course, being a guy, something in me said, Let s just get that thing out of there. I like to think of that trait as being decisive, but it is probably more a factor of I can t handle the stress of thinking about it so let s just get it over with so I don t have to think about it any more. After thinking about it I decided that the appropriate question was not Why get a 2 nd opinion? but Why not? Also, grading the cancer cells is somewhat subjective. That s why more than one pathologist looks at them, even in the same lab. But I wanted a different pathologist in a different lab to look at mine. I had learned that there is a big difference between a Gleason 7 that is 3+4 and one that is 4+3 which I had. There is an even bigger difference from a 3+3. My internet research revealed quickly that John Hopkins is one of the best places in the world when it came to prostate cancer. Many say it is the best place in the country when it comes to

10 page 10 prostate surgery. The nerve sparing surgery used for the last 20 years was developed there by Dr. Patrick Walsh. They also have one of the leading pathologists in the world (Dr. Epstein). A friend of mine with PCa, Joe, recommended Dr. H. Ballentine Carter. Other physicians had been telling Joe he should get surgery, but Dr. Carter recommended watchful waiting and that sounded good to me. Also, I had read a Johns Hopkins White Paper he had written on PCa and thought it was really good. So I had the biopsy slides sent to Johns Hopkins and requested their report. By the way, the labs transfer slides all the time; it s no big deal. Besides that, they belong to me anyway. I scheduled an appointment with Dr. Carter in Baltimore for February 9 th. FUD Attack You know what FUD is; fear, uncertainty and doubt. My pride wants to tell you that I am such a good Christian and so close to God that FUD can t get to me; or, that when it does I just deal with it and then I never have it again. But the truth is that when FUD comes I turn to God and he is faithful to get me past it, but then a while later we have to repeat the process. Around the end of January I began to experience a lot of fear and anxiety. There were lots of negative thoughts going around and around in my mind. The cancer is worse than Dr. Green led me to believe. I am alone with that thought. I don t want to alarm Janet and those close to me. I m trying to be strong for Janet and my family and that s hard to do. This may not just be a matter of a quick surgery. It may be a long hard process. Maybe I m not going to live that long. Blah blah blah. After one night of almost no sleep I went up to the mountains (January 31 st ) and spent a very emotional, intense time with God. I wrote this in my prayer journal. (By the way, I don t always right this stuff down, but sometimes it helps me clarify my thinking.) Lord, I trust you, but I don t want what you may have in store for me. You may be ending my love life. You may already be getting somebody new ready for Janet. I trust you but I am not willing to accept your plan for me. I believe you love me and have only the best in store for me. Intellectually I believe Romans 8:28. I am afraid of what may happen to me, even if it does filter through your hands. I then opened my Bible to the next passage in Mark where I had left off the day before. In verse 50 Jesus said, Take courage. It is I. Don t be afraid. I decided Jesus was speaking those words directly to me. Right there I decided: o I will not be afraid, no matter what may happen. o I will not put burdens on Janet by creating expectations for her.

11 page 11 o I will do all I can to fight the cancer, but I will leave the outcome to my God. I will accept whatever he allows to happen to me no matter how bad it looks. A couple days later, God continued to encourage me and help me deal with the FUD. Psalm 57:2 I cry out to God Most High, to God, who fulfills his purpose for me Psalm 138:8 The Lord will fulfill his purpose for me; your love, O Lord, endures forever. Do not abandon the works of your hands. God was saying and I decided to accept it, Cancer cannot change this fact. A shortened life cannot change this fact. God will fulfill his purpose for you. Take it to the bank. Proverbs 3:5-6 Trust in the Lord with all your heart and lean not on your own understanding. In all your ways acknowledge him, and he will keep your paths straight. God was telling me, Don t be so arrogant and proud that you think you can figure out this PCa thing yourself. Seek God s understanding; don t trust in your own. I can t express my level of amazement that the Creator of the universe would love me enough to bother to meet me this way in times like this, especially knowing that he is going to have to do it again.and again. God is so faithful and I am so thankful. After this experience I was back on track again and resting in the strength of my God. A few days later, though, I began to learn about a lot of alternative treatments for cancer and began to wonder if I should be considering them also as possible treatments. The more I thought about that the more overwhelmed I got and I started stressing again. So it was back to the mountains. Lord, I am feeling stress because I am afraid I might make a bad or uninformed decision. The operative word here is I. I am listening to the lie that I am alone in this. I am fearful of bad consequences down the road that I might bring about, or, I could have avoided. I had taken along a book recommended by a friend, Nothing to Fear, by Larry Burkette. Chapter 6 nailed it for me. Here s what the Lord showed me through Larry s writing about his experience with cancer: Be peaceful but not passive. Don t take responsibility for what belongs to God. Trust God. Talk to God.

12 page 12 Ask for Peace. So I asked God for peace. He gave it to me. God is faithful. The trip to Hopkins It was real clear to me that this was the place to be if you had prostate cancer. Maybe it would be better to say, This was the place for me to be. Walking down the hall I even passed an entourage led by Dr. Patrick Walsh who invented the surgery everybody uses today! I felt like I had rubbed shoulders with a rock star. The meeting with Dr. Carter was professional and quick. He told me their pathologists pretty much agreed with the report I got at home, but it was slightly different. The most important part was that they agreed there were 4+3 cells in there. I asked him if watchful waiting was an option. His immediate response was, You have a very aggressive cancer. If you don t treat it, it will you kill you within 10 years. So much for that idea! I m not sure about his bedside manner but it was very convincing to hear that from the doctor who recommended watchful waiting for my friend Joe when others were recommending surgery. Dr. Carter said I could get beam radiation but that he recommended surgery by the conventional method. He recommended against seeds. He then gave me a graph that showed follow up studies of 704 patients he had operated on. It showed rates of incontinence and recovery of potency over time. It really encouraged me and gave me a high amount of confidence in him. He also gave me a list of over 500 of his patients along with their telephone numbers. It turned out that more than half of his patients come from other parts of the country and that traveling back home afterward would not be an issue if I wanted to get surgery there. Treatment reaching a decision Figuring out what treatment to get was a trying experience to say the least! After all, I decided a long time ago not to be a doctor (even though it wasn t an option) and I didn t want to be one now. On one hand I wanted to learn all I could to make an informed decision, but on the other hand I knew I would never learn enough. I had talked to two excellent surgeons, each of whom I was confident would be a good choice to do the surgery. I had spent countless hours on the internet. I found some great sites that I learned a lot from (Hopkins, Cleveland Clinic, NCCN, Prostate Cancer Foundation, Mayo are examples) but also some sites I wish I hadn t found. A couple boards drew me in until I figured out they follow the 99/1 rule; i.e. they spend about 99% of the time talking about things that happen 1% of the time,

13 page 13 and they magnify things to the power of 99. If I have to go through something like this again I think I ll avoid the boards. Along the way I also talked to several guys who had been through it. Some did surgery, others did radiation. I heard about outstanding results with both. I also heard from some guys who had complications with both. My takeaways from talking to other guys were: o Choose doctors and hospitals with a lot of experience and who handle a lot of patients like me o Ask to see statistics o Don t make a quick decision o Don t assume my experience would be like theirs o It s good to talk to other guys up to a point, but you can reach a place of diminishing returns. Not everybody is going to be encouraging. A lot of guys have trouble talking to other men about their problems in man-land and shy away from it. That s their choice, but in my case I m glad I did. And in case you hadn t noticed, I spent a lot of time going to the mountains and talking to God about all this. On February 22 nd while talking with the Lord about it, I reached a decision. It went something like this. o I decided that I didn t care about short term factors like how long I would miss work and what it might cost, or even how much pain there might be for a few days. I was going to choose the treatment and providers of that treatment solely on the basis of what I thought would give me the best long term results. It didn t matter to me whether the surgeon was in my health insurance network, for example. o I ruled out exploring the alternative stuff because it was pretty clear to me that the conventional treatments were highly effective in cases like mine. o I ruled out radiation even though it has success rates that compare well with surgery. I didn t like the idea of having those seeds in me. I even read somewhere that you can t hold a baby in your lap for six months. I couldn t get my mind past the idea that my radiation-bombarded prostate would be inside me for the rest of my life. One thing I liked about surgery is that they can get all the stuff out of there and put it under a microscope. If radiation doesn t work then surgery is usually not an option because of the scar tissue that gets formed. But you can do radiation if surgery doesn t get it all. o I ruled out robotic in spite of its success and promise.

14 page 14 6½ long weeks First, in terms of long term results I couldn t see any reason why it was better than the traditional approach The traditional method has been around many years longer and has been proven Dr. Carter and Dr. Green both favored traditional The idea of there being value in tactile feedback made sense to me I discounted what appeared to be the main benefits: Smaller incision - nobody other than my wife was going to see the scar either way Recovery time a week shorter so what? o I decided to have surgery with Dr. Carter at Johns Hopkins and scheduled it for April 10 th. Here s what I wrote about this decision. It s the best decision I know how to make. I was led to Dr. Carter by my friend Joe. He has given me a lot of good advice in the past, and subsequent research has shown Dr. Carter to be a leader in the field. It s the best hospital in the world for this kind of surgery, as far as I know. So let s get on with it! At the moment I made that decision with God s help I had a sense of peace about it that never left me. I just knew it was the right thing to do. The 6 ½ weeks until surgery were pretty much about taking care of business and making preparations for being out of work for 3 weeks. I found a good primary care doctor (never needed one before) who did a pre op physical. I informed Dr. Green of my decision to go to Hopkins and asked him to handle the post op follow up. It felt weird to do that but he was extremely gracious about it. I used some old frequent flyer miles to get first class tickets to Baltimore sitting in the front row of the plane, mainly for the trip home. That way I wouldn t have to walk as far back into the plane and restroom trips would be a lot shorter. I was pretty much at peace except for 3 short episodes but God was faithful and, as usual, as close as my next breath. 1. I had a bout with fear at an industry conference in La Jolla. God responded by showing me Psalm 75:7, You alone are to be feared.

15 page Had another bout with fear about possible side effects of surgery. While talking to God, resolved it by telling him, I will focus more on your omnipotence than on my potential impotence. 3. Experienced a lot of fear and discouragement 6 days prior to the surgery. Asked God, Lord, show me the truth. This time he answered me not by speaking personally about my situation, but by showing me TRUTH. a. God is the ultimate truth (Psalm 97) Power. Might. In control. Faithful. Protects those he loves. b. Jesus in Gethsemane (Mark 14:32+) Suffering, agony for mankind. Rejected by those he created. Pain. c. Man (Ezekial 12) Clueless. Rebellion against God, turning to idols. Evil. Living under condemnation. d. Jesus paid the price for our sin (1 Peter 13:8+) He died once for all to bring us (me) to God. Salvation and baptism. Now no need to fear. We have hope in him. The day before surgery I came across the passages above serendipitously but they pretty much summed up the message of the gospel. All of a sudden my fear of a surgical procedure seemed small compared to the truth of God. Janet and I flew to Baltimore and met with Dr. Carter at 4:00 to handle all the pre-op preparations. I don t remember much about the meeting except that he said I could have a glass of wine that evening if I wanted. He didn t say how big of a glass and I didn t ask. I also remember noticing a Bible verse at the desk of one of the ladies I met with in the outpatient center. Have I not commanded you? Be strong and courageous. Do not be terrified; do not be discouraged, for the LORD you God will be with you wherever you go. (Joshua 1:9) At the time it seemed appropriate to the occasion; later it would be really important to me. Later that night after having my glass of wine in the hotel lobby we went to bed. At that point I was fairly relaxed. But I awakened at 4:00 am feeling a lot of anxiety, almost panic. I had to get up but didn t want to awaken Janet so I went into the bathroom with my Bible, spread some towels on the floor, turned on the shower and laid down. As I lay there I remembered the passage from Joshua, so I just started repeating it in over and over in my mind. The Lord also reminded me of Deut 31:8,

16 page 16 The Lord himself goes before you and will be with you; he will never leave you nor forsake you. Do not be afraid; do not be discouraged. and Psalm 121: I lift up my eyes to the hills where does my help come from? My help comes from the LORD, the Maker of heaven and earth. He will not let your foot slip he who watches over you will not slumber; indeed, he who watches over Israel will neither slumber nor sleep. The LORD watches over you the LORD is your shade at your right hand; the sun will not harm you by day, nor the moon by night. The LORD will keep you from all harm he will watch over your life; the LORD will watch over your coming and going both now and forevermore. So I just laid there with my eyes closed and recited those verses over and over in my mind. As I did a feeling of strength, calm and peace began to take over. For two hours God ministered to me on that bathroom floor and gave me a total sense of assurance that I was safe in his hands and that I had nothing to worry about. That confidence stayed with me for the rest of the morning, even as they wheeled me into the operating room. Thank You, Lord, for your faithfulness. The surgery itself, 10:45 am. Not much to say here. I was off in dreamland. I think it lasted a couple hours. After the surgery, in the hospital I remember awakening in a really good mood. I m not sure what they gave me but it definitely was working. They also gave me a little remote control device with a button on it that I was aloud to push whenever I felt pain. That was pretty cool, but I didn t need to use it much. I had to spend more time than usual in the recovery room because they didn t have a room open yet, but with all the medication I didn t get too upset. They let Janet in to see me for a couple minutes and I said something to her that I can t remember and to do this day she still refuses to tell me what it was. I think it was good but it would be nice to know.

17 page 17 For some reason they couldn t give me anything to drink in there and I was really thirsty but a nurse gave me a little ice. But then they got me into a private room and Janet could be with me. And they let me keep the little remote control. I was only in the hospital for two nights and the experience is kind of a blur. It quickly became obvious that the goal was not for me to just lie around in the hospital; the goal was to get me ready to leave. That took a little getting used to; I kind of wanted to just hang out. I interacted with a lot of nurses and attendants who all had different responsibilities and I began to appreciate why it is so important to go somewhere where they have a lot of experience. Everybody I dealt with seemed to be experts when it came to prostate surgery and all the aspects of dealing with it. It turned out that the in the same ward with me were a bunch of other guys who had had the same surgery. I saw them walking up and down the hallway rolling their IV s with them. Two of the most important practical bits of advice I have for anyone are 1) pick a surgeon who has a lot of experience AND 2) go to a hospital where they do a lot of prostate surgeries. The little things can make a difference, like how they tape the catheter to your leg. I never had a problem with the catheter like other guys I had talked to. In general things in the hospital went really well. Probably my biggest problem that first day was that they had given me a laxative because they want you to have a bowel movement before you leave the hospital and a lot of times guys have trouble going. Well, it turned out it worked too well. I had to keep going to the bathroom, which was a little uncomfortable that first day. I also had to get used to the feeling of my bladder adapting to the catheter, causing short spasms. It wasn t really all that painful, just a little strange, and it would stop quickly. I didn t really have much pain except for what felt like stomach cramps, as if I had done a lot of sit ups. I learned that they stretch the stomach muscles some to get them out of the way, and it later feels like muscle fatigue. So I learned how to roll out of the bed without having to use my stomach muscles as much. Believe it or not they had me up walking that first day and several times the next day. The second day they wheeled me out of there. The recovery I neglected to mention one important factor that made it easier to decide to go to Hopkins. Janet s brother, Mark, and his wife Stacy and their kids live nearby in Maryland and offered to let us spend a couple days there after the surgery. Riding in a car felt a little strange but the hour was not a problem. We need to talk a little about plumbing. I left the hospital with a catheter and bag I would carry with me for 10 days while things healed up in there. The catheter was strapped to my leg with a

18 page 18 clear plastic bag at the end of a tube about 3 feet long. Janet had gotten me a pair of loose fitting workout pants with zippers at the bottom of the legs and they were perfect. I pinned the bag inside the leg where it would be hidden and not gross out everybody. That was a whole lot better than carrying it around with my hand for all to see. When it filled up I would just unzip the pant leg, remove the bag and empty it into the toilet. Mark and Stacy treated me like royalty. Mark put me in a room with a special reclining chair and TV, right next to the bathroom. Stacy is a nurse and was really helpful. The first day at their house I was trying to get my computer to work on Mark s router and did way too much walking around and climbing stairs and got a little sore as a result. Mark said I was trying to set up command central. As far as I m concerned it was just poor planning; I should have gone there before the surgery and gotten everything working. I finally decided I could do without the internet for a few days. The Pathology Report As I said before, in my mind one big advantage of surgery is that they remove the prostate and take biopsies of surrounding tissues and a pathologist analyzes it all under a microscope. They can then see the total extent of the cancer, measure margins to see if was all contained in the prostate and see if it had spread to any surrounding cells. Dr. Carter called me three days after the surgery to give me the results of the path report. He said, I have excellent news from the pathology report. It is an A+ report! The cancer was totally confined to the prostate. You have been cured of prostate cancer. Do you have anything else you can worry about? I answered, I can probably come up with something. He replied, That s good, because you are going to have to find something else to worry about besides prostate cancer. After sharing the good news with Janet, Mark and Stacy, I went back to my room to have my daily time with the Lord and found myself telling him, Lord, I have said from the beginning that I would look to you as my source of truth. You have the final say. Please show me how to take what Dr. Carter said and what my future actions should be. I then started picking up in my Bible where I had left off from the day before. Ps 102 v. 3 He forgives all your sins and heals all your diseases v. 10 he does not treat us as our sins deserve v. 17 from everlasting to everlasting the Lord s love is with those who fear him.

19 page 19 John 1:16 from the fullness of his grace we have all received one blessing after another. My takeaway God has been gracious to me. He has shown me his love and compassion. From these passages and a couple others I sensed God saying to me: Yes, I have healed you out of my gracious love and compassion. I have taken away your cancer. I have a purpose for your life that s in place right now. Continue to work at developing your character so that you will be more effective in carrying out my purpose for your life. I m not finished with you yet. That sounded good to me. Back home On Sunday, five days after the surgery Janet and I flew home. I am really thankful to Mark and Stacy for letting me spend those days at their house. Even though I could have gone home from the hospital (they recommended spending one night in a hotel first) I m glad I waited. By the 5 th day I was very much used to getting around with the catheter and bag, using the bathroom and all that stuff. The flight went fine and it was nice to be able to sit in the front row. Even though I probably could have walked it was nice to be wheeled through the airport. 10 days after the surgery I visited Dr. Green in Atlanta and they removed the catheter. I had heard stories about what that might feel like but it was NOT a big deal. I could have done it myself; I hear some guys do. They gave me some special pads to use for incontinence but by that evening I realized I hadn t needed them and probably wouldn t. I have never had a problem with that since the surgery. I stayed at home for the next two weeks, mainly because that is what Dr. Carter suggested. Altogether I was out of work for 3 weeks and was more than ready to get back, physically and mentally. What about the cancer coming back? Dr. Carter said I was cured and I decided to believe that. But in spite of that I did ask him if there was anything I could do to minimize the chance that it could come back. I was expecting him to talk about tomatoes, pomegranate juice, broccoli and all that stuff I had read about being cancer preventers. His answer was that all that stuff is only theory. He want on to say that he is personally at risk for prostate cancer and all that he does can be found in a book called Younger Next Year, by Crowley and Lodge. It s basically about diet, exercise and quality of life. He told me to read it

20 page 20 twice because just looking at me he could tell that would be necessary. I guess he s not known for his bedside manner. So I read it twice and decided to take it to heart. I didn t agree with a lot of the science they use to back up their recommendations, but decided that the recommendations were intuitive enough to stand on their own. I recommend the book, except don t take the theories about our prehistoric past too seriously. It is targeted to men in their 50 s but it wouldn t hurt younger guys to read it. There is a version for women too. The rest of the story, as of July, 2008 It has been 15 months since my surgery. I have no recordable PSA in my blood and everything is pretty much working the way it should. I started an exercise program about four weeks after and have kept it up 45 minutes of hard exercise six days a week (as prescribed in Younger Next Year). Life is normal. I often tell people the only way it could have been better is if I never got the cancer in the first place. In some ways I am better off because of the cancer. My relationship with God is even closer. Though I don t know why he let me get it, I can honestly say that he was right there with me throughout. The reason I wanted to include so much about that in this story was to show how faithful he was to me. He was as close as my next breath. Sometimes only adversity can allow us to see how much God loves us, how much we love him and how much we need Him.