Tuesday, December 3, 2013

What Chemistry Is Doing to Me, Part 3




Time to get back to the subject, I guess. As I wrote a couple of posts ago, I discovered in high school chemistry class a kind of natural skill of getting off the topic (a skill--weakness?--my students exploited for years, though I often found getting off the subject a lot more fun--even more educative--than staying on it) ... let's see ... where was I?

In late July this year--the 26th--Joyce and I drove to the Seidman Cancer Center (University Hospitals) near Chagrin (appropriate) Blvd. and I-271. Son Steve came separately. That was the day I received my first quarterly injection of Lupron, the hormone-inhibitor that gets rid of my testosterone, the hormone that my prostate cancer requires to live. As I've posted before, Lupron does not cure anything; at some point, some wily surviving cancer cells will evolve--figuring out a workaround--and will start multiplying again, and my oncologist will have to try something else.

As readers of these posts know, my cancer had returned after my prostatectomy (removal) in June 2005; it had returned again after my thirty-five daily radiation treatments at the Cleveland Clinic in the winter of 2009. When prostate cancer metastasizes, it prefers going into the bones, and by last spring, I was feeling pain in the back of my ribcage. Bone scans showed illumination (activity) only in one rib back there--but along its entire length, and my Clinic oncologist wasn't too sure what that meant; he'd never seen just one rib light up like that. But I knew. It hurt when I leaned back against a chair. Not normal. Finally, my PSA had risen sufficiently (sign of certain activity) that my Clinic oncologist said it was time for hormone therapy. I decided to go to University Hospitals for a second opinion (though I was certain what it would be). And I was so happy with the oncologist there that I decided to switch from the Clinic to UH--after all, the Clinic had taken two shots ... and missed. Time to give someone else a turn.

I had been dreading this treatment, this Lupron. I knew what it meant: the end of my libido, the end of intimate relations with the woman I've loved since I met her in July 1969 in a course in American Transcendentalism at Kent State University. More crudely put; no testosterone = no sex drive. I know ... I know ... in our culture it's "gross" to think about the sex drive of guys on Medicare ... but not to the guys on Medicare. What I never understood when young is that older people, inside, are much the same as everyone else. Sure, we retirees look different (we are "carded" only when we try to get a Senior Rate on something), but, at least in my case, even in my late 60s, my heart was still beating in rhythm with that boy who'd run around the streets of Enid, Okla., in the 1950s. who'd played baseball and gone steady at Hiram High School in the 1960s, who'd played tennis and fallen in love with American literature in the 1960s, who'd ... get the picture? And now ... a chemical--an injection--was going to change all that. 

The UH nurse assured me (while she prepared the injection) that the symptoms would not arrive swiftly. Mildly comforting. (But she was right: It's taken some months.) Also--a coffee shop acquaintance had begun the therapy a month or so before me, and he was giving me updates (he hadn't noticed much change in anything). I didn't find his reports all that encouraging--just as I've never found anecdotal evidence of any kind too convincing. So many times, people, hearing of my situation, have said something like, "Oh, I had an uncle once with prostate cancer, and he ..."  Yeah, well, good for him. But all bodies are different. Your jolly old uncle might have had a great experience with his prostate cancer--remaining randy as a rabbit and twice as frisky. But I've learned to wait and see what happens to me--and I would not presume even to suggest that what's happening to me is going to happen to someone else. As I said, we're all different ...

She stuck the needle in my backside, right hip, while I wept quietly. Afterwards, I walked back out to the waiting room, feigning insouciance, and joked that I wanted to go find some herb tea and talk about my feelings. Joyce and Steve laughed--but politely so. It's not all that funny. I thanked Steve for making the drive--hugged him farewell. Then Joyce and I drove back to Hudson to wait. What would the New Me be like?

Well, I can tell you some things ... and I will ... next time ...

TO BE CONTINUED --

BTW: I found this image of the Lupron formula (I think--remember: my chemistry skills are abysmal). Oh, what all those little letters and bonds have meant ...


LUPRON DEPOT (leuprolide acetate) Structural Formula Illustration


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