New normal

Well, we saw Dr Parente this morning, and the news continues to be good. Everything is looking fine on the blood test; the PSA continues to be undetectable. Dr P was saying that everything was totally normal, then corrected himself. An undetectable PSA score is not normal. However, I’m happy to be an outlier — some might say, a freak — in this context!

So, how high should PSA be? According to Medline Plus, a score of 2.5 is considered normal for males 50 or younger. This will rise gradually from that age onwards. But in the context of prostate cancer, it is not so much the quantum of the score as its trajectory that counts. If your PSA takes a sudden jump, that is what gets everyone suddenly very concerned. As the Medline article says, prostate cancer can’t be diagnosed from a PSA test alone — that needs a biopsy. The test just raises a red flag.

The reliability or otherwise of the PSA test for mass screening test is extremely controversial, as it should be. But for individuals, there doesn’t seem to be another test that is as good. My impression is that males are under-tested, insofar as we tend to be at the GP’s office less often than females. So when a man in his fifties or older finally gets around to going to the doctor, the GP may order PSA to be tested as a just-in-case.

My message to male readers? It ain’t rocket science — get it checked out! Early detection still gives the best prospects. Men may feel reluctant to open that door; I certainly did. But just because you need to pee more often, it could just be benign prostatic hyperplasia. Treatments for this condition cover a spectrum of “let’s just keep an eye on it” to something more elaborate. That is a judgement that obviously needs to be made by a specialist. On the other hand, and not wanting to be alarmist, but you could have no symptoms and have something going on that needs to be nipped in the bud. (This was my experience.)

If you see a specialist, and want to get some more information before you commit yourself, get along to a prostate cancer survivor’s group, or join one of the discussion lists. You don’t need to have had an operation to join a group or a web site. But if you want to talk to those who have had surgery, radiation, chemo, or whatever else, this is a great opportunity. The Prostate Cancer Foundation of Australia is a good place to start.

Nothing to see here …

The main news, and you will forgive me if I repeat myself, is the PSA is still undetectable.

Getting the all-clear from the good Dr P always gives me a bit of a boost. Before we saw him I had made an appointment for the following day (i.e. today) for an induction from the volunteer co-ordinator at the Melbourne Museum. (I will be working there on a project to make digital scans of archival scientific documents, and add metadata to records linked to those digital images.)  Being involved in this enterprise will be a good thing, because manageable. I will be there only a morning a week, breathing those cataloguing muscles back into life after five years of inactivity. I made notes on the train on my way in about how much I am really appreciating Melbourne this winter — the grey days, the European lanes in the CBD, the lovely gardens and Victorian buildings through and past which I walk on my way to the Museum. 

The morning went the deceptive way of days when everything seems to just fit in. I left the GT in a side street and walked back to the station. The train before mine stopped the traffic at the level crossing on Riversdale Road in nice time for me to cross, touch on with my Myki, and get the all-important coffee. I had allowed half an hour to get from Parliament station to the Museum, plenty of time to walk along Spring Street, past the Royal College of Surgeons, through the Carlton Gardens, and, with a slight detour, past the Exhibition Building. (In the course of my Museum induction, I learn that this huge structure, the best preserved of the Victorian era exhibition buildings, is technically part of its 15 million item collection.) 

Of course, when things seem to be going just right, some sand gets thrown in the gears. I had planned to do the food shopping on the way home. In my haste to leave early in order to get the coffee, I had forgotten to bring both the cool brick for the little esky in the car boot, and (disastrously) the shopping list. Rather than have to go home then go out again, I reconstructed the extensive list of comestibles as best I could on my homeward journey from the Museum. I decided to go to the supermarket, then the butcher, so that the meat wouldn’t be sitting in the esky sans cool brick. Of course I promptly forgot about this, arriving at the butcher first. Curses! Should I backtrack to the supermarket? No, I’ll just get the meat, then whiz through the grocery shopping so the meat doesn’t go off. (With ambient temperatures of about 12 degrees, this was never likely, but it is one of the things I am most neurotic about.) Of course, not having a proper list, many things remained annoyingly needing to be purchased in a second excursion tomorrow.

That day I am to have two cooks, the first to make a banana bread for morning tea. One of our neighbours is moving to the inner city; she and her daughter have been clearing the ancestral home. I offered to bring them around coffee and a snack to sustain them in this enterprise. Fortunately, they have no dietary issues for me to consider. (I wouldn’t mind if they did, it just makes things a tad more complex.) Unfortunately, I am not sure that I have enough sugar — this being one of the things left off my reconstructed list. If I don’t, I am going to have to improvise by making up the shortfall with a few spoons of jam. (I have done this once before — one just has to take a guess at quantities — but it worked surprisingly well.) The second cook is dinner for us and our niece. I have all the ingredients for the main course, but not the dessert. So I will have to head out after morning tea and get the things I left off the list. You’ll be sick of hearing about this list! I’m sick of thinking about it! My usual scattiness is being given a turbo boost by the stress of measurement anxiety — bringing me back to the start of this rather ratty blog post.

Still, compared to what they could be, the little niggles and irrits I am having a whinge about here are great problems to have. I do know this. Thank you, universe! You feel you can’t make things too easy for me — in case I get too complacent? Fair enough. You the man.

Anticipation is half the pleasure

My beloved and I just saw Dr Parente for my regular 6 weekly check-in. Executive summary: the PSA is still undetectable.

Getting the news was almost comically protracted this morning. First there were no parking spots in the car parks at the practice.  So my beloved had to drop me off and go and hunt for a spot outside. She found one, but didn’t have many coins to put into the meter. (Some meters accept credit card, but not those in the City of Whitehorse.)  When I went in, the waiting room was almost empty.  This made the lack of parking somewhat peculiar. There are, admittedly, other doctors’ practices in the building; it is unusual, though, that none of the cars in the carparks should belong to Dr Parente’s patients.

Because of my beloved not having many coins, we didn’t have long to go on the meter. This wouldn’t have mattered had Dr P been on time, but — doubtless for excellent reasons — he was running late. We were chatting to the other patient in the waiting room when I arrived — his chauffeur had had to drop him off, too. And he had an appointment booked at the same time as me! Who would get to go in first? He did, of course. The time ticked away on the waiting room clock.

My turn came. Dr P had to connect his laptop to the practice’s wifi (or something). It was slow to load up with the results of the blood test I’d had on Monday. At least your name’s not in red, he said encouragingly, peering at his screen. Still, the news, when we finally got it, was good. McFate had obviously read the famous advice to writers: make ’em laugh — make ’em cry — make ’em wait.

(PS: I had always thought this advice to have been the work of Wilkie Collins. When checking this, I found that it is now attributed to Charles Reade. Warning — this link points to a Guardian article.)

Nothing to see here …

We saw Dr Parente yesterday morning. The PSA is still undetectable, and I remain in remission. After receiving this good news, we went to the oncology unit, where I had another Zolodex implanted. (You will remember that this is the hormone treatment — androgen deprivation — that is aiming to starve the cancers of what they feed on.) The implants are about the size of a grain of rice and last about 3 months. They just go in in the abdominal fat, of which there is still plenty, even after the gastro! There is very little discomfort. I booked in the next appointments with Dr P & the oncology unit, for the next implant.

My beloved is going to Paris in early April for a few days. She will be representing her work at an international transport meeting. We thought of me going as well, and tacking a cruise or other expedition onto the end of her work commitments. However, there is bugger-all happening in that line at that time of year (too cold, I suspect). So I am going to hold the fort. Of course this depends on nothing going awry in the meantime, but (touch wood) all seems to be quite stable. I have been going to an exercise class for oncology patients run by Lauren, the exercise physio, and this is pretty good! I will be going back to the gym soon as well (I stopped for a few weeks with the gastro).

My lovely old Luxman pre-amp has spat the dummy again and is only working on one channel. This is a real bore as I have to disconnect everything, pull it out, and run it over to the valve amp guru in Glen Waverley. He will have it for however long he needs to ponder its mysteries — could be weeks. (His workshop is like an Aladdin’s cave of amplifiers, many much more expensive than mine. So he knows whereof he speaks.) This is not my first pilgrimage there, however, and to be honest I am a bit over the vintage gear. Maybe I should sell it on Gumtree and get a nice, soulless, reliable, solid state integrated amp!