Hismones 12/24/25

One year. One year ago today, I took my first Orgovyx (120 mg Relugolix) tablet and began the spiraling down of PSA and Testosterone. Tammy drove extra amounts of miles due to confusion over where the urologist's pharmacy had filled and was holding the prescription, but I (we!) got started. With a PSA of 6.4 at diagnosis, Orgovyx reduced it to 3.1 before February radiation and it has been undetectable since May, tested one month following radiation and twice since. Confirmed by Dr. Keith Courtney's second opinion at UT Southwestern in Dallas, I'll be taking Orgovyx a minimum of six more months, hopefully to finish in June but perhaps extending to December for a full two years. We'll see; PSA tests will advise. Imodium is still a daily friend, and I"m taking Psyllium Husks (fiber) as a prebiotic and also probiotic capsules daily. I've shared previously the various symptoms of living without Testosterone. There are better and worse days, and yesterday was one of the worst. I exercised at the YMCA, took a little break, and then attacked the front yard. I mowed it twice (mulching, then bagging) and spread the mulch thinly over the front plant beds. After lunch, I tinkered with the Miata a bit, trying to solve a fast idling issue. By then, I was exhausted. Tammy and I went for a simple dinner and then downtown to see the Christmas tree in Sundance Square but didn't stop to walk around. I used my cane whenever walking but everything seemed to hurt: feet, hand, back, hip and according to my cardiologist, I can only take Tylenol which gives extremely little help. On the verge of tears (another no-Testosterone effect), I thought "This would be a good night to die." That was completely selfish, of course: wanting to abandon your family during Christmas week, but the pain was pretty awful. I may have mentioned earlier that I lost my dad and sister to suicidal depression, and I swore to Tammy years ago that I will not leave her by choice. I have to push through and after resting last night, today's a better day even after morning exercise, although I'm still a bit tearful while writing. Even though I'm really good at feeling sorry for myself at times, I'm thinking this morning of two friends in struggles with dangerous cancers, one on hospice and on Morphine in his last days, mostly sleeping and the other, a marvelous music teacher taking severe treatments due to late-diagnosed colorectal cancer. And two other friends with prostate cancer who refused hormone (i.e. Orgovyx pill or Lupron injection) therapy, one of whom who said,"I'll die from prostate cancer before I'll take that." I feel pretty blessed spiritually regardless the aches and pains and weakness. Do you recall the scene from "The Green Mile" in which the massive Black man headed for an unjustified execution draws a man close to the cell bars and miraculously breathes in his disease, leaving him healed? That act reminds me of Jesus. "He who knew no sin was made sin on our behalf." While we celebrate the Incarnation at Christmas, I'm reminded of Gethsemane and Calvary where Jesus "breathed in" all our past, current, and future sin and took them with him to crucifixion. I don't expect miraculous physical healing, but that God has allowed and nurtured medical progress that is capable of extending my life. More importantly, I have experienced miraculous soul healing, removing the sin that would have kept me separated from God permanently. That's quite a gift to celebrate Christmas day and every day.

Hismones 12/04/25

Does life sometimes seem like too much trouble? Nearing my first treatment anniversary, I had a second opinion appointment with Dr. Keith Courtney at UT Southwestern in Dallas. He and a physician Fellow working with him studied my records and agreed with the diagnosis and treatment plan of my Fort Worth Urology Partners and Texas Cancer Specialists team. That was the good news. The "oh, well" news was that I'll be continuing with the oral medication as planned for another 6-12 months and then be monitored afterward. I don't know why, but I suppose I was hoping he had some sort of magic plan that would lessen or shorten treatment. Another year with zero Testosterone is less fun than it could be but should be worth it long term. So, disappointed and in agreement with one of my medication side effects, I came home, let self pity build up and shed a few tears. I'm already better, but I seemed to need a little tantrum before getting back to reality. Dr. Courtney's advice imcluded, "Eat less and exercise twice as much," this just a week after Thanksgiving and leaning into Christmas. Darn. Intestinal distress is still my daily companion, so I'll be having an appointment with a gastroenterologist soon. My next PSA check and oncology follow up are in February, so it may be awhile until the next post. Regardless, Merry Christmas!

Hismones 11/26/25

One year ago. After office hours on Thanksgiving Eve, my urologist called me personally with the biopsy results: "You have prostate cancer." What started as elevated PSA at my semiannual PCP checkup in April had been followed by a surprisingly lower PSA at my first urology appointment in June, then a highest-yet reading in September followed by an inconclusive MRI in October and an office biopsy in November. A PSMA PET scan December 9 revealed three lesions in the prostate and two outside in adjacent lymph nodes. Amazingly (miraculously?), I was able to have rapid-fire successive appointments with urologist December 16 and with radiation and medical/surgical oncologists December 18 and 19. Surgery was an iffy solution, so I chose radiation with androgen deprivation therapy (ADT), a daily pill. I started the prescription Christmas Eve, had 44 weekday radiation treatments beginning near President Lincoln's birthday and ending April 22, and continue taking the oral ADT. While my treatment has been punctuated by holidays, it's not been a vacation but the pathway has been effective and I am managing with God's, Tammy's, and various support groups' help. I am grateful. Happy Thanksgiving!

Hismones 11/24/25

Happy Thanksgiving week! I had forgotten about posting updates, so I must be doing reasonably well. I had a six months' PCP appointment November 3 which included blood tests that indicated typical changes during treatment: Triglycerides, Blood sugar, weight up; red blood cells, creatine down; but nothing in a danger zone at this point. PSA still undetectable (since first tested in May following radiation). On November 11, I had a follow up with my medication oncologist. He is pleased with my progress but referred me to my PCP for medication/health management. Since I've been prescribed hormone treatment for 24 months, I quoted to the oncologist that a recent study indicated 36 months on hormone deprivation showed no better survival rate than 18 months, so obviously 24 months is no better than 18. He agreed that 18 months, if PSA remains undetectable, will be a good stopping point to take a "holiday." So long as PSA remains low, no more hormone therapy after June. Yea! I still have a December 3 second opinion appointment at UT Southwestern in Dallas to confirm or consider modifying treatment. No one seems to know about my abdominal issues, so I stay near a bathroom each morning and consume 3-5 Imodium tablets. I've been having increasing hip soreness and have an appointment with a pain management specialist December 1 to consider having a spine injection (L1-L2) to determine whether the pain is originating in the back or in the hip itself. My spine surgeon's PA says they wouldn't be eager to do more spine surgery because, in combination with the previous L4-L5 fusion, I would likely lose stability. I don't need anything else to affect adversely my balance or stability, but I would like to be rid of the soreness. We are doing well enough to have enjoyed a visit with friends in Tampa FL last week. We met them by dining together on an Inspiration Cruise (Michael W. Smith) a few years ago. We subsequently visited them at their summer home in Maine and joined them for a Viking Rhine River cruise last year. They're a great couple and excellent hosts. We're planning to go together on a more extensive Alaskan cruise, including inland excursions, next summer. All in all, we're doing well. I have started the combination of exercises at home MWF and going to the Benbrook YMCA TTH to add weight training exercises. I believe the extra work on leg strength is beginning to improve my walking stability. We have lots of reasons to be Thankful for faith,family, and friends. Our girls and their families will be with us this Thanksgiving weekend. May the God of grace and comfort provide all your needs obviously and abundantly.

Hismones 09/27/25

"Life with Zero Testosterone" is an ongoing saga. The results of this week's bone density scan show Osteopenia, which is low bone density but not yet Osteoporosis. My wife says this may be due as much to age as to medication, but I've asked the oncologist whether I should be taking a bone strengthening supplement such as Fosamax, which some online support group members suggest. I am currently taking a "senior" multivitamin and 600mg of Calcium Citrate twice daily (dose is divided because the body only absorbs a certain amount within a four hour period). Chronic diarrhea is still an issue. I've sent a request to my PCP for recommendations since my oncologist thought this would stop after radiation ended, and I've started a BRAT (bananas-rice-applesauce-toast) diet, more or less, which is suggested by the Orgovyx manufacturer as a low-fiber option to help control the issue, and it is getting better. Unrelated to cancer, I had a carotid ultrasound at a vascular surgeon's office. It indicated mostly normal levels of blockage and no change to current (statin and blood thinner) treatment. The "optional" chest calcium scan at my cardiologist's office suggests borderline levels of arterial plaque but no need for immediate intervention. I have another test there on Monday. I had given up on using an injection for ED due to the significant pain it was causing. In a webinar this week, I learned that one of the three Trimix chemicals is known to cause pain in some people, and unfortunately it is the most effective of the three. I am going to try Bimix, which is a formula that leaves out this chemical but may take more experimentation to be effective. Fatigue is a moving target: I split my daily exercise in half, now about 40 minutes daily, because I was simply getting too tired. The overall experience is better now, but my energy is somewhat unpredictable. Tuesday, I felt like I was pedaling a bike with both tires flat and, at the end of the day, would not have been disappointed to fall asleep and not wake up. Fortunately, I woke up Wednesday to a better day and Friday was even able to do some yard work and help close the pool for winter. The expressions "This too shall pass" and Jesus' promise "I will be with you always" help keep me going. I wrote my oncologist for a potential counseling referral and continue talking with my wife and being active in prostate cancer support groups. I know that this disease is much more manageable than some, but living with zero Testosterone definitely takes its toll.

Hismones 09/03/25 Update

Sorry that the table lost formatting when inserted, but the news is good. Dear Mr. Ekrut, Your PSA and testosterone are undetectable. Great news! Please let me know if you have any questions or concerns. Best, Dr. Hollander Results: Date Result Name Ind Value Ref Range 9/2/2025 9:24 AM PSA Tot <0.01 ng/mL (current PSA: was 6.4 at diagnosis and also <.01 May 22) (0.00 - 4.00) 9/2/2025 9:24 AM Testosterone Total (L) <10 ng/dL (280 - 800) I don't meet with the oncologist until November 11, so may have another test for that follow-up. I have sent to the doctor a question regarding other blood testing and bone density/supplement, since hormone therapy is known to affect all this. Jim

Hismones 8/29/25

"Your results may vary." My daily routine continues and I'd prefer it were boring rather than challenging at this point. I am taking Psillium (sp.?) and a Probiotic in the hopes that my digestive tract will calm, but I am still having 3-4 bowel movements daily (my PR is 5 before lunch), often with very little warning. Hot flashes continue around the clock, but not severe and are sometimes followed by feeling chilled. Daily strenuous exercise helps a bit with combating fatigue, but I still have to take projects around the house in very small bits and accept slow progress. Just when I think I've found a good combination of dosing and application to use a Trimix injection for ED, I experience a dull ache and that its effect subsiding is unpredictably short or long. The addition of Myrbetriq for urinary frequency hasn't made a difference, yet. I've reached out to my PCP to inquire about a program of diabetes prevention training and education provided by Medicare because my weight continues to climb (I've gained 30 back of the 40 I lost during Covid season), and I'm pretty sure that trading prostate cancer treatment success for diabetes isn't a desirable outcome. So I'm both happy and jealous when I talk with a friend who is also currently taking hormone therapy and claims he has little or no side effects. In the plus column...I had a very fun experience in Austin recently, singing with about 350 fellow church musicians for a concert celebrating the 50th anniversary of the Singing Men of Texas (I joined two years after its founding.). We stayed with a fellow member of my Baylor freshman class and his wife, retired missionaries to Europe. It was great to reconnect and catch up with our stories. My wife and I are looking forward to join two other couples, all of us having known each other in church 40+ years, for a September vacation week in east Tennessee near Dollywood, and the two of us are planning to visit friends in Florida in November. Our girls and their families joined us last weekend to celebrate my birthday, and among their gifts I now have a motion-sensing video recording bird feeder outside the kitchen window. I finished PT for my thumb surgery, and while the specific pain in that area is gone, I have a short list of exercises to continue strengthening grip and increasing flexibility. I have a blood test next week to gauge PSA progress during treatment. All in all, life is survivable and my wife, other family, and friends are a great support team. God is good, even when circumstances seem a bit inconvenient.

Hismones 07/31/25 "Hair Today, Gone Tomorrow"

Well, I was expecting to have another PSA test done July 22 and follow-up appointment with radiation oncologist July 29, but apparently I have been transferred across the hall to the surgical oncologist/hormone therapy specialist who can't see me very soon. I was scheduled to meet with him September 9, but we will be out of town. My next PSA will be September 2 and I'll know the results a few days later, but I won't be seeing this specialist until November. If the test results aren't as expected, that will likely change. Now, back to the blogpost title: every bit of body hair below my neckline is reverting to childhood. It's the strangest thing: head hair and shaving are remaining as normal, but all (and I mean, ALL) of my hair from arms, chest, abdomen, thighs and legs is becoming "peach fuzz." I suppose that's another result of having no Testosterone, including some very appreciated body parts shrinking back more like they were when I was 12. If I remain on hormone therapy for the full recommended two years, I read that I have about a 50/50 chance of life returning to normal afterward. This week following vacation, I've returned to a regular exercise regimen, and that helps a bit with energy levels. I repaired a leaky toilet, unstuck a door latch, and am about halfway to a cooling fan solution for our daughter's Miata. Last weekend, though, edging front and back yard and washing my wife's car apparently were a bit too much for one day. I continue to have urinary and bowel urgency/frequency issues and have been prescribed a new medication (generic for Mybetriq) that will hopefully reduce my getting up four times nightly. Imodium helps me ge through mornings that typically include three serious bathroom visits, starting about as fast as I can get to a bathroom when first waking up. PT is progressing well following June's hand surgery and I've been allowed to use a topical NSAID for pain despite taking Eliquis. Hormone therapy is no joke, but I read about more severe treatments others receive for more immediately life-threatening cancers. My next medical event is a Calcium chest scan Monday (outside insurance) to determine what heart-related arterial blockage I may have. This test may simply provide a baseline or it may suggest additional treatment. I'm not having concerning symptoms at this point. Thanks for reading and for joining me in prayer through this journey!

07/22/25 I wish I had written this!

"Fifty Shades of Beige: How to deal with Your Chemically Castrated Mate," copied from a prostate cancer support group post: "Let’s begin with a truth bomb that should come with its own trigger warning: once you’re chemically castrated, you don't "feel like less of a man"—you feel like a retired man who's been laid off by his own body and wasn't even offered a cardboard box for his desk stuff. There’s no farewell party. No watch. Just a needle and the distant sound of your libido packing its bags and slamming the door on the way out. Welcome to Androgen Deprivation Therapy—ADT to its friends (which are few). In my case, it's Firmagon. Sounds like a medieval battle axe, works like a medieval curse. One shot a month and you too can enter the exciting new realm of hormonal flatlining. It's not just chemical castration—it’s a metaphysical rebranding. One minute you're a man; the next, you're a slightly puffy, mildly weepy, heat-flushing human marshmallow who cries at dog food commercials and can no longer remember why he ever liked breasts. The Shriveling Let’s be anatomically specific, shall we? The testicles don’t hurt, per se. They retreat. Like war criminals going into hiding. They sense the hormonal apocalypse and evacuate the premises. You find yourself peeing like a sad bishop and adjusting your pants with the hollow knowledge that there’s less and less reason to do so. Muscle tone vanishes. Your biceps, once mildly competent, now feel like overripe bananas. Your jawline begins to resemble a melted candle. Body hair gives up entirely. You become… smooth. Not “ooh-la-la smooth,” but wax museum smooth, with all the sexual charisma of a lightly used sponge. Hot Flashes and Colder Truths Men don’t talk about hot flashes. Because normally, we don’t have them. But ADT fixes that right up. Picture this: you’re standing in a grocery store, minding your own business in the frozen peas aisle, when suddenly your body attempts to spontaneously combust. Your neck sweats. Your scalp sweats. Your earlobes sweat. You panic—not because it’s dangerous, but because it might happen again in public. You learn to dress in layers like a menopausal spy. And what of sex? That dear, lost hobby? Sex becomes an anecdote. You remember it fondly, like an old car or a high school band you were once in. The desire doesn’t just vanish—it dissolves. You’d rather alphabetize your spice rack than mount a partner. Erections become as theoretical as time travel. You develop a polite detachment from your genitals. “They're just here for show,” you say, like a man giving a tour of a museum he no longer believes in. Emotions: Now in Technicolor And then there are the feelings. Oh, the feelings. Before ADT, I could count my annual cries on one finger—usually triggered by sports losses or dog deaths. Post-ADT? I cried because I saw a pigeon limping. I wept during a pasta commercial. I sobbed when I couldn’t find the other sock. My wife looked concerned. Then amused. Then slightly afraid. You're no longer “the man of the house.” You’re more like “the man-shaped person who watches bird feeders and talks about feelings with inappropriate intensity.” The Social Landscape Explaining this to others is a joyless ritual. "Yes, I'm chemically castrated. No, not voluntarily. Well, sort of. It's for prostate cancer. Yes, still technically a man. No, it doesn’t grow back. Yes, I’m fine. Why do you look like you want to call someone?" People don’t know where to look. Other men avoid eye contact, lest the condition be contagious. Women offer sympathetic head tilts normally reserved for widows or dogs in wheelchairs. No one knows how to react to a castrated man who isn’t in prison or ancient China. The Upside, If You Squint They say chemical castration can lead to a kind of inner peace. I assume they mean the same peace you get when you’ve been lobotomized—there's simply less of you to argue. You don’t want much anymore. You don’t need to win. You’re not aroused. You’re not enraged. You’re just here—a hormonally muted Switzerland with a Costco membership. And yes, there is some relief in being released from the tyranny of testosterone. You’re not constantly checking your phone for messages that never come, or pretending to enjoy lawn equipment. You're free—liberated from lust, ambition, and body odour. But let’s not sugarcoat it: if this is the price of surviving prostate cancer, then surviving comes with terms and conditions, footnotes, and a major lifestyle update. And those terms include becoming a softer, sweatier, moodier version of yourself with a reduced interest in everything except napping. Final Thought: So here I am—chemically neutered, biologically deflated, but still kicking (gently, and only if stairs aren't involved). I am not “less of a man.” I am a different man. A quieter man. A man who cries at the sound of cello music and owns two kinds of moisturizer. Would I trade it all to feel like my old self again? Of course. But until then, I’ll be the bald, mildly tearful sentinel of aisle six. Do say hello. Just don’t touch me—I bruise easily now." Now, my next PSA/Testosterone blood test? This Thursday, 7/24

Hismones 6/18/25

"Your shoulders are crap." It's been a busy medical month. Having blown through coinsurance due to radiation treatments and taking hormone therapy, I decided the time had come to deal with other medical issues. On June 4th, I had thumb arthritis surgery, removing the trapezium bone and replacing it with a tendon from my forearm. Two weeks later, I have the very first hard cast of my life (keeping the thumb immobilized during healing), never having broken bones as a child. I had a routine colonoscopy June 16th which discovered a couple of polyps but nothing seemingly consequential.Then today,I had evaluation of my shoulders since my left shoulder started hurting while driving the Miata at the track May 10th. I kept hoping it would heal but the pain just wouldn't quite go away. So after lots of x-rays and the report from the shoulder surgeon I had seen in Dallas last year but had since retired, along with a physical exam, the new local specialist gave me the news. Both rotator cuffs are completely gone and not repairable. He said, "You must have a high tolerance for pain and be a person who can function without rotator cuffs" (He said I'm severely arthritic, bone-on-bone in both shoulders). He gave me a steroid injection in the left shoulder and wants me to try driving on the track again to see whether the shot helps relieve the pain. He said the only reason for shoulder replacement would be to relieve pain because there would be no additional strength with rotator cuffs being missing. Since my right arm will be in a cast for a while and I'll begin therapy sometime in July, it will be August before I can drive again. And in cancer news, I keep taking Orgovyx and will have my PSA tested again in July. Mayo Clinic, University of Minnesota, and local support groups have been invaluable. Thanks for reading! Next week? Just one doctor appointment, an ENT hearing evaluation. Now, to find a foot specialist. I'm thinking of taking the nickname, "Lucky." All things considered, I'm one very blessed guy. :-)

Hismones 6/1/25

Speaking of diet: when I comment that I'm attempting to "go vegan" with my eating, please understand that this is not prescriptive for all men. A plant-based diet has not been shown to prevent prostate cancer, but it has been demonstrated to limit prostate cancer growth and stop rising or even lower PSA once diagnosed. A vegan diet is especially challenging because our social meals are primarily meat-based, and it requires planning and creativity,including getting all the nutrients needed that formerly came from meat or meat products. I'm not suggesting to all my male friends that they revolutionize their diets, but for my fellow prostate cancer patients, it's a good thing to do. And unlike other cancers, prostate cancer is not fed by sugar, curiously, but being diabetic doesn't help, so control sugar intake. And have a nice day! :-)

Hismones 05/29/25

I'm so glad that to the expression, "Good things come to those who wait," the word "patiently" wasn't added. Because I haven't been. That said, my telemed appointment this morning with radiation oncologist Dr. Jerry Barker revealed some very good news: after 5 months of hormone therapy and 44 radiation treatments, my PSA that measured 6.4 last August when diagnostics began is now down to 0.01 (the lowest they are able to detect). Thanks be to God, to the medical team, and to science! The follow up treatment is to continue Orgovyx daily (ostensibly for 19 more months) and to have PSA checked every 3 months. Dr. Barker and I discussed pros and cons of shortening the hormone therapy or changing to another drug, but I don't want to consider that until 1 year of this drug is completed. It was nice, too, that office staff worked to connect Tammy on the call even though she was driving across Kentucky at the time. It was in essence a three-way FaceTime conversation that their communication software accepted. On another very different aspect of my health, I have been doing a little vegan experimenting in the kitchen while Tammy is away. I've tried some packaged items ("Ultimate Burger," "Roasted Poblano Enchiladas") and our neighbor brought me a bowl of Panama-style chicken with vegetables soup with white rice (I gave the chicken and broth to our pup; all was delicious) but also followed recipes to create a Tofu Scramble (looks like scrambled eggs, served on toast and tastes pretty decent!) and Vegan Collard Greens which were pretty tasty but probably better with bacon or ham. :-) These might not be favorites but are palatable and make "veganizing" survivable. I'm not sure how completely I can follow the plant-based lifestyle, but the more closely I do when hormone therapy is complete, the better off my long-term health will be. I have two upcoming procedures: thumb reconstruction June 4 and routine colonoscopy June 16, so there's little time for boredom, and I'm working to have the Miata ready for Ashley to have a driving/instructor day June 21. My next PSA check will be August 22 and I will now be followed by Dr. Andrew Hollander, surgical oncologist and hormone specialist, beginning in September. God is good all the time, but today is an exceptionally good day.

Hismones 5/23/25

It's hard to believe it's been more than three weeks since my last post, but there hasn't been much additional activity. I had an appointment with an ED specialist last week, tried three different sample injections to determine dosage, and am to pick up my first compounded Rx this evening. In case someone asks, Aetna will spend a lot to save your life but not insure your love life. :) I had my first post-radiation oncology blood work yesterday and have a tele-health appointment with my radiation oncologist next week. I'm definitely hoping that my PSA (measured last fall at 6 and in April at .11) continues to drop and I can convince my oncology team to switch medications (to Nubeqa) at one year rather than continuing Orgovyx for two years. I'm hoping to maintain effectiveness while reducing side effects. BTW, changing to a plant-based diet is quite a challenge. Tammy has been wonderful at trying recipes and helping me attempt the shift. If I can do this and mostly eliminate consuming sugar/simple carbohydrates, I'm much more likely to drop the weight I've gained (15-ish) since diagnosis. Orgovyx is part of the issue; eating while stressed is probably worse. I had some sad news yesterday: our next door neighbor, a few years older and having fought lung cancer for years, got the news that she has dangerous metastasis in both neck (threatening immediate paralysis due to proximity to spinal cord) and skull. She has chosen hospice, and it was a stark reminder of the temporary nature of life to see her DNR bracelet. I shared with her the book, "Being Mortal," written by a physician who helps end-of-life patients. Someone recommended it to her while hospitalized recently, and I had a copy due to a friend's recommendation. It's personal and emotional but helpful in dealing with last things and quality of life. I'll try not to wait too long to post again, hopefully soon after my oncology follow up next week. I'll have my latest "numbers" and hopefully good progress to report. Fatigue is still my intimate companion. All the best!

Hismones 04/30/25

Mission 1 Complete: 44 weekday radiation treatments finished April 22. Radiation oncologist set follow-up labs for May 22 with Telemed conference May 29 to discuss outcomes. I've never been known for being patient. I have a semi-annual checkup with my primary care physician May 1. I asked to have labs done the week prior and to include a PSA (blood) test among the rest. The tests were done the day following my last treatment and posted on the primary care physician portal. Results? Whereas my PSA was 6.x in November when diagnosed, it was down to .11. Excellent early success (!) and my blood pressure and anxiety went down a bit! The tests also identified some deficiencies in my blood work that match side effects listed by the hormone medication manufacturer, so I'll check with primary care and confirm with the oncologist the best approach to compensating. Now that radiation is complete, I have to focus on weight management. I've gained 10%+ of body weight during treatment, in part likely due to hormone treatment but also certainly due to stress eating, so that part is personally manageable. Despite being embarrassed at the lack of self-control, I look forward to talking with my doctor about moving forward. I requested an appointment with the surgical oncologist/hormone specialist for next week. The purpose is to discuss the remaining months of the treatment plan regarding continuing, discontinuing temporarily or long term, or enhancing hormone treatment. The current plan is to take Orgovyx through December 2026 but that length of treatment will likely make permanent changes to the quality for whatever years remain. I'm hopeful that the oncologist will be receptive to my personal life goals rather than simply to optimal cure rates. In the meantime, I anticipate that radiation side effects will subside in the next several weeks and will plan to post again after the primary care and oncology appointments. I participated in an interesting online session from Duke University this evening on the subject of reducing the financial burdens of prostate cancer care. Topics included a referral network, resource specialist in the cancer clinic, and more resource education for physicians and clinic staffs. Whereas my PSA at its highest was still single digit, one of the survivors in the meeting was finally diagnosed when his PSA was 1000+! His disease had metastisized widely, so his treatment included chemotherapy and surgery...but obviously he survived. His story was quite encouraging. So now, back to the Orgovyx and Immodium. My wife was so sweet last week that she took me on a surprise two-day getaway to a condo a little over an hour away for some simple down time. Life could be so much worse; I have ongoing reasons to be very grateful.

Hismones 04/11/25

Wow: steroids are really awesome but just don't play well with radiation treatments! I was celebrating the first anniversary of my left hip replacement with a visit to the orthopedist, also asking him to take a look at my right hip (my last natural major joint below the waist) which had been sore for awhile. He didn't find any major issue but prescribed a steroid dose pack for the pain. Did I mention somewhere previously that I've been having a lot of fatigue associated with treatments? Well, not after beginning taking steroids! I started mowing and cleaning the yard, trimming bushes and shrubs, and getting the bulk waste out to the curb for pickup. That lasted until the next day's treatment Tuesday morning at which I learned a hard lesson: because steroids cause fluid retention, having your bladder full (required for treatment) takes a LOT of water and a LOT of time. I had drunk the normal amount of liquid that morning, but had to double up the amount and wait 45 minutes for the process to be complete. :-( So, no more steroids until after treatments end (7 more/April 22). I also hit a serious steroid withdrawal fatigue "wall" at lunchtime Wednesday. Oof! So I'm doubling morning water because I still seem to be filling up too slowly. I watched a video account of another person's treatment in which he said he was told to drink 40 oz. of water, and my plan is to drink 32 oz. plus coffee. If I'm about to "overflow," I have a handy dandy "incontinence clamp" which is a lot like the business end, albeit cushioned, of a locking pliers. It's not awful, but its use is limited to three hours and gets pretty uncomfortable after two. I don't always use it before treatment, but I'm always "packin'." If you see a bulge in my pocket about the size and shape of a harmonica, that's it. I did have a bit of fun this week in virtually joining a prostate cancer support meeting from the Mayo Clinic. The doctor leading the meeting answered a question about my treatment that I had posted in the chat, suggesting there could be an additional drug to add to my hormone therapy that would give even stronger results. I sent that news to my urologist immediately following the meeting. I also requested a PSA test with my annual labs for my primary care doctor visit on May 1, which will be three weeks before I'm to be tested for the urologist/oncologist. I just want to be a little more confident that treatment is doing what is intended. As the specialist from Mayo commented, all that it takes for cancer to reoccur is for one cancer cell to survive treatment, and that while I'm on a 24 month hormone therapy plan, surviving cancer cells develop immunity to this treatment at about 20 months by developing the ability to create their own testosterone. The additional medication helps eliminate that possibility at the cellular level. All in all, it's a bit hard to be discouraged: I'm sitting in a patio rocker outside on an absolutely gorgeous and comfortable Friday; my radiation treatment team is all smiles because Tammy brought them homemade (from scratch, double boiler style) banana pudding. (It's one of her signature dishes and is wonderful); and she told me yesterday that she's taking me on a "surprise" two-day adventure to celebrate as soon as radiation treatments are complete. Cool, cool, and cool. Happy Friday!

Hismones 04/02/25

F-A-T-I-G-U-E, find out what it means to me.... Today I completed treatment 30 of 44, with the continuing hope of finishing radiation April 22. So far, so tired. The legendary Green Bay Packers coach, Vince Lombardi, said it this way: "Fatigue makes cowards of us all." I'm not sleeping very well (which means that unfortunately Tammy isn't either), making bathroom trips four times during 10 P.M.-5 A.M. Most mornings are the best part of the day, with treatment followed by daily exercise, but my energy is basically gone from noon through the rest of the day/evening. Two Saturdays ago, I was so weak that Tammy kindly said,"If you need to go off treatment, it's okay." But we both know the outcome without treatment wouldn't be optimal. Yesterday morning, though, wasn't going well and I was tearing up during my weekly doctor appointment. He adjusted my medication to try improving my sleep pattern, so we'll try that this week with perhaps some sort of sleep aid to use if that's not enough. I'm writing this late afternoon, so I've been on the verge of sleep awhile on the couch and now amazed by God's new green growth while sitting on the patio outside, but also having to wipe away tears. I'm confident that God is not putting me through this as some sort of test or punishment but rather that he will bring me through this. Maybe I will be able to encourage others along the way or beyond. I'm mostly sad that Tammy is having to go through my daily treatmehts, mood swings, hot flashes, interrupted sleep, wobbly walking, lack of energy, and tears. But I don't want to think what this would be like without her. She commented around the time we married (almost 31 years ago) that she believed God was calling her alongside to fight for me, and she is doing so heroically. The oncologist says that I should be passing through the worst part of the fatigue at this point, but my reading and viewing indicate that relief will take some time. Perhaps by June I will be dealing with "just" the lack of testosterone. I did get two rose bushes planted and our clothes dryer repaired this week, so there's that. Baby steps, as Richard Dreyfuss and Bill Murray said.

Hismones 03/22/25

Halfway! Friday marked treatment 22 of 44 and so far I haven't had to miss any. Making sure the bladder is full upon arrival is required, and based on that struggle emptying the bladder immediately after treatment is also necessary. What do I think after half of radiation is done? I wish I'd have known and had more explained before starting this process, but I think we will get through okay anyway. I'm getting more control of diarrhea by reducing fiber intake and using Immodium, but hormone therapy is something I don't wish on anyone. I don't know how female cancer patients who are placed on long-term hormone therapy handle it,but I'm hoping their experience is different. Chronic fatigue with joint pain and feeling like I'm losing my gender aren't encouraging outcomes. I did have a positive visit with a new doctor Friday, a vascular surgeon. I was referred by my cardiologist due to blockage in the carotid arteries. This referral sets me up for closer monitoring. The surgeon said my level of blockage is well controlled with medication and will see me in six months for a fresh ultrasound evaluation. And last but not least is the way I drove at a local race track this week! On Wednesday, I took my daughter's '99 Miata to Motor Sport Ranch at Cresson (between FW and Granbury) to drive for the first time as a Novice at the SCCA Track Night in America event Wednesday. I may be old but I am slow! My left arm was a bit sore from waving so many other drivers by to pass, but I had a very good first experience. I plan to return on a day in which I can pay somewhat more to have an instructor's help, because I can tell the car is much more capable than I am at this point. At 73, I'm realizing a decades-old dream of driving on a race track. God and my wife and daughter are good. I even had the unexpected free excitement of spinning when a car close in front of me had a coolant system failure and dumped antifreeze on the track. I saw the car off the track ahead of me, hood up and steaming, and slowed down a lot but didn't see the liquid on the track in time. I spun harmlessly, not hitting or breaking anything (or needing to change clothes!). I plan to go to the track this weekend to contact an instructor and in May to drive again. By then, radiation treatments should be ended. I'm viewing videos by the Prostate Cancer Research Institute based in LA, CA that suggest hormone therapy for 70+ age men may not be necessary, so once the PSA tests are showing low or no activity, I may press for stopping the hormone pill at least for a while. As someone cleverly said, "We'll burn that bridge when we get to it." All the best to you this weekend!

Hismones 03/14/25

Happy Friday!? This morning was treatment 17, so 27 to go and still headed toward April 22 as last treatment. It seems remarkably easy to underestimate the cumulative effects of radiation and hormone therapy. I take a pill daily and have about a 90-second treatment daily that leaves no visible physical evidence, at least not yet. The main issue is that life is different, with fatigue and intestinal distress being significantly restrictive. During the summer between high school graduation and starting college, I spent off-work time reading the four books of the Tolkien "Trilogy" (early "new math?") and learning to wiggle my ears, not an insignificant achievement when done well. The past few weeks I have been trying to learn a new skill, much less pleasant but no less challenging: defecating without urinating, in which I have been mostly but not entirely successful. Abdominal radiation tends to cause diarrhea, sometimes but not always controlled by OTC medications, and I find myself bathroom-bound at least three times between my rising at 5 A.M. (lights out at 10 P.M., awake at 4 A.M. but forcing myself to stay in bed another hour) and leaving at 7:40 A.M. for my 8:15 A.M. sessions. I have to arrive with a full bladder (moves bowel structures out of radiation harm's way) or risk not being treated. A friend is farther along in his treatment plan than I but is trying to work full-time while having severe intestinal issues. He missed a treatment earlier this week due to dehydration and was too ill this morning for treatment. He finds himself hospitalized this evening for fluid infusion and has been told his work schedule must change during treatment. Retirement for me is a huge blessing through this process, and I pray for his health daily. Downsides of increased bathroom time are increased use of tissue and water; one upside is that I'm completing Large-Print Bible Word Searches much faster, books given me almost a year ago during hip replacement convalescence. "Aging isn't for sissies." I do find that an attitude of gratitude and a smile go a long way to make every day more pleasant. Sometimes just asking a clerk or cashier or med tech...or doctor, "How are you today?" can make their day a little lighter and brighter. And I haven't run out of projects at home. I replaced a hose clamp on my wife's car, solving a slow coolant leak; pulled the spark plugs and valve cover off the Miata I've borrowed from my daughter for track time, finding the engine in excellent shape but ready for new plugs which now have been ordered; changed the oil in said car and had it checked/certified tech-ready for my first adventure at SCCA Track Night in Cresson next week; performed a Redneck repair on my own car, cleaning and repainting a bumper corner that had accidentally been scraped by a friend at our men's choir concert last week; and managed to break a windshield washer part on my car while trying to unclog the system. At least, parts are available and inexpensive. I suppose it's a combination of age and treatment: I feel ridiculously tired and sore most evenings and look forward to lying very still in bed, but amazingly most mornings, especially after exercise, I'm ready to go again. I'm curious how well treatment is working, whether my PSA has dropped precipitously as anticipated, but my doctors (urologist and oncologist) have ganged up on me. My next PSA check will be one month after radiation ends, or 5/22/25. My concern is that my cancer is acting normally, with both androgen deprivation and radiation eliminating it. A very small percentage (but not zero) of prostate cancers don't respond to "ADT" and require additional medication/treatment. I.hate.to.wait. It won't hurt to get more clarification at my weekly oncology appointment after treatment next Tuesday.

Hismones 03/06/25

"Pick your battles." I told the radiation oncologist at our weekly Tuesday meeting: "I may get to have urological, orthopedic, and cardiovascular surgeries this year with no additional co-insurance costs, thanks to radiation treatments." His smile was a sort of "You're welcome." My recent ED specialist visit last week resulted in long-term recommendations for either self-administered injections or a surgical implant, to which the oncologist agreed. I'm out of commission for now due to lack of full function accompanied by pain, so I'll ask some more questions to address short-term concerns. I just completed radiation treatment 11 of 44 this morning. I'm not sure whether I have additional fatigue but there are certainly intestinal issues, so Immodium is a brand-new addition. I did learn an interesting technical fact yesterday, that the treatment machine irradiates virtually full circle, the table on which I lie being made of carbon fiber to allow the beam to pass through. In the cardiovascular arena, because of some recent dizziness, my family's strong stroke history, and previous carotid blockage identified, I had both a carotid ultrasound and CT scan in the past couple of weeks. One of the arteries is now at 52% blockage, so I'm being referred to a cardiovascular surgeon for closer monitoring with likely an endarterectomy in my future, sooner or later. And then there was the follow up visit Monday to a hand surgeon because of significant arthritis pain in my right hand. He's recommending a "remodeling" surgery to my thumb which should relieve pain and retain most function. So am I having three surgeries this year? Likely not, but probably the thumb revision in late summer. I haven't seen the cardiovascular surgeon yet and I'm not sure what the percentage tipping point is to recommend surgery rather than monitoring and medication. I'm headed to the Benbrook Y shortly for the second of my four introductory personal trainer sessions, hopefully resulting in a weekly exercise regimen that will help maintain muscle mass during hormone therapy, muscle mass loss typically being one of the side effects. Tammy continues to be a heroine, adjusting to my changes, appointments, and attempt to become plant-based in my eating. She has been researching recipes and ingredients ("These vegan things aren't cheap!"), trying a new and unfamiliar menu. I am volunteering monthly at one of my former teaching campuses for Academy 4 (4th grade mentoring) and Leaders 5 (helping 5th graders mentor 2nd graders) and begin Monday a weekly reading support for struggling students. At home, I'm trying to stay busy this week by updating cabinet hardware and working on my old (not "classic") commuter vehicle, along with daily exercise. God is good. I'm sitting in a comfortable paid-for home with plenty of food, clothing, and shelter shared with a wonderful life companion and communicating regularly with daughters who love us and each other. My six year old granddaughter visited us for the weekend. She's always been pretty distant toward me, but wanted to hug me when she left and told me she loved me. Life could be so.much.worse.

Hismones 02/26/25

"What's it gonna be: self-injections or implant?" When urologists and radiation oncologists talk with you about saving your life, they're pretty careful and probably wise not to share too many details about the features of said future saved life. Removing all testosterone to stop cancer growth eliminates virtually all sex drive (and can affect function) during treatment and photon-bombing your reproductive area increasingly affects function over time, even after treatments end. At my age, odds of recovering function aren't high, and pill interventions may give a little help for now but will be ultimately inadequate. Long-term solutions are pretty serious. Tammy's being an angel but it's another issue to negotiate. Fortunately, my medical team includes urologist, radiation oncologist, surgeon, and ED specialist/surgeon (whose exam room is decorated with Formula 1 memorabilia, very cool). Having a manufacturer's implant model demonstrated was a bit of a surprise. All the team seem to be good people, but the radiation oncologist is the one overt Christian and the most optimistic. I have done a lot of reading and watching online, but regardless differing perspectives and opinions, I am developing a strong faith in my team, especially including those technicians who aim and administer daily radiation. My appreciation for the team accompanies my trust that the same God who has guided and guarded my life to this point has purposes and plans that are abundant and beyond my understanding, at least for now. Sometimes life makes more sense looking back. When hope is mentioned in the New Testament, it's in the form of assurance rather than wishful thinking. If you don't have that kind of hope yet, you can. I'm open to discuss any time.

Hismones 02/20/25

"Drink more water." "I don't care when you start drinking, just when you finish." The kind but strict and efficient technicians who administered my first radiation treatment this morning reaffirmed that I need to come in every weekday with a full bladder, which is tricky for an old guy who feels an ultimately irresistible urge to empty said bladder even before it's completely full. They tell me the full bladder helps reduce collateral tissue damage by pushing surrounding tissue out of the beams' target zone. So tomorrow, it means finishing a bottle of water no later than 7 A.M. to be ready for my 8:15 photon "torpedo" encounter. Along the way,Tammy is helping (suffering with?) me as I am attempting to try moving away from animal protein and fat. Our nephew and niece who prefer vegan recipes sent one for chili that is pretty good. I found a few other recipes on a plant-based meals website, but most are soups...one lentil,one fifteen-bean, and a few others. A former brother in law whose wife is surviving utilizing a plant-based diet while having stage 4 cancer for more than fifteen years sent several recommendations: a book, "How Not to Die" by Greger that addresses dietary support in combating various diseases and several videos including "Forks Over Knives" which chronicles several doctors and their patients' health journeys. It seems that a plant-based diet and consistent moderate exercise can do a great job of preventing, treating, or even reversing many of our modern illnesses. Now, to make better choices for dinner at friends' house tonight...and to remember my morning dose of water! P.S. I didn't feel anything at my treatment: a technician holds up a small towel while you drop your drawers and sit down on a table, then lie very still with your feet strapped in and grip a towel with both hands on your chest and elbows tucked in to make room for the table to move you inside the open CT device for treatment. The technicians disappear and the machinery starts moving.After a couple of minutes, the technicians come back into the room to encourage you to get dressed to make room for the next patient. Just 43 more?

Hismones 02/11/25

I'm really struggling with weight gain, or maybe not struggling enough. I've historically been a stress eater, and there's definitely stress associated with this disease and treatment, but I've read and am experiencing that hormone treatment is commonly linked with increased appetite and weight gain, and of course at just the time you need to be in your best physical condition. During 2020-22, I lost 40 pounds and got all my blood tests into the normal range, but now I've gained over half of that back. I was encouraged last night by attending a local support group that meets in the Moncrief Center, 400 Magnolia. It's a prostate cancer support group that meets the second Monday of the month, 5:30-7P. Robert.Hernandez@moncrief.com is the contact. (Search Facebook for "Fort Worth Prostate Cancer Support Group," clicking the Pages tab) There were 8 of us patients, 3 oncology nurses, and two of the men brought their wives (wives/partners are welcome). As one of the ladies commented, "This affects us a lot, too." "Gail" led the discussion,mostly about upcoming treatment protocols and answering questions. She has been working with prostate cancer patients for about a dozen years and was very complimentary about Dr. Jerry Barker of Texas Cancer Specialists, my radiation oncologist. Men were there who had been diagnosed as recently as 2024 and as long ago as the early 2000s, which gave me hope! I also learned of the North Texas Prostate Cancer Coalition https://ntxpcacoalition.org/ (also on Facebook) which provides information and helps connect with support resources. There's also a movie (maybe on Prime with trailers available on YouTube) called The Silent Killer which focuses on prostate cancer and Black men's health. I've been watching a lot of Dr. Mark Scholz's videos via YouTube and highly recommend them. Tammy and I have an appointment in two weeks with an erectile dysfunction specialist, Dr. Sun, also associated with Texas Cancer Specialists but in their Arlington office off Cooper St. It seems the less attention given to sexual function during treatment, the less likely full recovery is afterward but there are helpful resources. I'm really grateful to be dealing with this during retirement rather than with a daily fulltime job or even worse, with children at home. Several people commented last night that there will come a day when prostate cancer isn't the first and last thought during waking hours.

Hismones 02/09/25

Peostate cancer feeds on animal fat and animal protein. I have work to do! PCRI interview with nutritionist Verne Verona: https://youtu.be/L9PE8a40wsk?si=-P5iHbgvYVbDY8AG Prostate Cancer nutrition specialist Verne Varona personal site: https://www.vernevarona.com/
Cancer Today article: https://www.cancertodaymag.org/winter-2024-2025/plant-power/?utm_source=salesforce-marketing-cloud&utm_medium=email&utm_campaign=February+11+2025+Cancer+Today+E-newsletter&utm_term=Read+More+in+Cancer+Today

Hismones 2/2/25

"Where could I go but to the forum?" and other resources... Friends recommended a couple of prostate cancer support forums which I have joined. Here are their links. Cancer Survivors Network, from the American Cancer Society: https://csn.cancer.org/categories/prostate?gad_source=1&gclid=Cj0KCQiA4-y8BhC3ARIsAHmjC_Gr64HrmXh3UPu9ONkmX9bm0MHyCRSXvLC3fQovdvXZGggMoopm63QaAiCdEALw_wcB Healing Well, which seems to reflect perhaps deeper research and more technical descriptions: https://www.healingwell.com/community/login.aspx?f=35& One of the respondents to my posts recommended a Harvard School of Medicine alumnus and prostate cancer specialist's YouTube videos: (sample) https://youtu.be/H3aNfFpInVI?si=tqFl6oCqld4UqiZ5 (Dr. Mark Scholz) Prostate Cancer Research Institute (non-profit that also has a dedicated helpline): https://pcri.org/ PAN Foundation (financial assistance for treatment): https://www.panfoundation.org My Orgovyx grant is from them. All my preliminaries are complete. Radiation treatment begins February 20. I had a cardiology appointment Friday to adjust medications for adequate blood pressure control without the dizziness I've been having. I think we have a better game plan going forward. I try to remember that it's my health, not the doctors', and I need to be my own best advocate, speaking and/or acting up to express my health needs and desires. All the best!

Hismones 1/28/25

Would my parents be turning over in their graves? I got my first-ever "ink" today: three freckle-sized dots, one on each hip and one in front between (gratefully above the most sensitive areas) for the purpose of radiation targeting. Those tattoos, along with the markers placed in my prostate last week and a full bladder ("Don't urinate for 90 min. prior to your appointment, supposed to help the bladder be out of the line of fire.) will assist the technician in applying the treatment exactly where needed. I'm to have a "dry run" (practice) February 12 and 44 weekday treatments following, starting the next day. But nothing between now and then other than the daily oral med. The doctor and team will look at my case and develop a radiation plan that may have some adjustments before finally approved in time for my first treatment. I'll have sessions after lunch each day, theoretically ending mid-April unless they or I have to miss and be rescheduled (Any missed treatments will be added to the end of the schedule, like when at school you have run out of "snow days.") So now we wait. Thanks so much for those of you who are prayerfully supporting this journey. Now I have a new medical folder, with names and phone numbers and a list of possible side effects. Fortunately,Tammy is helping keep up with all the information. She is an excellent organizer. Financially, this is an interesting endeavor. My PET scan copay was $1116 of an originally filed $20K ($9K for scan, $11K for the radioactive media IV). The SpaceOar/Fiducial Markers procedure incurred a $950 copay (haven't seen total filed yet). There's been no mention of radiation costs, and no copay for the prep CT scan (with three free tatts!) today. So I'm on hold again, this time with insurance to verify what costs to anticipate. The rep is getting the "codes" from the oncologist's office. Breaking news: the office assistant assured the insurance rep that I will "complete" my annual co-insurance maximum of $4000, with about $2800 remaining to be spent. Grateful to have insurance and to have lived conservatively. God always provides, but it's easier on him when you cooperate. Now off to more home projects that retirement allows one to "get around to." Blessings!

Hismones 1/21/25

Back home after 7:15 A.M. "SpaceOar/Fiducial Marker Placement" surgery. https://www.mskcc.org/cancer-care/patient-education/about-placement-fiducial-markers-and-rectal-spacers-radiation-therapy-your-prostate The surgeon placed three "seed" markers in my prostate and then injected gel between prostate and rectum to create space so that radiation doesn't damage the rectum (apparently a very bad collateral damage outcome). Procedure was actually less than 15 min. Next step is CT scan for radiation targeting, then weekday sessions of about a minute or less. It looks like I'll be closely connected to the oncologist's facility until early April. Thanks to all for prayerful support.

Hismones 1/20/25

Is being on hold for ten days worth $3,000? At about 9:20 this morning, I received via FedEx my first 90-day shipment of Orgovyx 120 mg, my two-year hormone (hence the blog title, "Hismones") assignment. The Androgen Deprivation Therapy is supposed to stop prostate cancer growth and help end the disease in me. I actually started calling to find a "90-day pharmacy" in December while visiting with KY family. Apparently, there are only two pharmacies nationally that can dispense the extended amount. Calls started January 3 when back home. The Rx couldn't be filled until January 6 (memorable date nationally) due to my existing 30-day supply. I don't want to go through the entire ordeal, for my fingers' and your eyes' sakes, but suffice it to say that January 8 and 10 and every day afterward, I called the pharmacy and insurance and on occasion sent a message to or answered a call from my urologist. The pharmacy kept getting a rejection when trying to get the med approved. This was unnecessarily complicated by talking to a different person with pharmacy or insurance each time, usually with slightly (or completely) different information. God bless the insurance rep who shared their "pharmacy help line," only accessible by pharmacies but able to dodge or correct approval issues. Finally on January 15, after having two separate reps each from insurance and pharmacy confirm that my medication was approved without further action, "Kyle" said my Orgovyx scrip would be sent for dispensing and offered to enter my information to apply for a copay grant. I didn't think we would qualify, but I gave him our monthly pension information, answered a few other questions and after a few minutes he came back online to tell me we were approved for a $2,000 grant. I wrote $3,000 earlier, correct? Had I simply continued filling the prescription monthly, my copay would have been $125 or $3,000 for 24 months. The 90-day supply has a $250 copay (three months for two-months' cost), or $2000 for 24 months. Had I not buldogged through the approval process, we would be $3000 poorer assuming I'm taking the med for the entire time. That was Wednesday evening, and Kyle said we would receive a call for shipping information. No call Wednesday. No call Thursday. No call Friday morning (my last dose on hand was for today/Monday). So I call one more time, and it's as though they were waiting for me to call them for shipping instructions. After tossing around delivery dates, we agreed that today would be best for me and workable for them. And while it was shipped from just across town (they don't allow pickup), FedEx showed up this morning. And I am both exhausted and extraordinarily grateful. The grant is actually for just one year, but only half of it will be used by then so hopefully extended. Tomorrow, I show up at a surgery center to have gel injected (stop reading now if squeamish) between prostate and rectum. It will harden as a pillow/spacer to allow thorough radiation of the prostate without endangering the rectum which cannot take exposure without damage. Radiation lasts two months; the gel pillow, three before dissolving harmlessly. Thank you for your prayerful support. I have a CT scan soon following the gel procedure to finalize targeting, then two months of weekday radiation. Progress, thanks be to God and to the medical team. The prescription grant softens the blow of the $2K copay for PET scan and tomorrow's procedure. Blessings!

Hismones 1/11/25

Life.On.Hold I spent (without specifically timing them) approximately a half day Friday on hold: Insurance, pharmacy, and doctor's office. Still trying to get Orgovyx filled as a 90-day supply. While waiting for responses, I was at least able to paint trim and baseboards in the front entry. The major failing of both insurance and pharmacy was the inability to reach the same person with each call,and there were several calls and online logins that involved them. Added to that was different staff having conflicting information, so that the reason for the delay was difficult to determine. At the end of the day, a pharmacy rep kept me on the line while calling insurance and was able to confirm that my three-year medication approval only applied to one-month supplies from the original pharmacy. This medication requires prior authorization of medical necessity, which means another doctor request for the pharmacy that can fill extended prescriptions. Following my call, the doctor's office hopefully sent clinical documents to the pharmacy...to submit to insurance for approval...to send back to the pharmacy...to call me for payment information...to fill the medication...to send it to me. I have nine days of tablets left, and insurance approval itself can take three days. Thankfully, the end-of-day pharmacy rep gave me her name and extension, and my next call Monday morning is to her to confirm receipt of the doctor's notes and their submission to insurance. Failing that, it's another doctor call. At retirement, coworkers called me a "bulldog" for pursuing tasks to completion, and I'm not planning to quit. My wife and I agree, though, that it would be so easy, especially for patients with limited experience or understanding, to stop the pursuit and work on finding a way to pay the higher cost of short-term prescription fills. Insurance says what I'm asking is available, and I'll do my part to make it so. I'm not sure I could continue the chase if I were working fulltime. So I'll keep calling and pray for more patience.

Hismones 1/10/25

PLEASE (please, please) don't give up on getting the medications you need. Getting my hormone medication (Orgovyx 120 mg) as a 90-day supply rather than a 30-day fill will literally save us $1000 over the two-year course of treatment. But it is taking 12-15 phone calls and hours on hold and we're still not through. My local pharmacies couldn't fill it, but with help from them I found an area pharmacy that can and I called to confirm its being in-network for insurance. My urologist (Jeffrey Applewhite) sent a prescription and that pharmacy got multiple rejections. Following several calls to insurance (Aetna/Express-Scripts), they say they can specially approve to fill it by mail, but need a release from the doctor. So it may come from them instead of the local pharmacy. Am I back to square one? Maybe not, but I have just 11 days of medication left, a little close for mail order filling. I should know something early next week. And don't wait for people to call you back, unless you're in no hurry. It's your health, not theirs, so be your best advocate. And be gentle on the post-call surveys, because the poor people answering the phone have little to no authority to fix anything. And trust God. I'm sure his eyes roll, too, over the shenanigans involved in getting appropriate care. He is still in charge, but don't expect the miracle to come to you without your participation. While you're at it, if you're in the area, enjoy the snow!

Hismones 1/08/25

Maybe it is okay to pray for healing. I was at www.milestonechurch.com 's Prepare event this evening,and the speaker commented that while God's character and personality are unchanging, his actions are unpredictable. On a couple of occasions, Jesus healed everyone who came to him; on another, he must have stepped over or around people hoping for healing at a pool in order to heal one. In the Old Testament, King Hezekiah learned he had a terminal illness but cried out to God and was given another 15 years. God doesn't change,but he can change his mind, or our prayers would be meaningless. Any healing is temporary: Jesus resurrected Jairus' daughter and Lazarus, but both died eventually. Until he returns, we have to leave this life behind to join him. Jesus most often healed to prove a point,that he was authorized to forgive sins and that everything he did was to bring glory to God his Father. So I will pray for healing and, like Jesus's prayer that last night in the Garden, trust that God knows and will do the best for me but ultimately to fulfill his purposes and that he receives glory. Another aspect of prayer: how may I pray for you? One of the unique practices that Fred "Mr." Rogers had was to ask those enduring illness and disease to pray for him, because he believed they were in closer relationship to God due to those challenges. I expect that I'll be spending more time in prayer and will be honored to join you in praying for whatever is especially important to you. Depending on your desire for privacy, you're welcome to contact me through FB Messenger or jimekrut@gmail.com. Blessings!

Hismones 01/05/25

Happy New Year! We just returned January 2 from a week in Kentucky visiting Tammy's family and then enjoyed a late Christmas with our girls and grands yesterday. God and family are so good, loving, and generous. I learned some important information this week from a friend who has been treated twice for prostate cancer: PSA doean't have to be so high in order to warrant checking. His never exceeded 4.x whereas mine passed 6 before biopsy and diagnosis. My results passed 4 in 2023, an increase of 2 points from 2022. Had I received a biopsy then, treatment might have been simpler. Caveat emptor! I have to get stricter with diet now. I lost weight during 2020-21 to avoid entering the diabetic blood sugar range, but have gained half of that back. Obesity significantly increases the likelihood of a second cancer later, and weight can increase during hormone therapy, so it's time to crank down. I appreciate Tammy's support and help by making healthier food choices available. Tuesday will be two weeks taking Orgovyx, and typically it's a time of reaching full effectiveness of the medication. I'm not experiencing any major side effects, but there may be a little more fatigue settling in. My current prayer is not for healing, although I believe that will take place (or at least the radiation oncologist seems to think so!), but rather to claim the Scripture from John 9, that the blind man's condition was "that the works of God might be displayed in him." I want to live and express hope and confidence in God and to help others find God for themselves. Other than Jesus, my Bible heroes are Daniel and his three friends, with a favorite passage being Daniel 3 in which they declare allegiance to God regardless the outcome. Some area churches are having new year's emphases on fasting and prayer. I am scheduling to attend services this week, but rather than a complete food fast, I plan to follow my initial weight loss diet strictly. Despite some inconvenience, I will feel better quickly. I have a treadmill test this week to verify heart health. The "gel pillow" surgical procedure is January 21, and then radiation begins soon afterward. All the best!