The Movember After:

… you might be feeling better, but you’re not “cured” yet:
(c) 2016, Davd

Last Movember i was a selectively frail old man, going to Radiation Treatment over half the days of the month1, and getting more rather than less weak as the month went on. Though modern radiation machines aim the deadly rays more accurately than earlier machinery did, there is damage to the parts of the body near the target tumour, and “cleaning up that damage” puts stress on the body. Until radiation treatment ends, you get weaker, not stronger; and after it ends, your weakness gradually decreases.

Do you get back to where you were before treatment? I probably won’t, because i’m past 70 and was in good physical condition when i was diagnosed. I may get back to being in better than average physical condition for my age—by the time that age is 3-5 years older than when i was diagnosed. For a man in his 70s, that’s not likely to be as good condition as he enjoyed 3-5 years earlier. A man who is in poorer condition when diagnosed, might take up eating and fitness habits that bring him above his condition on the day of diagnosis—but being in poor condition when diagnosed is not hopeful for response to treatment. I’d rather be expecting to get back to something not quite as fit as i was in 2014, than facing the greater risks and lesser hopes of a man who was badly out of shape when diagnosed.)

In Movember 2014, i walked long and fast, most days, and sometimes ran. In Movember 2015, i had the strength to walk Fritz around a block or two, to “relieve himself”. This Movember 2016, i’m walking at a speed, and for distances, intermediate between those two. It’s partly aging, partly being in a town compared to a rural acreage in 2014 and a large city in 2015.

In Movember 2015, Lent began—for me.

The Long, Long Lent:
I got austere advice 13 months ago, when my Radiation Treatment was well begun but far from over; it was not clear to me if i should abstain totally from beer, coffee, and wine, or limit them to less than most people take at one social sitting. The implications for food were even more vague.

I did not have a normal social life, not even for a monk2, last Christmas season.

This advice despite blood tests indicating my liver was OK, my cholesterol count better than the norms, …. I was told, vaguely, that for the remainder of radiation treatment and about three months after it ended, i should consider myself “frail”

By three months after treatment ended, it was officially Lent. I did not keep that Lent with Orthodox strictness, but by Western Church standards, it was Lenten discipline3. It lasted five months, compared to six and a half weeks with Sundays off, for regular Lent4.

It is customary for people to get together with coffee and food. Suddenly, i was to strictly limit both. (I won’t go into detail, because i don’t practice medicine, and my discipline was shaped partly by such facts as an ability to eat one grain-and-legume “meatless meal”, but not three and seldom two, without indigestion.)

I did eat much less beef, more chicken, more beans, and about as much fish as when I lived near the ocean (meaning much more fish than is customary in Alberta.) I ate more beans, peas, and lentils than is usual here, but about the same amount as i’d eaten for years, “for the sake of dietary fibre and variety.”

I also socialized less. I did go food shopping, but not often. I carried nose masks to wear when i was in crowds. I avoided Christmas dinner at my son’s house because one of the household got sick the week before. The purpose wasn’t to pray, study and meditate, as it is for Christian Lent, but the austerity was very similar, and having so much time by myself, i did spend more of it writing, studying, and at prayer, than i likely would have if i’d been free to go about the city.

It would be a good idea to provide men in, and after, Radiation Treatment, with somewhere like a cloister to live; somewhere they could have a quiet social life and a minimal risk of infection while they are frail.

PTSD and Canine Support:
Three GPs have accepted that i did have PTSD (it was treated in 1990-91, back when Movember wasn’t even a word); and have advised that i should take some precautions to protect myself from relapse. Canine Fritz’ company is an important part of those precautions: I was “right” and prudent to being him with me, and would have been even if there were someone in NB who could have given him a good home and who he knew and liked.

Perhaps you nave read, or seen on TV, about the training of dogs to be emotional support for PTSD survivors. I am not the only “PTSD veteran” to have a support dog who he raised himself rather than acquiring from a bureaucracy. (I think it will be more proper if i not name one such man, who got his PTSD in Afghanistan, who i got to know somewhat in N.B.)

I’ve learned that some places will refuse Fritz, and those places are less healthy for me than if he were accepted. I do intend to continue to have Fritz’ beneficial presence in most of my life; and to give him my reciprocal support. Not only do i care about his well-being; it’s also true that the greater his well-being, the more beneficial his effect on me.

PTSD is not rare, and as Afghanistan and Croatia and Rwanda veterans reach middle and old age, there will be many thousands of them coming to places like Cross Cancer Institute for day treatment. I have paid a few thousand dollars more during the past two years, to have him with me—as if he were a luxury rather than a health enhancement. Those men should not have to pay premium rents and other costs to have their support and service dogs with them.

For that matter, PTSD is not the only condition for which canine support is valuable.

It would be a valuable work of charity, to establish a household with several guest rooms, where men coming to a city with support dogs, for treatment, could stay with those dogs in a canine-friendly home5. I doubt a government bureaucracy could do it half as efficiently as a church or men’s charity. Anyone interested?

Recovery and Prognosis:
I walk faster and more comfortably this month, than i did a year ago. I think i can eat a bit more varied diet than i could then; but that’s difficult to assess, because my eating habits are biased toward healthy foods and have been for years. I am convinced i can tolerate more exposure to colds and ‘flu; but again, i don’t go out in crowds much anyway, i’m spending this winter in a town rather than a big city, and i’ve had the ‘flu vaccination.

I’m not as fit as i was in Movember 2014; and very possibly never will be again. Aging entails weakening, and after 70, we weaken more rapidly than before 60. Exercise can help, but “getting back to where i was when i was 40” is a goal that’s probably impossible for men who were in good shape at 40. Even “getting back to where i was when i was 60” or “…70” might well be impossible.

The rule i learned decades ago, in school, was that medicine will say that a cancer is cured if there’s no sign of its return five years after treatment. I haven’t heard nor read of any new rule replacing it. Five years after treatment ended will be early December 2020, and if i’m alive then, i will be 78 years old. That’s neither a very short nor a very long lifespan for a Canadian man born in 1942… nor “American”, Australian, Austrian, British, … Finnish, French, German, Greek, … basically, for a man born in a modern country, who survived World War II.

“All men are mortal” is a slogan that’s thousands of years old. If cancer doesn’t kill me, and plausibly i might survive those criterial five years, then before two more decades are past, something else probably will.

Movember can remind us to look after our health and be regularly checked for silent illness. It can remind us of ways specifically to reduce our risk of cancer. It can’t empower us to live forever.

Not all Christian men look at life as a story. I do; and my story has run much longer by now, than it has left to go. Whether or not my prostate cancer was cured last autumn, I’m in better shape this Movember than last, which seems to indicate the treatment did some good.

Now, cured or not, i have a far shorter time left than i’ve lived so far, to finish the story.

Notes:

1. In addition to weekends, there was no treatment on legal holidays and a few days when the radiation machines were “down for maintenance”.

2. I’ve never been a monk, but for three weeks in 2005, i lived in a monastery “cell”, keeping the same routines and eating the same diet as one.

3. It has been my custom for more than a year—more than three years, as best i recall—to begin the day with the Apostles’ Creed and Lord’s Prayer, slowly and reflectively. Many Roman Catholics have additional Lenten disciplines, but many do not.

4, Lent is “40 days long” an old Anglican priest explained to me, but Sundays are always feast days, so the 40 days take over six weeks to count off.

5. There should be such a household in every large city whose hospitals have day patients.

 

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About Davd

Davd (PhD, 1966) has been a professor, a single father keeping a small commercial herb garden so as to have flexible time for his sons, and editor of _Ecoforestry_. He is a practicing Christian, and in particular an advocate of ecoforestry, self-sufficiency horticulture, and men of all faiths living together "in peace and brotherhood" for the fellowship, the efficiency, and the goodwill that sharing work so often brings.
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