This morning I stopped in the Urologists office, just to see what condition my condition is in. I have been getting Lupron Depot shots (no relation to Home Depot) every six months since last April, to lower my testosterone and turn me into a eunuch. Also to keep the cancer from spreading. I wish I could say that I have gotten used to the hot flashes and night sweats, and the spells of fatigue, caused by the hormone therapy, but frankly, I am not sure anyone could get used to their body having a mind of its own. It sucked when it first came on, and it still sucks. But I have learned to just get through it when it happens, and not fuss about it too much. I can still work (though much more slowly), and cook, and do my wash, and all the things to take care of myself. I only have a year left of getting Lupron shots, of the two year course originally planned.

The fatigue is the worst. When they first told me, before the radiation treatments, that I would suffer fatigue, I wasn’t really up to speed on just what the word fatigue meant, but figured that being ADHD all my life, it might slow me down some, but nothing I couldn’t handle. And I am handling it. But when you are going along doing things with your life, and all of a sudden you have absolutely no energy, and have to either sit down or you will fall down, it is very startling. And happens unpredictably. I have tried to tie it to natural things, like, was I hot? Did I drink coffee? Should I eat more or eat less? Was I pushing myself too much? It never seems to be related to anything I can logic out. Doesn’t seem to be related to anything I am doing, or eating or drinking, or time of day, or the temperature. Sometimes it follows on the heels of a hot flash, but not always. Fortunately, it rarely lasts more than half an hour. So I rest for a bit, and then get back to work. Some days it happens 2 or 3 times, and some days 6 or 8 times.

2 months ago they had me start taking a pill every morning called abiraterone, a sort of chemo drug, that keeps my testosterone low like the Lupron Depot, but does it differently somehow. And it has to be taken with a low fat breakfast. I have always had issues about breakfast. For years I never ate it. I would wake up, make a cup of coffee, and head out the door to work. Some days I would eat lunch, and some days I would just wait till dinner to eat. I don’t get hungry much. And in the mornings, which I love, eating has not been a part of my enjoyment. But now I have to eat in the morning, whether I like it or not. The abiraterone has the same side effects as the Lupron, so I have not noticed much difference. But both Lupron, and Abiraterone can help bring on osteoporosis, so I have to take calcium pills to hedge my bets about that. And with the Lupron shots, I also get a shot of Prolia, which also helps me hedge against osteoporosis. And I am doing resistance exercises which also help with the osteoporosis. It is always something. Another side effect of hormone manipulation can be liver and kidney damage. Oh goody.

Since I started Abiraterone, they have been taking blood every month, to see if there are any effects with my kidneys and liver. And this morning I asked the doc to tell me the outcome of my blood tests. Liver and kidney function are normal. Yay!

I asked about my PSA level, which they monitor, to see how the testosterone repression is doing. The docs tell me that as long as my PSA is low, I shouldn’t worry about the cancer spreading. A man my age has a normal PSA of between 6 and 7. Before the Abiraterone, my PSA level was down to 0.05 just from the Lupron. Today it was 0.04. So I guess the hormone therapy is working.

Testosterone is not only in charge of my libido, which is all but non-existent these days, but also affects a man’s gumption. I know that is a non-medical term, but that is what it is. If your testosterone is low, so is your desire to get up out of the chair and get on with things. Like going to work. Writing stories. Cooking food to feed yourself. Cutting the grass. It causes the fatigue. So far, I am overcoming that. I am still working, though slower, and cutting the grass, in three sessions, and writing. And if you have been reading my stories, you will know that cooking is something that I love to do, and eating a balanced and delicious supper is something I enjoy doing every day.

All this doctor stuff can get you down, so I try to make it fun, for me and for them. I flirt with the receptionists. I compliment their nailjobs, some of which are amazing. I make jokes when I go in for my appointments. When the medical assistants have to give me a shot, and they get the needle ready, I beg them to please not kill me. If the doctor stutters or is vague on anything, I encourage him to take a refresher course at ACC. (Austin Community College) When leaving, I go to the check out, and say, “Well, how many million dollars do I owe you today?”

Me: Hi! I am here to visit your vampire!

The receptionist: Hi Sam. Conner is waiting to draw your blood. May I see your driver’s license?

Me: What? I have to be able to drive to get my blood taken? When did this become a requirement?

The receptionist: Yes, it is a new law by Governor Abbott. Helping us to have less govt interference in our lives. If you don’t know how to drive a car, or have any traffic tickets, we can’t take your blood. (She has become accustomed to me)

The phlebotomist, Conner, is the best I have ever had. He slips the needle in so smoothly that I don’t even notice it. And he never ever fishes around with the needle, which as you may know, hurts like the dickens. I told him the story of donating blood at a hospital in Mexico once some years ago. My buddy Chava had a daughter who was delivering her first child, and she was anemic, and needed several units of blood. If the hospital gives you blood in Mexico, you have to find someone to pay blood back to them or you can be sent to jail. So Chava came to me one day and asked if I could go give blood for what his daughter had needed.

I had to think about that. In Mexico, as in most of Africa, and probably a lot more places, hospitals are where you go to die. Hospitals in Mexico are full of people who are dying of something and have no other place to go. And those that are not dying, are there because they have some hideous and communicable affliction. And I can’t hold my breath very long. The General Hospital in Reynosa is for the poor people, more functional than pretty, with basic services. I have been there visiting people I knew several times. Dreary pink walls. Flickering fluorescent lights. No A/C. Understaffed. No meal plan, your family has to bring you food while you stay in there. People who come from afar with their sick one, sleep on the ground around the border of the buildings. They have no money for a hotel.

I did not want to see Chava go to jail, and was sure he had asked everybody else he knew already. So I agreed, as long as I could see the nurse take the needle out of the sealed plastic package. It was a hot day, and the hospital was hot and clammy inside, with all the hospital smells of sick people. There must have been a hundred people waiting in the lobby. We skirted by them and went back to where they take blood. I had given blood to the blood bank in Austin many times, and had been in Peace Corps, where they stick you with needles every time you turn around, so being stuck wasn’t a big deal.

I was taken into a very small room with a chair and a big fan on a pole in the corner. The nurse came in, and looked at me, and did a comical doubletake. I guess not many Americans gave blood at the General Hospital of Reynosa. She got ahold of herself, and launched into the preparatory questions just like the ones they ask you in the Blood Bank. Where you have lived. Ever had malaria. Have you shared a needle or been an intravenous drug user. Are you a practicing homosexual. But in Spanish, and in those days, my Spanish was not very good. And she was soft spoken, and had turned the big fan to faster, and set it on the back and forth sweep. So her voice competed with the vwoosh vwooshiing of the fan.

I held up my hand, and asked her to start again, and speak more slowly. She smiled, and began again. It was easier to figure out words that I did not know because I had heard the rap lots of times in English. We got through the questions ok. She handed me the new needle, wrapped in its nice sealed plastic, and I looked it over, and we were ready to go. As she tied off my upper arm, and prepped the needle and stuff and alcoholed where she had found my vein, I started telling her the story of going to visit a hospital in Zanzibar, and finding out afterward that it was a Tuberculosis clinic. She was hanging on to every word of my clumsily told story, and looking in my eyes. I admit it, she was pretty beautiful, so I was looking right back. I came to the end of my short story, and said, “Ok, I am ready. Stick the needle in.” And she laughed and said, “Oh, I finished a minute ago, and just need you to hold this gauze on while I tape it.” And I looked down, and there was a bag of my blood hanging from my chair arm. I never even felt anything. Strong heart, o+ blood, universal donor. When I left the hospital with Chava, we went to a nearby restaurant and I bought a hamburger with all the trimmings, a large order of fries, and a large diet coke, and went back to the hospital, and found the nurse, and gave her supper. Health food for a health practitioner. And thanked her for her skill.

So, the upshot of what condition my condition is in, is I guess I am as good as I can be. The cancer, as aggressive as it is, is in a sort of remission. That is the best I can expect. After the Lupron course is finished, they are talking about adding another oral chemo type drug with the continuation of the Abiraterone. And watching my PSA level. If my PSA level rises, then it is time to complete any bucket list that I have. I have blown through the 30 grand that I raised on my GoFundMe page, and most of my savings. Any more expensive necessities are out of the picture. But I am doin ok.

And you know, that is ok with me. It is not possible to go through what I have gone through, and not think of your life in a bigger picture perspective. I have written stories about my life, and come to see what a lucky boy I am. A chico Afortunado. And I have not a single complaint. Just about everything I have ever really wanted to do, I have already done. Being single after a wonderful marriage gave me the opportunities to have a life like that. Well, I never got to be an astronaut, or a fireman. But pretty much else that I ever wanted to do, I did.

So, basically, it is all gravy from here on in. I have some very tasty jobs on my bid list, that will be fun to build. I have this rich life. My backyard bird feeders provide great entertainment. My truck has a good 100,000 miles left in it, and is paid for. I have good food in my pantry. What do I have to complain about? Nothing. I am living up to what I have been teaching girls for 20 years… YO soy el dueno de mi vida. I am the owner of my life. I make the decisions. All this cancer stuff notwithstanding, I am a happy boy. Who can ask for more than that?

I love mornings 

I love life  

I love my peeps.