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Showing posts from 2009

The Hobson Saddle

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I held out for almost two months. That's pretty good. I just couldn't stand it any longer. I needed to ride my bike. I was told no riding any straddle type things (bicycles, motorcycles, horses, certain bar stools) for three months and I promised myself I would follow doctor's orders. But it's been tough. Gorgeous weather, boredom, sad looking bike in the barn, it all takes a toll on a guy.

I figured if I was going to void the warranty on my prostate surgery, I was at least going to be careful about it. Some research on some cycling blogs, particularly crazyguyonabike.com led me to try a Hobson saddle. This is one of a relatively few "alternative" saddle designs out there that popped up during the whole "BICYCLE SADDLES MAKE YOU STERILE" craze back in '02. It's basically two pads that support your butt and no horn to put pressure on nerves or the pelvic bone. I tried it on the bike on a stationary trainer for about half an hour last Saturday …

Recap

It's coming up on two months since my surgery. In some ways the time has flown by. In others it feels like I'm still in the hospital, except without the morphine which kind of sucks.

So much of the detail is already fading away. There are a few things I've learned I want to share for anyone who might be going through this before they slip away completely.

When you start the laxative routine the day before surgery, plan on staying close to your toilet for the next 8 hours or more. I'm sure it's different for different folks but it took maybe two hours for it to start working and I was expelling waste from 3pm until midnight and had two more trips to the bathroom Wednesday morning. There were probably snacks from the 70's I was getting rid of.

Drink a lot of liquids. The laxatives are dehydrating you like crazy, as do the antibiotics. I suspect that going into surgery hydrated helps everything afterward. Also, they don't give you coffee in the hospital. So if y…

Addams Family Values

Vincent and I were having lunch last week and he asked me one of those questions that was probably lurking for years waiting to spring on me and remind me that I talk too much. He asked me what I meant when I said that Carolyn and I base our marriage on the movie "Addams Family Values", an observation I make on a pretty regular basis.

I have to admit, I didn't have a particularly good answer off the top of my head. It's one of those things we say to newly married friends or people who wonder at our 23 years together. We'll also say things like: "The booze helps!" when asked about our longevity as a couple and I'd never given that much thought either. So why do we say such things?

I almost hate to think about it too much. We don't spend much time thinking about the mechanics of our marriage or why we do and say certain things. Just as your peripheral vision is sharper than your direct stare, sometimes it's best to keep looking ahead and let the…

Incontinence Part III

...And then I lost bladder control. A little. They warned me this might happen. I think after the catheter was out, my muscles, once encouraged to get back to work, stayed in clench mode for the better part of a week. When they finally began to relax, some weakness began to manifest itself when sneezing or coughing.

That was a week ago. Since then, I've become something of an expert on male pads. Thanks to some good advice from one of Carolyn's coworkers who went through this last year, I've learned that the Serenity brand of pads for men seems to be the best. The Depend diapers certainly did the job, but were overkill for the small amount of leakage I seem to be suffering. If I was looking at a weekend pub crawl or a cross country stalker drive, I might consider them. Carolyn bought me a package of "Prevail" brand male pads. They worked just fine too. My only complaints were they were a bit bulky and the name made it sound like I was fighting a protracted trench…

Choices

During the drive in to get the catheter out, we talked about the near miraculous results of the robotic surgical procedure. We wondered why anyone would submit to open abdominal surgery at all? I suppose at one level, you have a large entrenched base of surgeons used to doing this procedure a certain way. To change that requires not only additional training but frequent access to a robotic system that must be insanely expensive and in high demand. It also struck me that robots are very good at doing precise things in predictable environments . How the system would work with someone who was, say, morbidly obese or had had previous surgery that left scarring inside, is beyond me.

While we were waiting in the doctor's office, almost on cue, a really overweight man arrived for an appointment. He must have been somewhere north of 350 lbs and I'm guessing in his late 60's. A very nice guy with a good sense of humor, he was nonetheless, in terrible physical distress. His breathing…

Incontinence Part II

By the time we got home, the uncontrolled laughter and urination had subsided and I felt pretty nasty. I changed out of the really soaked diaper and showered. I spent my first catheter-free night wearing a diaper. Seemed sensible after the leaky day. Not comfortable. The plastic gets so sweaty it actually fooled me into thinking I had filled it up. I'm down in the bathroom at 3 in the morning earnestly pinching the absorbent pad and wondering why it wasn't wet. I spent the rest of the night wondering how an otherwise sane man would end up doing such a thing.

In the morning the diaper looked dry so I got brave and tried shifting to a pad. Way more comfortable though at night it was still strange, like having a few wadded up baggies stuffed between your legs. Amazingly, I seemed to be getting bladder control back. Sneezing tended to yield some unfortunate results and I had to concentrate a bit when standing up or sitting down. By Thursday I was going commando. At least I was goi…

Incontinence

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Leaving the doctor's office began what might be the most difficult part of this process. Thus far the improvements have been coming very quickly. I'm one week from check-in at the hospital and I'm walking around bag and tube free. I can climb stairs and stay on my feet for long stretches of time. I'm sleeping a good deal but I have a lot of energy. From here on out, we're waiting for my insides to heal - hence the bicycling ban for 3 months. There's no way to remove the prostate surgically without traumatizing the muscles that control bladder functions. Only one in four men have full control of their bladders at this point in recovery. Sadly, I'm not one of them. I'm sporting a pair of Depend man-diapers as we head off for lunch at the Daily Cafe in the Pearl District.

I'd like to say a few things here about incontinence. It plays a lot on our subconscious. We were taught as infants that it's bad to wet your pants. When our parents finally toile…

Back to the Doctor's

Between Friday and Tuesday I got used to having a catheter. I didn't travel from home during that time. I was happy wandering around the house in my shorts with my bag taped to my leg.

I had a night bag that looked like it could hold a couple super-sized big gulps. That hung off the side of the bed and meant I had no late night trips to the bathroom. The smaller day bag was attached to my leg and needed to be emptied every 3 or 4 hours. A few days of changing and emptying bags and you settle right in to the routine. I stopped being squeamish about having a rubber hose coming out of the end of my penis and went to great lengths to keep everything clean to prevent infection. They gave me oxycodone for pain but the only real discomfort I had were frequent bladder spasms and occasional cramping. Really quite manageable. I'm still on pretty heavy antibiotics to reduce possible infections related to the catheter so I tapered off the pain meds. One or two at night and one or two dur…

Seepage

So I'm on the phone to my step-mother yesterday morning when I feel something wet on my left side. I do a quick mental inventory of bodily orifices that might cause this to happen. Am I drooling? No, shirt's dry. Sweating alot in one place? Nope, I'm sitting at my desk not working up much of a sweat at all. Have I just wet myself (again)? A quick check of the plumbing indicated all was sound. OK, I'm going to have to concentrate on this. I said good-bye to Joan, hung up the phone and took my shirt off. The moisture had thoroughly soaked my left side and it appeared to be coming from under the 2"x2" gauze covering the incision that used to hold the drain. It looked like around a cup of tea colored liquid had escaped my abdomen and poured down my leg. All I could muster was "Ew, Gross!" but coming from a guy with a bag of urine taped to his leg, that's really saying something.

This wasn't on any of my lists of things to look forward to after pr…

Say Hello to my Little Friend!

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I'm home now and I have a bag of urine strapped to my leg.

For the definitive description of what it feels like to have a bag of urine attached to your leg, Listen to David Sedaris' wonderful description of the "Stadium Pal". But bear in mind, David wore his under slacks.

I'm sure many of you are thinking "Dude! put some long pants on! Nobody wants to see that!" I can see your point. You probably didn't want to start your day looking at this. It's not really something one would strap to the outside of ones slacks (Say, wait a minute...).

No, credit for rockin' the catheter with shorts goes entirely to my father-in-law. His last experience with one began with it leaking on the way home, soaking his pants leg, and his announcing to his wife, and probably everyone else in earshot that he was wearing shorts until the damn thing came off.

My experience with a catheter began in the hospital where trained professionals drained mine regularly and I did…

Morning in the cancer wing of Good Samaritan

Where to begin?

The pathology report came back and the cancer was confined to the prostate. It was also more aggressive than they originally thought making the early detection and treatment even more fortunate. What I write now is from the perspective of needing no further treatment.

Walking back from the sky bridge at the end of the hall, I passed a guy who had clearly been through the same procedure I had. Slow shuffles, battery powerred IV units in tow, as we passed each other he asked "Wanna race?" I don't pray very often but I'm praying right now, and with the same conviction I usually reserve for praying that state trooper didn't clock me at 75, that his report was as good as mine.

I'm crying alot. Not great heaving sobs of gratitude though those might be appropriate. I'm tearing up quite a bit. Could be the morphine. I like morphine. It's the bacon of pain killers. Everything is better with it. I had two really great nights of sleep thanks to thos…

Grateful

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...To everyone for their prayers, best wishes, toasts and one chant over a crystal skull and candle.


More anon...

Here We Go!

Time to shower, scrub up and try to sleep a bit. I check in around 5:30 tomorrow morning. They start the operation around 7:30. It's supposed to take two hours or so.

I wish I could think of something profound to say about how I feel. Mostly I feel hungry. And I'm tired of running to the bathroom every 15 minutes. I miss food and my digestive tract.

I'll let you all know when I'm back around.

Dookie

So I popped the laxatives around 2pm and they seemed to work their magic by around 4. Then they worked some more magic around 4:30. More Magic at 5 at which point I figured "There can't be anything left! Let's go for a walk." I really didn't understand that I was only one hour into a 6 hour continual bowel movement.

REI has very clean restrooms. That was our first stop. Why I didn't pack it in and head back to the loft is anyone's guess. "Oh no, it has to be over now. Let's head up to city market and get some fancy cheese to celebrate my recovery".

City market's restroom was not quite as sparkly as REI's, but at least it was private and it was there. By now we're a mile from home and just a few blocks from Trader Joe's. We needed to buy a bar of antibacterial soap as part of our hospital imposed nightly hygene. Off we went.

Trader Joe's had an ok restroom but no soap. By now I had figured out that this walk was a really, rea…

In Portland

We're loaded into Anne's loft. I've checked in to Good Sam and had my blood taken. I have to scrub myself with some antibiotic towel this evening. I'm going to be shiny tomorrow!

Seem to be holding down the laxatives. Can't tell if... Oh. Gotta run.

24 Hours and Counting...

It's 7 am and I'm starting my clear liquid diet for the day. I'm most of the way packed and things are pretty much ready to go. I need to report to the hospital around noon for blood typing and cross matching in case they need to do a transfusion. At around 1 or 2 this afternoon I start my laxative routine with a nice chilled bottle of magnesium citrate and four bisacodyl tablets. At 7 pm I take the first six antibiotic pills (neomycin and metronidazole) to kill everything in my digestive tract. I repeat the routine at 11 pm to kill off whatever survived the first round and then I wait for 6 am to roll around. By the time I get to the hospital, my intestines should be so clean, you could see your reflection in them!

My main concerns are:

I don't space out and pound a bacon double cheeseburger for lunch. Carolyn's already tried to feed me molassas bread.The magnesium citrate doesn't taste as bad as it sounds. The instructions say to drink it as fast as I can "…

Inspiration

My friend Matt Elerding sent me this video yesterday. It's a joyous celebration of human potential. I will never ride like this but I love that someone can. I also love that the video ends with the word "Hope", which is actually the name of a company that makes disc brakes but I'm inclined to take it my own way.

I didn't Photoshop this...

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If I see a copy laying around the operating room, should I be worried?

I'll be honest; I've always hated these books. It's not that the content is bad. It isn't. They can be quite useful. And if you're starting from zero trying to research prostate cancer, I would be doing you a disservice discouraging you from buying this.

It's the packaging. "Prostate Cancer for Retards" wouldn't be any more insulting. The base assumption that we're all stupid really gets on my nerves. People with prostate cancer aren't dumb any more than people who can't figure out pivot tables in Excel are inherently dumb.

These books came into being as a sort of wink and a nod resource for people not baptized in the fire of technology to help them get by in a world that they find foreign. I get that. The chapters led with a funny comic that touched on the topic at hand. I can't imagine what the comics would look like in this book. Have you been to the Dummies we…

The Ashland Watershed

The Friday before the wedding I took a ride around the Ashland watershed. It's around a 25 mile loop that follows the Spring Thaw race long course. It runs roughly the opposite direction of the Cat III course looping up forest road 2060, the Horn Gap trail and around the watershed, intersecting with the Catwalk trail that meets up with Caterpillar and then the BTI.

I used to ride these roads and trails years ago. I think the last time I was on them was maybe 1996 when I was working at the Shakespeare Festival. Unlike most wilderness dirt roads around Oregon, these aren't used primarily for logging. They've been thining the forests here and doing controlled burns for decades so the land has a more diverse ecosystem and is much more interesting to ride through.

The long ride up 2060 was humbling. I could ride it easily enough but I used to interval train on this road and could crest the first summit in 25 minutes from the gate at the bottom. Now it's more like 40 minutes. …

Marriage

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After 18 years together, my sister and Joe decided to get married. It's been a subject of some discussion why two people, with a 14 year old daughter and a comfortable life that suits them, would embrace the crusty old social convention of marriage.

It's a fair question. I haven't asked them directly and I don't plan to. There may be some practical reasons involving inheritance or medical visitation. Carolyn and I married after 15 years together. The impetus was her COBRA running out but that was probably more of an excuse than a reason. The thing is: we were married. In some way, after a decade or two, living together becomes the crusty old social convention and marriage starts to look like the new frontier.

What does it mean to marry after so many years together? Weddings traditionally are the send-off to a life together. A collective well wishing for a future of happiness. Everyone holds their breath and hopes it all works out. About half the time it seems to. A wedd…

Pickett's Charge

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Last weekend we grabbed the big book of cancer, loaded the Golf and headed off to Bend for the Pickett's Charge bike race. It may be the last race I can do before surgery and we needed to go find some sun in the Oregon high desert.

I shouldn't feel as good as I do about beating a 12 year old kid in a bike race but when you're 49 with prostate cancer, you take your glory where you can. I think he beat me at Spring Thaw too so it's high time he learned that payback's a bitch. Get started on that lifetime of disappointment early! I did feel a little bad. He was working hard and reeled me in fair and square on the twisting single track. He did have an annoying trick of yelling "On your left!" as if he was going to pass and I'd look back and he was like 50 feet behind me. I did finally let him by when he actually was on my wheel but he just didn't have the body mass to brute force his way up some of the tricky rock gardens so I ended up hanging on to h…

The Book of Cancer

I pulled up to the gate on our driveway Friday night and found this huge yellow envelope dropped in the driveway. Upon opening it, I found a three ring binder that said "Legacy Cancer Services" in huge letters on the front and spine. Apparently, when you get cancer, you also get one of these binders, sort of like the "Book of the Dead" in Beetlejuice. It takes a kind of big brush approach to cancer lumping prostate, breast, lung, brain and skin cancer together to provide an overview of resources for dealing with your disease. There were some informative pamphlets on prostate cancer stuck in the outer sleeves.

It's a disturbing book. I'm sure there's good intention behind sending it but that intention is buried in the overall weirdness of finding this, unanounced and unexpected, laying in my driveway. Who sent this? It's like being in the book of the month club from Hell. Can't wait for next month's selection.

Meet the Surgeon

The Monday we returned from Spring Thaw I called my doctor's office and let him know I'd made a decision on treatment. He said he'd speak with him the next day to see if he could fit me into his schedule. Within a few days, Dr. Lowe's assistant called me to schedule a meeting on June 1st. That Monday we headed up to Portland for our meeting.

Dr. Lowe seemed a very nice man. He went over the procedure in some detail. We'd be doing "robotic laproscopic surgery". The robot, called a DaVinci is operated by the surgeon at a remote console. They would make 5 small incisions into my abdomen that would allow for the insertion of a drain, camera and the robotic arms. According to the Johns Hopkins website, the procedure would take 3 to 5 hours. The prostate and lymph nodes nearby would be removed, the catheter inserted and, I gather a few things rearranged to make up for the lack of prostate. Most of this was familiar to me. I think Carolyn appreciated the diagrams…

Final Results

The race couldn't have gone better. I beat my sister by 7 minutes, finishing 18th out of 61 riders and 7th in my age bracket. I came in 58:21 so I broke an hour, my personal goal. Mallory beat my time last year by 5 minutes so she beat her personal goal and Joe finished 5th in his category which made him grumpy but there was free beer after the race so he couldn't be unhappy for long. We spent a lazy afternoon in the park soaking up the sun and catching the odd piece of swag thrown our way. Didn't win anything big in the raffle. Maddie got a huge bucket of Heed energy drink and a Jones Bicycles t-shirt.

The evening was spent gathering morels and barbecuing steaks for dinner. It ended with Mallory and Joe asleep and Carolyn, Maddie and I sprawled on the sofa watching "Hot Fuzz". The perfect family vacation.

Before heading north, we spent some time sitting on the porch talking about my treatment. After some discussion to check my logic, I was ready to make the call. …

Race Day

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Sunny, warm, Saturday was perfect for racing! We piled into Mallory and Joe's Westy and headed down the hill to the starting line. The Spring Thaw is a pretty big race, drawing around 400 riders from around the Northwest. Saturday is the cross country, Sunday the Downhill. Cat III riders were off first. Mallory, her friend Amy and I lined up toward the back of the pack of 61 riders. I notices the woman I was riding with yesterday was lined up close to the front, which surprised me. She was certainly fit, but lacked the sponsor jersey or demeanor of someone who expected to win. She was wearing a simple blue jersey you might wear on an easy Sunday ride. Definitely didn't make a statement.

We had agreed to run our own races today but starting next to my sister seemed important. We were, in the end, doing this together, whenever we finished. The clock started and off we went. There's always a few seconds of standing there if you're in the back, waiting for the pack to get r…

Spring Thaw

What with getting cancer and all, a vacation certainly seemed like it was in order. Heading south to the warmer weather in Ashland to do the Spring Thaw bike race was just the ticket. It's one of my favorites. The cat III course is only nine miles. The support is outstanding and the race finishes in Lithia Park with hours of loafing and free beer!

We stay up at my sister's cabin in the Greensprings about 30 miles from town. It's quiet and beautiful and it was a relief to be off and away.We had a chance to process a bit and talk about what to do next. But first we had a race to run.

Bike racing has turned into something of a family affair for us. Maddie, my niece, guilted me into doing this race a year ago, ending a 12 year hiatus in my riding. Her dad podiums in CAT II pretty regularly and this year my sister decided she could beat me so she joined the fray. Carolyn would have been left at the sidelines except that Maddie was benched following some leg surgery so they cheere…

Ask Me About Erectile Dysfunction!

I have to go into some detail about the inner workings of male genitalia so if you're squeamish about such things, you should read on because without such things, none of us would be here and you should just get over it.

The prostate creates ejaculate which is what the sperm travels in as it makes its merry way toward an awaiting egg, an empty womb, or the ceiling. If you remove the prostate, no more ejaculate. It's still possible to have an orgasm, but it's dry. Removing the prostate, however, is not simple and there's a high possibility that the nerves that control erection can be damaged, leaving the patient unable to have as much fun as he had prior to surgery.

This is apparently a source of enormous anxiety to a lot of men. So much so that my doctor sort of skipped over that last paragraph, muttered something about loss of bladder control and possible problems with erections but there were a lot of things that could be done to help with that including a variety of s…

The Meeting

Carolyn and I finally met the doctor Wednesday evening around 4:30. We waited for around half an hour in the lobby of the McMinnville urology clinic. Waiting seems to be a big part of having cancer. You get someplace and you wait to be told what happens next. When that happens, there's more waiting for results. When all else fails, you're waiting around in lobbies waiting to be told what you're going to be waiting for next.

The McMinnville clinic uses doctors from Portland and, despite the modern building it's housed in, has a decidedly seedy feel. The receptionist's station is covered in unfiled papers, postits, bad art, broken printers, you name it. The doctor's office consisted of some mystery photo of a vintage car, a used steelcase desk with broken formica, a dusty monitor, a couple of chairs, no windows. He clearly didn't live here.

The good news was the bone scan was clear. He gave us a copy of the biopsy report, which was a monument to clear informati…

The Bone Scan

The doctor scheduled a meeting with Carolyn and I the following Wednesday the 13th of May. He really didn't want to say much until he'd looked at the results of my bone scan and could talk with us in person. The whole "don't research online" thing was odd and I pretty much ignored the advice. I think it had to do with an over abundance of content dealing with possible side effects of treatment. I'll come back to that later.

Friday I went in for the bone scan, a radionuclide bone scan, is the proper name . I arrived at the hospital around 8:30 and sat around for a bit waiting to get sent in. It was here I learned one of the first challenges of rural medical care. In a town the size of McMinnville, you can't sit in a hospital waiting room for very long without bumping into someone you know. In my case it was Dave Gilbert, a retired Mass Comm professor. And when you bump into someone in radiology, they pretty quickly figure out something's wrong. So now D…

The Call

Being diagnosed with a potentially fatal disease is one of the cornerstones of the American psyche. We are raised on movies about it. It's the plot point of many television series. We fantasize about what it would be like to tell the world "I'm dying". Those of us who grew up during the Cold War fantasized about being consumed in a nuclear war. We'd have maybe 30 minutes to do whatever and then poof! It's kind of the same thing. It's something that happens to you that you can't prevent, so you have this opportunity to make your last living statement in a fixed time frame, after which it's out of your hands. What would you do? Would you be the same person you always were, only more so? Would you just keep going the same as always? Would you try to make amends for your failures? Would you go all Mr Hyde, living it up, doing and saying all the things you wanted to in life, but didn't out of some moral obligation that's been rendered null and …

Probing Day

Couple of things to put on the table first.

This is going to be graphic. They don't call this the "G-Rated, Happy Fluffy Bunny" procedure. They call it a "Needle Biopsy" with the kind of clinical detachment that only the medical profession could embrace. Even the Spanish Inquisition was more creative when naming devices designed to inflict pain. On the other hand, maybe "The Rack" is just as alarming as "Ratcheted bone dislocation procedure".

If you are a man facing the prospect of a needle biopsy of the prostate, the one thing I want you to take away from this post is this: Ask the urologist if they do a local anesthetic prior to the tissue sampling. If they say no, FIND ANOTHER UROLOGIST. Would you use a dentist that didn't use Novocaine? Apparently, quite a few urologists don't use a local prior to taking the tissue samples. Everyone who told me the procedure was really painful went through it without anesthetic. I had anesthetic. I…

The Mudslinger

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The Mudslinger has a bit of sentimental value to me. I think it was the 3rd mountain bike race I did back in 1988, the first year they ran it, I think. I remember my rear derailleur fell apart a couple miles into the race. I managed to find all the pieces and get it together again but I finished pretty far back. I did the race quite a few times after that and it was always a good time.

The Mudslinger is appropriately named, to say the least. We arrived in rain, rode in mud, and departed in more rain. It was also more fun than I had any right to have the day before a biopsy. I had done this course before, maybe 12 years ago. Familiarity takes some anxiety away. I started fast on the fire road but slowed down after maybe 3 miles to conserve some energy. This time I was riding better. After five or six miles, you start to get a feel for descending in slippery mud. It probably has more in common with snowboarding than cycling. It's counter-intuitive but going fast seems to help. It'…

Horning's Hustle while you wait

My visit with the urologist was April 1st and the biopsy was scheduled for May 4th. So I had a month to kill waiting for "Probing Day". April 5th was Horning's Hustle, a multilap mountain bike race up in North Plains. I don't really care for short course events but this one would be fun to watch and poor Carolyn has spent quite a few hours standing around in parking lots waiting for me to come back from a long out and back course so it seemed like it would be fun for a change. As an added bonus, our friends Anne and Vincent came out to watch so I had a small entourage to cheer me on.

I wish I could say I decimated the field but I'm afraid the opposite was true. There wasn't a huge amount of climbing, or mud or anything, really. But I just couldn't find a pace I could build on. Never seemed to recover from even short climbs. Finished 15th out of 25 in my age bracket. Meh. It was a lovely sunny day and the company was great. Free beer at the finish too, so I…

The Story So Far...

I started this blog in 2006 to talk about the wine my wife and I drank, but I was too drunk to keep it up. Between then and now, I didn't really have much to talk about. I was having fun. I didn't need to share much past the annual Christmas letter. I left those old posts there because they are actually pretty funny. Sort of a "Come on in, the water's great!" ovation from years ago.

I'm kick starting this thing again because I need to talk.

In the last year I started racing mountian bikes again. I lost a lot of weight, got energized in a way I hadn't felt in years, and felt ready to roll into my 50's with life to spare. I still kind of feel that way. Except for that damned PSA screen in March.

"Prostate Specific Antigen", in case you were wondering. It's "controversial" in that the blood test is wrong 75% of the time. It looks for an antigen that has some relationship to the prostate and often does appear elevated when cancer is p…