Tuesday, July 23, 2013

Premature Good News 5/20/13

 
The following was sent on 5/20/13 after having recieved an initial clear report.
Well I have some good news to share tonight: my cancer hasn’t spread to the lymphatic system. This is good news; it’s great news. It means that I’ll have to cancel my early retirement party, round the world tour and as my dad would say, I can resume buying green bananas. Of course, not all is clear sailing. While this is among the best possible results from the surgery, the tumor was bigger than they thought, it seems to have grown from the time I had my first appointment with my surgeon until I actually had my surgery and I’m definitely a stage IIB which confirms my original concerns.
Stage IIb has 5 year survival rates of around 70% and 10 year survival rates of 57%. So while I’m not stage IIIb and the cancer looks to have been fully cut off my body for now, with melanoma you’re never out of the woods. In fact it is one of the only types of cancer that not only has no cure, but also continues to have increasingly worse survival odds the farther out you go in time. With many/most cancers, once you’re cancer free for some period of time, say five years, you’re considered cured as the odds that it comes back become so small as to be insignificant. Not so with melanoma. The odds of it returning are greater in the first five years than in years 6-10, which are in turn greater than years 11-15, so the longer you go the more secure you can feel, but the risk is still there and most docs won’t ever declare you cured of melanoma like they would with most other types of cancer. As one doc put it, you will know you were cured of melanoma when you die from something else! That actually made me laugh when I read it…got to find humor where you can.
I haven’t yet actually talked to my surgeon about the pathology report yet, the nurse was just forwarding it to me to read for myself but she hadn’t had a chance to talk with Dr. Byrd about it. She didn’t want to give the all-clear sound because she couldn’t tell if the margins were large enough. I guess I’ll hear from her again tomorrow about this. Theoretically, if the margins are inadequate, I’ll have to go back for more surgery which would entail taking out more tissue followed by reconstructive surgery and skin grafts by a plastic surgery.
During the past surgery Dr. Byrd came out and told Jamie that he might have severed a nerve to my face which would have resulted in me with a limp/paralyzed cheek and mouth on one side. Jamie didn’t know until seeing me in the recovery room if this had indeed happened. The prospect of them digging around again and doing what Dr. Byrd had previously described as “major reconstructive surgery” doesn’t sound appealing. My bet is that I won’t need more surgery but I guess I won’t know for sure until tomorrow. If you don’t hear from me tomorrow about it, then assume I’m in the clear.
All in all I feel much better today. Regardless of the statistics, you have to plan on being alive. I don’t see how sitting around expecting the worst will help anything. However, I also don’t view this as over or behind me either...that seems to be simply a naïve assumption as well. I feel comfortable with the ambivalence, with living in the tension of perhaps having a long normal life or maybe dying in the next few years.
This seems to be a very healthy place to be, indeed I consider it a gift. Rather than being allowed to exist with the illusion that I’ll live forever, I get to have a constant reminder that our time here isn’t permanent and to hold it with open hands. Rather than being allowed to have a stranglehold on life and a fear of one day no longer having a pulse, I get to regularly have a gentle nudge to let go of being alive here and as a result be fully alive while I am here. As my spiritual father puts it, “die before you die”.
Surgery was a much bigger deal than I thought it would be. Going into it I was in a great state of mind and spirit and really felt quite strong. But since then this past week has seen a much larger range of emotions as I’ve also felt exhausted, frail, down, very stressed, and depressed. I think that it felt like as much letting go as one can do, as much as one can live with open hands and an open heart, we end up being taken to new depths where we are shown where we have even more work to do.
This past week was an experience in having to let go…ever more and yet again. Letting go is certainly not a onetime affair, it is a process as well as a posture, and it is never mastered no matter how long we practice it. I feel fortunate to again be taken to a place where I’m in over my head, a place of powerlessness where I must rely on love, grace, and on the support of all of you. I feel fortunate to be able to have been shown a few more places where I need to release my grasping for control, for power, for my ability to impose my will. Sensing one’s lostness is an important place on the journey of being deeply found, I think it always must predicate new depths of development almost by definition.
I did have some great moments in the last week as I got to spend some quality time with Burch delivering gravel to a rental property, fishing, and buying an old 1989 Ford F150 for projects on our new Greenwood home which we’re enjoying. Jamie has absolutely blown me away with her love, strength and energy through this whole thing and I have felt tremendously lucky to have her on my side. But I’ve also been short tempered with all the kids at times, had to apologize to Truss for over-reacting to his not being a full grown man already, and have felt stressed over insignificant things that shouldn’t bother me. Ah well, failing is part of life. My struggles to be the kind of father I wish to be will never be over.
Thanks for all your love, support, prayers, thoughts, calls, etc. I don’t know what the next steps are…(likely it will be monitoring and hoping that it doesn’t reappear) but whatever happens I know I’m not alone in this adventure and for that I’m very grateful.

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