The verdict is coming

I have made it through the surgery. It went longer than expected, but they were able to remove the testicle in one piece. Of course that meant a larger incision and consequently more staples. The incision is 8 inches long. That length required 12 staples to close it. I am still amazed that this whole procedure was done on an out patient basis. I had surgery at 11:00 am and was home by 2:30pm. I was out of surgery for 30 minutes and they had me up and walking. In times past I would have been hospitalized for 3 days. I was told that walking helps speed the healing process. It turns out that I my case this was true. I was off work for only 2 days. That still amazes me.

Today is the post-op appointment. Today I get the results from the pathology report. I am fairly certain that it is cancer, my urologist told me that he was 95% certain it was cancer, I am just wondering how aggressive this cancer is. I am already shopping for an Oncologist. Once I get the results I will know what direction things will take. It is possible that it had not spread and all of it has been removed. If that is the case I could be done with treatment. If it has spread or it is an aggressive type of cancer then there will be more decisions to make and more treatments to take.

I am at a point where I am tired of the waiting and not knowing. Another part of me is wondering how this is going to affect my moods. I have been all over the map since this started. Depression has been the most prevalent. But there have been moments of mania. So I suspect I am getting into a mixed state. I absolutely despise mixed states. I never truly realize that I am in one. I can see it coming but I never know when it has arrived. To me it is the worst kind on "instability". I just get rocked from one side to the other. I know I am never in tune with it either. At least if I am in tune with my mood I know what to do to help myself. A mixed state brings on all of the worst of the spectrum. It is mixed states where I have attempted suicide. I do know that I have to rely on my support network to keep myself out of harms way. But that does not stop the thoughts. It usually takes a major med adjustment, or perhaps hospitalization this time. Neither are options I like, but to keep on living one will have to be chosen, if not both. Of course I can work myself out of it without any help. Yes I know that is whistling past the graveyard. But at the moment that is the thought running through my brain.

Two hours to go. I have always known that life can change in an instant. In point of fact I have experienced that many times. However I have never known the exact time of that instant before. Perhaps this time the instant will never come.

Stay tuned.

Now the uncertainity begins

I have been diagnosised with testicular cancer. Tomorrow is surgery day. Then the waiting begins. Three to five days for the pathologists report. Then I find out for certain what type of cancer it is. Seminomas or it's faster growing cousin nonseminomas. After that is determined then it is time to find out what stage I am at. Has it spread or not. Then the referral to the oncologist, who will likely order a ct scan to determine what stage the cancer is at. There are three stages. thanks to the National Cancer Institute the stages are detailed below.

Stage one is described in the following section:

Stage 0 (Carcinoma in Situ)

In stage 0, abnormal cells are found in the tiny tubules where the sperm cells begin to develop. These abnormal cells may become cancer and spread into nearby normal tissue. All tumor marker levels are normal. Stage 0 is also called carcinoma in situ.

Stage I

In stage I, cancer has formed. Stage I is divided into stage IA, stage IB, and stage IS and is determined after a radical inguinal orchiectomy is done.

• In stage IA, cancer is in the testicle and epididymis and may have spread to the inner layer of the membrane surrounding the testicle. All tumor marker levels are normal.
• In stage IB, cancer:
  • is in the testicle and the epididymis and has spread to the blood vessels or lymph vessels in the testicle; or
  • has spread to the outer layer of the membrane surrounding the testicle; or
  • is in the spermatic cord or the scrotum and may be in the blood vessels or lymph vessels of the testicle.
  All tumor marker levels are normal.

In stage IS, cancer is found anywhere within the testicle, spermatic cord, or the scrotum and either:

• all tumor marker levels are slightly above normal; or
• one or more tumor marker levels are moderately above normal or high.

Stage two is as follows:

Stage II

Stage II is divided into stage IIA, stage IIB, and stage IIC and is determined after a radical inguinal orchiectomy is done.

• In stage IIA, cancer:
  • is anywhere within the testicle, spermatic cord, or scrotum; and
  • has spread to up to 5 lymph nodes in the abdomen, none larger than 2 centimeters.
  All tumor marker levels are normal or slightly above normal.
• In stage IIB, cancer is anywhere within the testicle, spermatic cord, or scrotum; and either:
  • has spread to up to 5 lymph nodes in the abdomen; at least one of the lymph nodes is larger than 2 centimeters, but none are larger than 5 centimeters; or
  • has spread to more than 5 lymph nodes; the lymph nodes are not larger than 5 centimeters.
  All tumor marker levels are normal or slightly above normal.
• In stage IIC, cancer:
  • is anywhere within the testicle, spermatic cord, or scrotum; and
  • has spread to a lymph node in the abdomen that is larger than 5 centimeters.
  All tumor marker levels are normal or slightly above normal.

And finally Stage 3:

Stage III

Stage III is divided into stage IIIA, stage IIIB, and stage IIIC and is determined after a radical inguinal orchiectomy is done.

• In stage IIIA, cancer:
  • is anywhere within the testicle, spermatic cord, or scrotum; and
  • may have spread to one or more lymph nodes in the abdomen; and
  • has spread to distant lymph nodes or to the lungs.
  Tumor marker levels may range from normal to slightly above normal.
• In stage IIIB, cancer:
  • is anywhere within the testicle, spermatic cord, or scrotum; and
  • may have spread to one or more lymph nodes in the abdomen, to distant lymph nodes, or to the lungs.
  The level of one or more tumor markers is moderately above normal.
• In stage IIIC, cancer:
  • is anywhere within the testicle, spermatic cord, or scrotum; and
  • may have spread to one or more lymph nodes in the abdomen, to distant lymph nodes, or to the lungs.
  The level of one or more tumor markers is high.
  or
  Cancer:
  • is anywhere within the testicle, spermatic cord, or scrotum; and
  • may have spread to one or more lymph nodes in the abdomen; and
  • has not spread to distant lymph nodes or the lung but has spread to other parts of the body.
  Tumor marker levels may range from normal to high.

After the staging is determined then additional treatment options are discussed and decided upon.

This promises to be a journey that I never expected to take. One that I will try to document. If for no other reason than to give me an outlet for what is going on in my life, and how this all affects my moods.

Stay tuned, the journey begins.

On the Outside Looking In

I am beginning to fell like my face is pressed against the window of life. I can see all that is going on but it does not have a direct affect on me. It is a mental seperation for all that is around me. It is getting harder and harder to interact. Human communication eludes me a times. I feel like screaming, but I know the glass is too thick for anyone to hear me. Try as I might, I can not reach the life that is behind the glass.

I go through my day trying to be normal, engaged, responsive. But it is just an act. I know that I am outside the daily flow of life. But the act is a good one, no one suspects.

The thoughts swirl in my brain but I do not let them escape. For I fear that they are not coherent. That my thoughts wil further seperate me from the flow of life. I can not share them with the ones closest to me. I know I can not put them through this downward spiral once again. I fear that the only way to break this glass that seperates me will be a trip to the hospital. That is what I fear the most. In the past I have been able to talk my way out of hospitalization. For I knew it would relieve me of the remaining friends I have on this earth. Additionally if my employer found out, my job would disappear before my eyes.

I do hope that one day the ignorance and stigma of this disease will evaporate. I do dream of a world where I can be who I truly am. A world where having BiPolar Disorder is not the "scary" thing that it is today.

But that day is too far in the future to give me any comfort today. So I continue my little act and pray no one notices, and keep my eyes focused on what is happening beyond the glass.