August 27th, 2009:

For the past week or so, walking has become increasingly difficult. On Monday, as I began walking down Market St to lunch at the Ferry Plaza, my hip was really not wanting to move in any direction. It hurt. I tried walking slower, but still, the effort seemed larger and more ponderous than I'd experienced before. These days I always carry morphine in case I need break through pain relief. On Monday, I didn't take the morphine, I just kept walking. Bad idea. The pain did not let up for a couple of hours. By then, I had dosed myself with four morphine sulphates and presently, I felt a lot better. For those who have never taken morphine before, I can attest that it does not create dopiness. At least not for me.

This Wednesday, Eileen Lemus and I were at the UCSF Oncology Clinic for the first appointment with Dr. Jahan in some seven weeks. The only thing I had to report was the difficulty in walking and the increasing role of morphine for some days. He was totally supportive of taking morphine as much as needed. As he said: "That's what it's for." Meaning, immediate pain relief, when required. So, I will work with myself to be more enthusiastic about taking the pills. I know how much I like the results.

Additionally, Dr. Jahan asked if I'd be interested in talking with Dr. Alex Gottshalk, a radiologist who I had met last Fall when we were originally considering surgery for my pelvic tumor. "Radiology might shrink some of the tumor?" I asked. "And give you several months of relief," Dr. Jahan added.

Well sure! What possible harm in talking about getting more months of walking? That possibility of prophylactic radiation raised my spirits immediately. Dr. Jahan cautioned that radiology in the perineum and pelvis is extremely touchy because that part of the body is packed with vital organs and passages. I would not want to burn any tissue that would cause discomfort or damage during the last months of my life. Still, Dr. Gottshalk is a real pro. He and the other surgeons originally decided not to operate on me because the odds were too great that vital pelvic organs would be either removed or compromised. We are talking tissue that you don't want to try living without such as the prostate, the rectum, urethra, bladder, etc. It's not that those organs are infected with cancer, but they are so close to the cancer that the doctors would want to take them or parts of them as well. My quality of life would plummet. Don't want that.

This is the first time in six months that I've considered medical treatment, and frankly, I'm excited. I'll keep you posted about the visit to Dr. Gottshalk. For sure there will be new scans to determine how much the cancer has grown. Additionally, there will be the doctor's evaluation of what parts of the tumor he might radiate, which parts not. Or, as happened last Fall, he may send me home with no plan of tumor reduction. That could happen as well. But the hope to walk for more months is a powerful lure. Yes, yes, let's talk.