Tag Archives: living with cancer

The Calendar

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I am sitting in the kitchen this Friday morning, June 26th, drinking my morning coffee.  Got back yesterday from spending a few days in KC with the kids and grandkids.  I am still in vacation mode.  I only know what day it is because of the kitchen calendar.  Yes, the calendar.

I find myself looking, no staring often at the calendar.  It was purchased last year while in Alaska.  It has many beautiful pictures.  For the month of June, you see a wonderful picture of a Humpback whale jumping out of the water.  That picture makes me smile.  It takes me back to our adventure and seeing with our own eyes many beautiful places and things.  Including whales jumping out of the water.  The beauty of this world.

When I look at the calendar, I also see quite a bit of writing.  Like most people our lives are somewhat controlled by what is written on the calendar.  Some things are written in pencil, and others in ink.  What is on my calendar tells me where I will be going and doing.  What is on my refrigerator tells me where I have been and what I’ve done.

As I sit here drinking my coffee looking at that whale on the calendar, I can also see the writing on the calendar.  Now I cannot read it from where I sit.  Damn bifocals.  But I know what is on the calendar.

Most of what is on my calendar these days are medical appointments.  A few are for Christy.  Most are mine.   My months are full of medical appointments, and June has been a busy month.  July and August will be repeats of June.  Probably busier.  A few of those appointments are already on the calendar.  

I have two surgeries on the calendar in July and most likely a third surgery in August.  One is a back surgery the others are cancer related.   A couple of those Humpty Dumpty surgeries.  I am going to be home a while.  I guess if I cannot travel, they might as well do some cutting.  I hear that parts are parts, but I wish they could use original manufacturer parts.  I do not want to do anything to ruin the warranty on this great body of mine.  Back in the day.  Many calendars ago.

A guy called and told me that his records showed that the warranty on my car was expired.  I told him it was not my car I was worried about, but I could sure use a warranty on my body.  I explained that I was a classic 1959 model.  Had all the extras you know.  I just needed a little tune up to get that varoom back.  He hung up on me.  That is okay, because right now I have no room on my calendar for any other appointments.

The calendar does more than organize my days, weeks, and months.  Birthdays, anniversaries and other important dates are found on the calendar.  It reminds me to ask Christy if she sent my mother a birthday card.  I do not know what I would do if I were not married.  Probably miss a few birthdays. Also starve.  

What is not marked on the calendar is that I am now starting year six with Brutus.  It is this time of year where I try to reassess my situation.  Where I am at.  A review of my disease.  Right now, things are not going my way.  Improvement will be coming.  I think.  Here is a refresher along with some new information.

You know the story.  When I was first diagnosed my medical team thought that things would be fine.  We later learned that things were not as good as originally thought.  About a year and a half after my diagnosis I had surgery.  A few months later I was told that I could not be fixed.  That my disease had spread and that I was not curable.

After my advanced disease diagnosis, I wanted to know my prognosis.  My medical team did not like talking about my prognosis.  I often heard that my life expectancy would depend on how well I responded to treatment.

I did not like that answer.  That was the play it safe answer.  They had a good idea of my timeline.  I wanted no bullshit.  How was I going to plan for things if I did not know?

This is what I learned.

My prognosis has two numbers.  The numbers were low and just a little higher.  Damn!    

Six to nine years.  My second urologist said that he had a few patients like me who had survived ten years.  He said nothing about any of his patients like me surviving longer.  Damn!

At that time, the prognosis did not mean that much to me.  Nine years, well that is a long time.  That would give them plenty of time to find something that would fix me.  Well that has not happened.  So, I am now thinking that nine years is not long enough. 

My timeline has not changed.  I was hoping that everything we have done would expand my timeline out beyond those nine years.  That does not appear to be what has happened.  Hopefully, the treatments, surgeries, and poisons have pushed me closer to the nine.  I do realize that if we had not done anything that I would most likely not be here today.  My medical team has given me time.  I have seen more days, weeks, months, and years.  I have used a few calendars.

Now I just said that my timeline has not changed, but in a way it has.  My timeline is now one to four years.  I think I would rather say that my prognosis is twelve to forty-eight.  Now that sounds better to me.  

Things are getting serious.  Well I guess they always were, but I could put my disease in the background.  Brutus now has more of my attention. 

As I explained in a past essay that at this stage of my disease it is the doubling time that is the best indicator of life expectancy.  My doubling time has not improved and remains just under four months.  If the doubling time does not improve, well that tells me that I will most likely not maximize my timeline.  

The life expectancy of a man with my doubling time is around six years.  I hope that my 1959 body can find the varoom to prove them wrong.  But I would be lying if I told you that I was not concerned. 

I think of a comment made by my current urologist when we first met.  He could tell that I was feeling good.  He let me know that my disease could blow up at any time so I should enjoy these good times while I could.  He told me that they would not last. 

What I have just shared with you not many people besides Christy and the kids know.   I have tried to stay away from this conversation.  Thankfully not many people have asked.  Usually when someone has asked, I have told them, “Who knows?”  

I have debated with myself if I would ever share this information while living.  Or if it would show up in one of the A.D. essays.  

I feel that sometimes I pull back and do not share my feelings the way I had first intended when I started this blog. I worry about upsetting people.  I do not want to make you feel bad.

Just remember what I say here stays here.  We will not talk about it in person.  It is much easier to say these things to the internet.  Not knowing who reads these essays makes it easier.

I hope that my ramblings will make some sense.  Putting my thoughts and feelings on paper always helps.  

I have always realized that Brutus would have his day.  It is tough knowing that day is getting closer.

What the calendar is reminding me is that we are getting deeper and deeper into my timeline.  I can no longer tell myself that I have plenty of time.  

The battle of living I am winning and will continue to win.  The battle of life.  Well, that is a different story.   Brutus continues to grow at a fast rate.  My medical team is concerned.  I am worried.  I am scared.  I must believe that things will get better.

I look at it this way and as I have said before I will beat Brutus by living to the fullest.   Enjoying each moment that I have.  I know that one day this will all be over.  But Brutus will not have won.  He will not have won because I am not playing his game.  In my mind living and life are two separate things.  I must think that way or my theory does not work.  I ask what good is life if you cannot live?

As a side note a few people like to point out that I might get hit by a bus before Brutus has his day.  Why so many people use the bus analogy I am not sure.  I do not think that many people die from getting hit by buses.  I have seen men taken out by jealous husbands and boyfriends.  I think that happens more often than getting hit by a bus.  I think that it will be a jealous husband who gets me long before a bus.   Just kidding…maybe.  

Christy is not worried.  She asks me what woman would want a 60-year-old man with cancer.  She has a point there.  She is a smart lady.  She married me.  Well I guess everyone is allowed one fuck up in their life. 

Hope you laughed.  I needed a break.  Now back to the not so funny.

I think at times I get a little depressed.  Christy says that I am more than a little depressed.  I try to hide it.

I am not sure if I am now more depressed because of my timeline.  I find that to be just a little depressing.  

Am I more depressed because the coronavirus has cancelled many of my travel plans and I realize that I do not have extra years to do the things I wanted?  That too is a little depressing.  But I would give up my travel plans if the virus would stop killing people.  Damn virus!  Damn Brutus!

I hope to be able to again travel with Camden.  He loves trains.  We build tracks and play trains all the time.  He loves watching trains.

I talked to him about one day getting on the train in KC and going to St. Louis.  Making a few stops in between.  In St. Louis we would of course see a Cards game.  I have talked to him about that trip.  He got extremely excited and gave me a big hug.

I want to make that train trip.  I want to make that trip more than going to New York, New Orleans, Spring Training, fishing off the coast of Alabama, or going anywhere else.  I want to be with the little man.  I want that trip on the calendar. 

When I feel comfortable traveling again, I will hit the road.  The dates will be written on the calendar.

I have finished my third cup of coffee this morning.  So now I feel that I need to go write down some of these ideas before they disappear.

Before getting up from the table I want to take a few more moments to again look at that whale on my calendar.  I see a strong beautiful animal having fun enjoying living.  Not worried about the obstacles of life but enjoying the moment.  We should all do the same.

In a few days I will flip the page of the calendar to July.  I will have the surgeries and make all the doctor appointments.  The calendar is incredibly good in helping me keep track of where I need to be and when.  The calendar does more than that.  It motivates me.  It gives me an urgency that I might not otherwise have.

I do not know what the future holds.  I do not know what the next twelve, thirty, or forty-eight months will bring.  Good things, I hope.  I am prepared to make lemonade out of life’s lemons.  Hopefully, we can share a glass.  I would like to put that on my calendar.

After reading this do me a favor.  Look at your calendar.  What do you see?  Cross some of that shit out and add some play dates.  Live with some urgency.  Be that whale.  Jump out of the water and shine.

Oh, and if you are in the kitchen looking at the calendar treat yourself to a bowl of chocolate ice cream.  Enjoy!

Kevin 

Are You Sure About That?

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Hello Neighbors!  Yes, I have seen the Mr. Rogers movie.  I liked it and if you have not seen it, I would recommend it.  I give it a five donut rating out of five. Cops rate things on a donut scale.  

I am certain about that rating.  Not sure that I am certain about anything else.  The cancer world is so uncertain. One day you think you have the answers and things figured out, but you soon learn that you do not. 

It has been around three months or so since the last post.  It is not that I don’t have anything to talk about. Many things have happened.  I have just not felt like addressing them. But recently I have been getting text messages asking how I am doing.  People are asking Christy at work. I even got a postcard in the mail from my friend Cindy. Getting a postcard tells me that it is time to talk.

I have been out and about on different adventures and often meet up with friends.  Sometimes it is just for lunch other times we go on adventures together.  

I enjoy my travels and visiting with friends.  I also enjoy making new friends. You know that sometimes when I travel I might stop at a Dairy Queen or two, or more.  Who knew they had so many Dairy Queens off of I-70 in western Kansas. I gained a few pounds on that trip.  

Often I travel alone and when I stop at a restaurant, a rest stop, or even on the highway itself, I will often strike up a conversation with someone.  

I have had a few conversations along the side of the highway with new friends.  It is funny that they all had the same name. Who knew that Trooper was such a popular name?   I have met Trooper Williams, Trooper Johnson, Trooper … you get the picture. I still have a license… for now.  

One of my new friends asked me how fast I was going.  I told him that I was not sure. He told me how fast I was going.  I asked him if he was sure about that. He was. I said something like, “You know sometimes you just gotta let them ponies run!”  Remind me to tell you how that ended when I see you. Long story, but Camden my advice is that you remember to take bond money on your adventures. 

What motivates me to go out and hit the road?  Well you know the answer to that. It is Brutus.  

Brutus thinks that he is going to kill me.  I am not so sure about that. But just in case, I have no desire to sit at home just waiting for it to happen.

I have many places I would like to see. Things I want to do.  Conversations I would like to have.

I have felt urgency since I was told that my cancer was not curable.  I feel that urgency even more now. 

I am hoping that 2020 will be a good travel year.  This weekend I will be in KC for Camden’s fourth birthday party.  I will be back in KC for Adalie’s first birthday party in February.

In April I will be headed back to the White River in Arkansas fishing with friends.  In October I am taking Christy to New York City for a week maybe longer. I have trip ideas for Colorado, Wyoming, Montana, Mississippi, Louisiana, Arkansas, Oklahoma, and of course Missouri during 2020.  We will see how things work out.  

When I am in your area, hopefully we can spend some time together.  I look forward to seeing you.

Man it just does not seem possible that Camden will be four and Adalie one.  Time goes by so fast. It goes by even faster when you want it to stand still.  

This summer it will be five years since my cancer diagnosis.  I remember many of those days like they were yesterday. Or at least like last week.  I had a medical appointment last week. I see my urologist in a couple of days. Oh boy, fun, fun.

Anyway I want to update you on what we have learned and what the future might bring.  In order to do that I would like to step back and explain a few things from the past. I might have mentioned some of these issues before, but I am going to touch on them again.  It will be a good review and helps me explain where we are at in this process.    

I would like to go over four things that I think are very important for someone dealing with prostate cancer or PC for short.  

  • The first being how the cancer was diagnosed
  • The second is the Gleason Score reported by the pathologist after the biopsy.
  • The third is how you respond to curative treatment.

The fourth concern, and really once you get this far is probably the most important factor in your survival, is the doubling time of the cancer.

Now just remember that I am not a doctor.  But I have spent a night or two at a Holiday Inn.  Or was that a Hilton. Oh well, I was drinking. Anyway I just want to say that these are my thoughts, but I do have a little experience.  Let’s look at each one shall we.

Screening or Symptoms?

During the early stages of PC a man will have no symptoms.  The only way to discover the early stages of the disease is through testing.  You will find arguments both pro and con from members of the medical community on whether or not men without a family history should be tested early or at all.  Educate yourself. I will flat out tell you that I think every man should be tested at least by age 50, and earlier if you have a family history. If the test is positive, you will have many options.  It may need to be treated, maybe not, but you need to know.

If by chance you go to your doctor displaying several of the symptoms pointing to PC, you are in a bad place.  I will not go over the symptoms; you can Google them. I pretty much had them all. When I approached my primary care doctor with my concerns, he told me I was too young to have PC.  I was in my mid 50’s. He added that I had no family history.   

Well when I learned that in fact I did have a family history, the tests were done.  I had cancer.  

If you have symptoms before being diagnosed you most likely have a disease that has metastasized. 

I have seen many doctors over the past four plus years.  When talking to the doctors I have noticed a change in demeanor from a couple of them when they learn that I had symptoms before diagnosis.  They realize that my situation is going to be tough, but they do not want to speak those words. I see it in their faces.

If found early PC is very curable, but when not found early it is not.

Be PC aware and get screened.

Gleason Score

Now I am not going to get all medical on you here, so if you want to learn how they calculate the score you can also look that up. I am trying to keep this essay under 10,000 words.  Really, I am trying.

I just want you to know that the highest number the Gleason Score can be is 10.  It is a number that tells you and your medical team how aggressive your cancer is and what treatment protocols should be considered. Gleason Scores of 8, 9, and 10 are the most aggressive cancers.  These are the cancers that kill.

My Gleason Score is 8.  Damn!

Curative Treatment 

Once you have a Gleason Score you and your medical team can talk about treatment options.  I chose surgery as my curative treatment. I had several reasons for choosing surgery. One was that the gland had gotten so large that it was causing a considerable amount of pain.  I wanted the bastard gone.

The goal of surgery was to remove the cancer and cure me.  Around two months after surgery I was tested to see if any evidence of cancer was present.  What they look for is the presence of a protein that is only produced by the prostate. It is called a prostate-specific antigen, or PSA.     So if your gland is gone you should not have a PSA number. The problem is that prostate cancer cells also produce PSA. They are concerned with any PSA number showing up after surgery, even a fractional number.  If you have a number you still have cancer.

I had a number after surgery.  It was rather high. So high that if I still had a prostate they would want me tested for cancer.  Damn!

My oncologist thought that number could not be accurate.  He had me tested again two weeks later. So I had two tests after surgery, both of which showed a very high PSA.  Damn!  

So we moved onto the second attempt at a cure which would be more than 40 radiation treatments along with hormone therapy.  It is also called androgen deprivation therapy or ADT. The drug used was Lupron.

I loved my radiation oncologist.  We sat down together many times and had long discussions about my disease.  I greatly appreciated the time she took to help me understand what was happening.

She told me that she normally did not radiate men with a PSA number after surgery as high as mine.  I said humor me doc and make those lymph nodes glow. She did.  

When it was all over and the tests were repeated, I again had a number.  The hormone treatments combined with the radiation did not quite work as well as hoped.  They beat Brutus up pretty good, but he got up off the mat. The curative treatments of surgery and radiation did not work.  My cancer was not curable. Damn!

Many men will have a PSA of 0 after curative treatments.  They are cured or have at least gone into remission. If their cancer does return, then how long they were in remission often is an indicator of how well they will do going forward.  

I did not go into remission. I have what they call persistent disease. The outlook for men with persistent disease can be tough. The doctor referred to my disease as being systemic. Whatever the hell that means. Come on doc speak English.  

Dr. O explained that Brutus was in my blood and in my lymph system.  He had spread throughout my body. 

So we decided to aggressively treat the disease using a combination treatment or what I like to   call a drug cocktail. Shaken not stirred please.  

I would stay on the poison Lupron, and I would also take the poison Zytiga along with Prednisone.  Clinical trials have shown men using this protocol had their disease slowed down substantially and I was hoping that I might even see a remission with this combo.  I hoped that the side effects would not be bad.  

I took those drugs as long as I could, but the combo was making me sick.  I no longer wanted to be sick. I told the doc that I was done. When the drugs worked their way out of my body I started feeling so much better.  Now I deal with discomfort from time to time, but that has mostly been manageable.

Doubling Time

The doubling time is how long it takes the PSA to double.  It is the growth rate of untreated disease. Of course you cannot know your doubling time when on treatments.

Since I was off treatments we could track the doubling time.

About six months ago my urologist mentioned that the numbers were rising too fast and we might need to think about going back on treatments.  

Three months ago my urologist told me that it was his advice that I go back on treatments immediately.  The growth of my cancer was too fast.

I agree with the fact that the rate of growth is fast. I see the numbers. I did not agree that I needed to be back on treatments. I told him no.

Once you have been through the curative treatments the doubling time of your PSA is the single best indicator of your prognosis. The PSA number itself is important, but what is even more important is the growth of that number.  

Of course you want your doubling time to be as long as possible.  Some men’s PSA might have a doubling time of years. Others are not so fortunate.

The doctors get very concerned when the doubling time is less than twelve months.  Of course the shorter the doubling time, the more aggressive the disease and the harder it becomes to treat.  My doubling time is three months. Damn!

My medical team is a little concerned.  I figure that sometime Brutus is going to get tired and slow down. At least that is what I hope.  

Now let’s talk about my last visit with my urologist last October.

We talked about the numbers.  We talked about the doubling time.  Then he hit me with it.

U3 told me that I would live longer by going back on treatments now.  I knew that he might be correct. I also knew that he was not telling me the entire story.  I was prepared.  

I knew what the research shows, that yes my survival might increase, but by only a few months.

I explained to the doctor that I understood what he was proposing might extend my life.  IT MIGHT GIVE ME A FEW MORE MONTHS! That was all that it would do.

The doctor replied, “That’s accurate.”

I told the doctor that if he could tell me that going back on treatments now would extend my life for five years, then I would do that. I told him that he could not tell me that. He said nothing.

I know that going back on the treatments will make me sick.  I want to enjoy what I have now for as long as I can. I see no need to be sick now and if things do not turn out well, also be sick at the end.  It is not worth it to me. I told him that I was not taking the drugs. He told me that he understood.  

We will continue to watch my numbers. When it reaches my target number I will go back on treatments.  That is what we agreed on months ago and that is the plan we are sticking with. My doubling time was not going to change my plan.  I told him that I would see him in three months. Which again is now only a couple of days away, but who is counting?

That visit with U3 was not so bad.  I was not looking forward to my visit with my oncologist, Dr. O.  Dr. O never wanted me off treatments. He stopped pushing when he realized that he was not going to change my mind.  I was afraid that he was going to make an “I told you so” kind of statement.

On the afternoon of December 11th, 2019 I sat in Dr. O’s office around 3:00 with a lot on my mind.  But one thing I didn’t bring with me that day was the anxiety that I often feel when in his office.

I started thinking about the wise old urologist, U2.  I was going over in my mind some things that U2 had told me about my cancer.  Most of what he told me has turned out to be very accurate. He never recommended the combination treatments like Dr. O.  He told me that I would never see a remission. He was right. I hope it turns out that he is wrong about some other things he told me.  

One thing I wished he would have done was communicate better with Dr. O.  Hell they did not communicate at all.  

That is one thing that Dr. O and U3 do well.  They share information they have learned from my tests and visits.  When I went to see Dr. O I was afraid that I was going to have to go over point by point with him what I had told U3.  It turns out that I did not have to do that.

I was moved into an exam room and the nurse took my blood pressure.  I do not know why they do that. Sometimes my BP has been so high that I was surprised that they did not walk me over to the ER across the parking lot.

My BP was normal.  It was actually better than normal.  It was the best BP I had seen in years.  Christy slapped me on the leg and commented about how good the reading was.

I did not say anything, but the thought going through my mind was that is what happens when you no longer give a fuck.  When you no longer give a fuck things do not bother you. At that moment I did not give a fuck about Brutus or this meeting.  I was going to listen to the doctor then say what was on my mind and leave. Easy peasy so I thought.

When Dr. O walked into the room the first thing he did was give me my results from his lab.  Like U3’s lab the results showed a very fast doubling time.

He knew what U3 and I had talked about.  He went over most everything point by point.  I did not have to say anything.

What he said next was unexpected and caught me by surprise.  Dr. O said the following:

“Going back on treatments now will not help you.  You will not gain any additional ‘Survivor Benefit’ at all, none what-so-ever.   The only thing that going back on treatments now is going to do is make you sick.”

As I listened to him he explained that my treatment goals should change.  Going forward the emphasis would be to reduce my discomfort and pain in an attempt to give me the best quality of life possible.  We were done with combination treatments. What that meant to me is no more drug cocktails.  

He talked about going back on hormone treatments when Brutus had reached my target number.  We cannot stop Brutus, but the hormone treatments can slow him down.

Dr. O was describing palliative care or comfort care.  He was no longer advocating what I would call aggressive treatments. 

Once Brutus develops a resistance to the hormone treatment, we will still have other options available.  We will once again revisit the chemo option. Maybe there will be a new immunotherapy option. Right now for men like me, an immunotherapy treatment is not yet available that is very helpful, but several clinical trials are ongoing that might help a person like me.  You never know what will happen in the cancer world tomorrow.

After leaving the doctor’s office my thoughts again took me back to that conversation I had with U2: The no remission conversation.  He told me that he has had patients like me. He said that a few of them survived ten years. I did not ask him how many he considered a few.  I let it be. I understood what he was trying to tell me.

Later I learned that one percent of men like me survive ten years.  When he said “a few” he was not kidding.

The reality of my situation is that I am not well, but I am not sick.  I am happy about that.  

Brutus will try to take away my physical abilities.  He might succeed, but it will not happen today or tomorrow.  In the meantime I have a lot of life I would like to live. What will be, will be.  

I had a conversation recently with my sleep doctor.  No he does not read me bedtimes stories. He did give me a machine that helps me breathe and I do sleep better.  Maybe another day I will go into more detail about that.  

I always enjoy my visits with him.   During our last appointment we talked about the holidays and our families. Then we talked about cancer.

He said that every time he saw me that I had so much energy and such a positive attitude.  He told me that cancer was not going to beat me. Did I mention that he was my favorite doctor?

He is correct.  Cancer will not beat me.  As I have said before, you beat cancer by the way you live. Right now the score is Brutus 0 and Kevin 1,625. 

I am winning.

I Am Sure About That…

Kevin

Survivor?…Don’t Give Up

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I have been asked a time or two about how long it takes me to put together one of my essays. Most of the time it does not take very long, because often I have worked on the idea inside my head for quite some time before putting it on paper. It flows quickly.

Sometimes I am working through an idea and I just write. Throwing mud and seeing what sticks, so to speak.

I also do a lot of writing that you do not see, and probably will never see. I write about what I am thinking and it often just stays in a file on my computer. When I am gone my kids will have them to read. If Erin later wishes to put them on the blog that will be fine. They will be hers to do with what she wishes. This was going to be one of those pieces.

The idea for this essay came to me while preparing for the Zero Prostate Cancer Awareness 5k Run that my doctor’s medical group sponsors each year. The race is run in Wichita on Father’s Day weekend. I think the first time we participated was 2017. In 2018 I wrote some things down, but never finished. I was not sure I was ready to share. The essay stayed in the file to be kept for when I am gone.

I have come back to this essay a few times this year. The last time was in June. Looking over it and adding and subtracting. Each time that I wrote I could not get the piece completed to my satisfaction. I put it away.

Just a few weeks ago my girls and I ran the Zero 5k Prostate Cancer Awareness Run in Kansas City, Kansas. That again got me thinking about this essay. It was time to finish. I decided to take it out of the file.

This piece is a combination of several thoughts that I have edited and turned into one. It has taken awhile. Here we go.

——————————————————————————————————-

Today is Sunday, June 2, 2019, and it is National Cancer Survivors Day. I sometimes feel at odds with the mainstream thinking on the different verbiage used to describe a person with cancer and their “cancer journey.”

My thoughts are that often the words and metaphoric phrases used by non cancer people do not describe me or provide a very good explanation of what I am going through. Often these words or phrases try to minimize what people with cancer are dealing with.

“You got this!”

Well, no. Actually I do not. You can move along now.

I think I understand why these words and phrases have become so popular. They are easy. These are fallback words that people rely on when they do not know what to say. They want to turn a negative into a positive and cheer up their family member or friend. I really do appreciate the effort, but I feel they are often misguided. I think there is a better way.

I will in the future write an essay on talking to someone you care about with cancer. But that is not what this essay is about today. Well maybe it is just a little.

Before moving on to the main topic I will share with you one thing I think is very safe to say to a cancer patient. I would love to hear it myself actually.

“Kevin, your ass sure looks good in those jeans!!”

I have not heard that yet so you could be the first one to tell me. You could lie. I am okay with that. It would cheer me up, and of course make me laugh.

All kidding aside I would now like to talk about just one word that is used often in the cancer world. That word is: Survivor.

Each year that I go to the doctor’s office to pick up everyone’s race packets and gear I am asked if I am a survivor. Survivors are given different shirts so they can be picked out from the crowd. I am not real comfortable with that, but what the hell.

The first year I was picking up the packets that survivor question surprised me. I thought for a moment and I then told the lady that no, I was not a survivor, but that I hoped to be a survivor one day.

She then asked me some other questions and handed me a survivor’s shirt. She told me I was a survivor. She explained that everyone with cancer no matter where they were in their “journey” was considered a cancer survivor. I took the shirt.

I have thought about that conversation a few times. Hence the reason I have started and stopped working on this essay several times.

I realize that many people identify with being a survivor. I am not writing this in an attempt to change their self image. If that works for them, that is great. I will support whatever helps people get through the mental challenge of dealing with cancer. Many people have been cured. They are survivors. I am so, so, happy for them.

I do not feel like a survivor. I do not consider myself a survivor. If someone else wants to call me a survivor, I will not correct them. If I am asked privately I will let them know my thoughts.

To me, something happens and when it is over you have survived. If it does not end you have not yet survived.

I have survived many situations in my life. Sometimes when it is over I wonder how the hell I survived. But I did.

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One November night many years ago a business was being robbed just two blocks from where I was. When I arrived and I approached the business l learned that the robber had just fled and the manager of the business, who had just had a gun held to his head during the robbery, pointed in the direction the robber ran. I had an idea where he might be going. I had arrived so quickly that I thought I had a good chance of finding him.

I pulled down a street that ran in front of an apartment complex. I thought that might be where he was going. Sure enough he emerged from a dark field into the light. He wanted to get to the parking lot where his partner and getaway car waited. What he did not know, and which I later learned, was that when his partner saw me he drove off leaving the bad guy on his own.

I hopped out of my car to confront the bad guy. I forgot to put my car in park. So my car continued to roll down the street. So excuse me bad guy for a second while I hop back into my car and put it in park. Okay that is taken care of and now I can deal with you.

In the bad guy’s mind I was blocking his getaway. He had to go through me.

I was telling the bad guy what I wanted him to do, but he just ignored me. He was walking straight toward me. When he got close enough I reached out and grabbed him. The fight was then on.

Now this man was taller and heavier than me. But that is not unusual. Hell many people are born taller than I am.

When I grabbed him he punched me in my right eye. Thankfully that was before I wore glasses. You do see a big bright light when you get punched in the eye.

The fight I imagine did not last that long. To me it was a long time. We punched and kicked each other. I was having a hard time keeping control of him. What the hell am I saying? I never had control of him. I was just trying to stop him the best I could.

During this fight I knew that one of us was going to get hurt.

I do not know where it came from, but I heard a voice inside my head and this voice spoke to me.

“Kevin! You are going to get shot, but you will not die! Do not give up! Do not let this man get away!”

The fight continued. Then I heard the voice a second time.

“Kevin! You are going to get shot, but you will not die! Do not give up! Do not let this man get away!”

The bad guy started to pull away. I could no longer hold on. Then came the shots.

I do not know what was going through Christy’s mind when the supervisor showed up at our front door. He was there to take her to where I had been taken. He was/is a very good friend of mine. We are neighbors. He lives across the street. I think that made it easier for Christy to be with someone she knew. Thankfully we had family in town visiting who could stay with the kids.

I do not know what Mitch told her. I do not know what they talked about. After all these years we have never talked about that. Maybe one day we will.

In my line of work you live with the knowledge that bad things can happen at any time. It is not something that you constantly talk about with your spouse. We both knew the danger.

When Christy walked into the room she saw that I was okay. We hugged and kissed.

I survived that night. The bad guy died. I am not proud of that. I wish that it never happened. I wish that I could have controlled that situation better.

That confrontation had a beginning and an end. I survived.

I have had three cancer surgeries. I survived.

I have been through radiation. I survived.

I have had poisons injected into my body. I survived.

I have taken pills daily that make me sick. I survived.

But until I am told that my advanced/incurable/terminal cancer is cured then and only then will I consider myself to be a cancer survivor.

Until that happens I am just a man. A man who happens to have cancer, and like most men I am trying to get through each and every day the best I can.

Many mornings as I am putting on my suit or sport coat and tie that voice at times can be heard once again inside my head. This is what he says:

“Kevin you have cancer. But Brutus is not going to take you today. Do not give up.”

With that thought in my mind I straighten my tie and I smile at the man in the mirror. Winston tells me that I am looking sharp and then out the door I go ready to enjoy the day and live my life. Then I ask myself if Christy is happy. Because if she is not happy well you know how that goes.

Winston also told me that my ass looked good in my jeans so I guess you will not be the first to tell me after all. Thanks Winston.

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Recently I was again tested to see what Brutus was doing. If you remember last time I was tested that my doctor, U3, was concerned because Brutus was growing so fast.

I got the results on October 15th. They were not good. Brutus continues to grow at a high velocity. I was concerned what the doctor might say when I saw him the next day. I suspected he was going to tell me that it was time to go back on treatments. Damn!

I saw U3 on October 16th. We had a very informative visit. I informed him on what was going to happen.

I am not going to go into the details today on what happened during our visit. I will soon write an essay about what has been going on and what the next steps are.

The doctor did tell me that it was his advice that I go back on treatments. NOW!

I told the doctor NO. I told him that for now I was not going back on the poisons.   I gave him my reasons and he told me that he understood.

I did not lose that November night and I do not plan on losing to Brutus. As I have said before…how you live your life is how you beat cancer.

In a few days I will be on my way to Kentucky to see my Tigers pound the wildcats in a football game. I hope the Tigers left the team they took to Nashville in Nashville or else I am going to be pissed.

Win or lose it really is not the game itself that is taking me to Lexington. It is the chance to spend time with friends. I want to enjoy my life while I am still feeling good. My doctor gets that.

When I picked up our race packets before the October 6th 5k race in Kansas City I noticed that the forms they had there for me to fill out had a better description on how I see myself. The box I checked had patient/survivor. I think that is more accurate. I feel that there are many people that feel like I feel. They gave me a shirt to indicate that I was a patient/survivor.

After crossing the finish line at that race I was greeted by a woman who congratulated me on running the race. She then congratulated me on being a cancer survivor. It was the shirt. I said thank you.

As I continue down the road with Brutus I do not believe that calling me a cancer survivor is correct. But like I told the lady at my doctor’s office I hope to one day be one. What will be, will be.

No matter what happens I will just have to continue winning each day.

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I have been running basically the same course in my neighborhood for 28 years. I run in the grass because running on hard surfaces causes my Achilles tendinitis to flare up. I know where all the holes are. Occasionally I find a new one.

I run through a church lawn and one day I saw they had a sign in my path. I figured it probably said: Kevin, keep off the grass. It did not.

It said: Don’t Give Up.

Now when I run through the church lawn I reach down and I will touch that sign. I then say to the voice inside my head:

“I Will Not Give Up.”

Kevin

Cancer Patient

This Is “The Place”

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This is “The Place.” Yes it is. Well if not “The Place” then one of the places.

I know you are probably thinking just what the hell is Kevin talking about. I am talking about Table Rock Lake. You know the Great Bambino of all Missouri lakes.

Took a photo of the sunrise over the lake because I like sunrises more than sunsets.

I am not going to debate which of the Missouri lakes is best. Each has its own pluses and minuses. Some would vote Lake of the Ozarks. I can see that. Table Rock does not have a party cove quite like the Party Cove at Lake of the Ozarks. Well except maybe our cove at Table Rock,   but we keep our clothes on. Well at least most of the time. Right, Erin and Megan?

I have chosen Table Rock as the best because of our yearly family vacation there. We have spent a week of vacation there every summer for the past 23 or 24 years…I think? Hell I do not know how long we have been doing this, but it has been a long, long time.

The Brown Family along with the Anderson Family and the Moehring Family have gotten together each year at the lake. There were 23 of us there this year. We keep growing.

Now I will not say that over the years we have not had issues during our time together. I have said in the past that family can be like fish. You know after a few days they start to stink.

Even taking that into consideration I can honestly say that it is a vacation that I look forward to each year. If or when the tradition stops then I will miss this family time together. We have had so much fun and have so many stories.

I have a story about Uncle Barry’s boat sinking in the slip at the dock. I think it was sabotage.

There is the story of Erin and Megan going skinny dipping and a swim suit being washed out into the lake. That was an interesting situation.

There have been a few ER visits over the years. Many fish caught and many stories told about the one that got away.

Many beers drunk, many card games played, many heartfelt conversations had over the years, and many pieces of advice given to nephews and nieces.

Camden! When Uncle Barry said park the boat I do not think he meant there.

My nephew Hayden will be a junior in college this fall. We were talking about his future career plans and he told Erin and I that he planned on being a stay at home dad. Erin explained that he probably should not share that when dating. I kinda like his career choice. Good work if you can get it.

Later we were floating in the lake doing our blue bobber thing.   I was drinking my Bud Light and all of a sudden we were talking about my party. My end of life party, or also called my Celebration of Life. NOT A FUNERAL.

Before I go into the details let me explain how we got on this conversation in the first place. The answer to that is that I really do not know. It just happened.

I am sure I brought it up in some way. How I was able to sneak it into the conversation I do not remember. I probably had too many beers. It was a brief conversation, but it is a start.

Christy and I have had this conversation. She is not in complete agreement with my wishes. Okay, okay, that is an understatement. She told me that if she is planning it then I will be having a church funeral. Noooo not a church!! She said that a funeral is for the living and not the dead. I am not going to like it, but if that is what happens I guess I will be there. Damn.

But if I can put a plan in place maybe I can get what I want. It has worked before so maybe one more time. Christy hinted that if I put everything together I might get what I want. With that in mind I brought the topic up at the lake. Maybe I was looking for Team Kev support.

It is a topic that people do not want to talk about. I understand that. But it is a conversation that I need to have.

When should I have this conversation with family? If you wait too long you never really get to have it, and things just happen. I do not want things to just happen. I want my desires known so people can get comfortable with the idea of playing “Dead Man Trivia” at my party.

No matter how much people wish to avoid having this conversation it has to happen. This is the part of my disease process that no one wants to talk about. No one wishes to talk about death. I need to face it. I need to talk about it.

I am going to share something I have not shared before. July is my cancer anniversary month so to speak. For four years we have lived under this cloud. That worries me a little. You see 70 percent of men who have similar disease characteristics as mine die within five years of diagnoses. I am a little concerned.

I remember a conversation I had with one of my doctors and he told me basically to enjoy the days when I felt good, because those days would not last. I hope he is wrong.

I keep telling myself that I am going to be one of the 30 percenters. I keep telling myself that the poisons have become more effective over the years and that these new treatments are giving men like me more time. I do believe that. I have to believe that. But what if it doesn’t? This shit does not work for everyone.

Well if the shit does not work then I better have my bags packed so to speak. I need to be prepared for the worst while hoping for the best. That means I better have this Celebration of Life party figured out. On to the details, but remember that it is a work in progress.

So I envision a meal being served. Like a last supper with Kev sort of thing. So you better get there early before we run out of food. Who knows maybe by then I will be able to turn water into wine etc.

Most likely I will not have that wine thing down yet so I anticipate it being a BYOB party. I am not paying for your alcohol. I have seen many of you drink. Wait a minute, yes go ahead and put it on my tab. Let’s see how they plan on collecting that.

Now who is going to be the host of the festivities? Well it has to be me don’t you think. Yes I will be very dead, but through the power of modern technology I can still host. I will video myself and it can be played at the party.

Did you really think I was going to miss my own party? You know better than that. I might need a little help so I will name a co-host at a later time.

Now one of the things I will be doing there is hosting a game I call “Dead Man Trivia!”

Yes I will be asking the audience questions about myself. Such as: Can you name the greatest Rock & Roll band according to Kevin? One of my kid’s better win Dead Man Trivia or I will be pissed. If that is possible.

Other things will be happening, but more about that later. This essay is getting rather long and I have other thoughts I want to discuss.

Where to be buried? That is a good question. I own a cemetery plot here in Wichita. I bought it years ago. I read a book that said that I could get rich buying land so I bought a cemetery plot. You know one day we will run out of those. I will have cornered the market. HaHaHa.

The problem I have is that if I am buried there then I cannot sell it. I obviously did not think this through.

I guess I was feeling a little cemetery plot market irrational exuberance. Thank you Alan Greenspan.

I also have a few other problems with my investment. The biggest one I guess is the fact that I do not want to be buried there. Hell I do not even want to be buried. I plan on being cremated. What to do with my ashes? That is another good question.

Do I want my remains in Kansas? I thought since my kids were born here and we raised our family here and actually I have now lived in Kansas longer than Missouri then Kansas would be where I would stay. I have decided that even though Kansas has become my adopted home so to speak it is still not home. That is Missouri. I am even torn about going back to Missouri. I have been gone for so long.

Since I am planning on being cremated I think that the solution to the problem is to have a little of me here and a little of me there, a little of me everywhere.

Now I am use to telling the ladies to stop fighting. I tell them that there is enough of me to go around. I am not sure after cremation that there will be enough of me to go around. So I will most likely keep the sprinkle spots to a minimum, or even change them as I think of a better place. I have a few places in mind that I do not think will change.

Busch Stadium! Yes Busch Stadium. Justin has been instructed to plant a small amount of me in the flower beds in front of the outfield bleachers. It will be like having season tickets, but cheaper. I think I will like it there.

I am going to tell Justin not to put too much of me there. Who knows in 30 years they might tear the stadium down. Where would I end up then? So Justin, sprinkle Kev lightly in Busch Stadium.

Wrigley Field! Yes, Wrigley Field. I hate the little bears. They think that the Curse of the Billie Goat was bad or the guy who caught the foul ball. I like Steve Bartman. What happened to him should not have happened.

The cubs will not ever win another series in Wrigley when playing the Cards. With a little of me in the ivy I plan on haunting those sons of a bitches for the rest of eternity. The Curse of Kevin MF Brown! I like that idea. Not too much Justin. A little of cub hating Kevin is all that is needed.

Those are two solid places on my list. I figured some of me will be kept with Christy and we will be planted together in the far, far, distant future. Maybe even in Kansas. Damn!!

I really do not want to be in a cemetery, but I do want to have a place where the kids can feel like this is where I am. I do not want them to come to a cemetery to visit. I want them to come to Table Rock Lake.

Yes, I think Table Rock Lake would be a nice place for me to spend more time. I am thinking that a little of me could be in a nice urn or even an empty Bud Light bottle. A glass bottle, it has to be a glass bottle. You know a long neck ice cold Bud Light never broke my heart. HaHaHa.

Anyway looking out into the lake east of the cabins off the dock near the no wake buoy might be a good place to drop me down. If you are using a beer bottle make sure the cap is on tight, and use some weights. Or even put a little Bud Light in the bottle with me. I might get thirsty. Double check the cap. I do not want to become fish food.

Erin I know you are asking yourself how I know that area is east of the cabin. That is where the sun rises little girl. Erin has always been directionally challenged.

Every year when my family vacations at Table Rock I will be there. You will not need to go to a sad place to visit. I will be at one of our Happy Places. A place where we have great memories that brings smiles to our faces. That is where I want to be. You can take a boat or a bobber out to where I will be and drop down a Bud Light. I would like that.

Our future is bright. My children, grandchildren, nieces, nephews and their significant others.

I have spent over two thousand words making light of what is a tough subject. What I have written are my wishes. Having these ideas will help with the plan.

Indian Hills Resort at Table Rock Lake will never become “The Place.” It will just be one of the places.

The main place I want to be is in your heart. No matter where my children go I will be with them. It will not matter where I am buried or where I am sprinkled. In their hearts is “The Place” I wish to be.

I am confident that future treatments will work and my plan will not be put into place for a few years. But at least you know my wishes if things do not work out.

Hey, anyone interested in buying some land? I have some property.

Kevin

Looking Good….Feeling Good….Winning

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I walked into my oncologist’s office this past Wednesday, February 13th and after saying hello the first words out of Dr. O’s mouth were “Looking Good.” I was thinking, “Well I know that doc.” Then I realized that he was talking about my numbers.

My urologist, U3, checked my numbers in January and they were down. Excellent! Dr. O is checking me in February. The test results show that my nemesis Brutus is still with me. He keeps fluctuating. We will continue to keep an eye on him. I am not worried at the moment.

Dr. O appeared to be a little confused. He basically did not understand how I could be doing so well. He shrugged his shoulders and moved his hands toward the sky with his palms up.

So we talked. Let me get this straight doc. Since I am not on active treatment, like you had requested, you do not understand how I am doing so well. Maybe it is because I am not on active treatment. He smiled. He told me that for now we would continue with doing nothing. That is correct doc. I agree that is what we are going to do. I appreciate the consultation, but Dr. Bad Ass Brown already knew what was going to happen.

He asked about my pain. I reminded him that Dr. Bad Ass Brown does not have pain. Just discomfort. I told him that when the discomfort hits that I have been taking more medicine than he had originally prescribed. One pill just does not help. The increased dosage helps with the discomfort. Also the discomfort has not been as bad the last few months. So we were good there. I told him that I was feeling good, and that I was happy.

We set up another appointment. As I was leaving I wanted so badly to tell him that if needed I was available for other patient consults. Sometimes with humor I try to make a point. I decided to shut up. It was so hard not to make that statement.

“Looking good” is a common statement I hear from people that have not seen me in a while.

I do have to ask myself a few questions once I hear that comment. Does this person not realize that I am Kevin “MF” Brown and that I always look good? Right Sharon!?

Are they making the comment because I look good for a 59-year-old? Is the comment being made because I look good for a man with cancer? Bingo, I think we have a winner.

What people do not realize is that a person’s outside appearance tells them nothing about what other things that person might be dealing with inside their body. I look good. I have been feeling better. BUT, I am not well. I have cancer. For now it does not appear that it is going to change.

I will never get tired of hearing people tell me that I am looking good. It reinforces my idea that I am winning. I still have the upper hand. Brutus will just have to wait for his day.

Sorry, but I am going to interrupt this essay for a moment to discuss another deep investigative journalistic question that people seem to want to know. No, I do not color my hair. I cannot tell you how often I have been either accused of coloring my hair or asked if I color my hair. No I do not. Stop being a hater. If you look closely you can see some gray. Look closer.

I have been blessed with my grandfather’s hair. When he died he had a full head of dark hair with just a little gray. I inherited his hair. I also inherited his cancer. So with that in mind I would rather be bald without cancer than have dark hair with cancer. I would take a bald no cancer Kevin any day. ANY DAY! Now back to regular programming. Where do I pick up my Pulitzer?

During the summer of 2015 around 1,303 days ago I was sitting in my family doctor’s office talking about my tests results. He let me know that the results were not good. He did not need to wait for the results of a biopsy or any additional scans. He told me that with a number that high that I had cancer. A biopsy later confirmed the cancer, and the process began.

Since then some days have been good, some days bad, and some…oh well I was breathing. No matter how you feel the day still happens. With the passing of each day you have a sense of victory. You put those days together and it looks pretty impressive.

I am kicking Brutus’ ass. Look at the score. I took the picture Friday when the score was 1,301 to a big fat 0 for Brutus. I have won each and every day and I do not see that streak coming to an end anytime soon. Now some of those wins have not been pretty. I along with my team have made some errors, but I will take the “W” no matter how it comes about. Brutus, well he needs a closer to lock down the late innings. He has not yet found one.

As for my team we just try to play the best game possible waiting on our chance to score. Hit and run. Steal a base. We do whatever it takes knowing the importance of the moment. We have done well.

In his great speech Stuart Scott talked about living and dying with cancer. He said the following:

“When you die, it does not mean that you lose to cancer. You beat cancer by how you live, why you live, and the manner in which you live.”

With that in mind I know that I will beat cancer. I also realize that one day Brutus will probably go from 0 wins to 1.

Some say that when a cancer patient dies that they have lost their battle with cancer. The idea that you lose to cancer is wrong. How can you lose when the score is 1,303 to 1? You do not lose.

You win by showing Brutus that you are not afraid to live. You win by living the best possible life you can each and every day.

That is how you win. That is how an advanced patient beats cancer.

I have decided that I am going to try to change the focus of future posts. I want to move away from talking about how I am in a medical sense. No more talk of doctor visits and test results. I want to focus more on how I am beating cancer. I want to focus more on how I am living. More essays for my kids and grandchildren to have for future memories.

I will continue to write about cancer and my thoughts about the process. I just think for a while I want to stay away from talking about where I am in my process.   We will see how that works.

So in the future if you have a question on how I am doing I want you to remember this:

I look good. I feel good. I am winning.

Kevin

Hard Questions……Tough Answers

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“Dad, have they told you how much time you have?”

That is the question Amy asked me recently while she, Allie, and myself had a meal at a local restaurant. Before I attempt to answer that question let me rewind for just a moment and explain what has happened the last few weeks and how we had arrived at that moment, and that question.

A few months ago Amy asked me if I would be willing to do her taxes one more year. I told her that I could help her out, but that she needed to come home and bring with her all the information I would need. I also told her that she was going to sit with me and learn how to do this herself. Her taxes are so easy.

When she arrived in town we went out to eat. I never thought that I would ever have a conversation with Amy where the topics were death and taxes. More specifically my death and her taxes, but it happened. Death and taxes cannot be avoided. So they say. I am just going to try to kick it down the road a little farther. My taxes! I will send a check on April 15th.

So we first talked about her taxes. Amy changed jobs this year and so she worked most of the year in Kansas, but a small part of the year she worked in Missouri. I pointed out that she needed, or I should say we needed, or better yet let’s get down to what was really going to happen and that I needed to file state returns for her in both Kansas and Missouri. Amy looked at me and said: “Really?”  Yes little girl, really.

After taxes she had some additional finance questions. We talked about her 401k that we had set-up, and we talked about the benefits of a Roth 401k. You know it was just a regular night talking adult shit at Applebee’s. I kept my Mountain Dew intake down so not to get hopped up and go all Spider monkey on our waiter, Chip. Have you ever been kicked out of an Applebee’s? I will save that story.

Eventually the topic turned to my health. Sooner or later it always does when I am with one of the kids. You see Amy knew that I had recently had my usual tests completed and that I had seen my new doctor to review the results. After that visit the kids were told that things were going well. Amy took this opportunity to ask for more details. Damn.

What these recent results show along with the results from the past few months is that Brutus grows for awhile and then he shrinks. Shrinking is good. So for now I can continue to stay off treatments.

I shared with Amy over Mountain Dew, chicken nuggets, and fries what happened when I saw my new doctor.

Hold on a minute I know that at this point Cammy will have a question. Let me answer. Yes Cammy, I will buy you some chicken nuggets when I see you. Promise! (That boy loves his chicken nuggets.) I will take you to DQ for chicken nuggets, and a chocolate Peanut Buster Parfait!! I am feeling a little hungry right now. How about you? Okay back to the doctor.

I went over the results with the doctor, and I told him that most of the time I was feeling really good. We talked about the tumors shrinking.

I was sitting down and all of a sudden I stood up and I raised both arms into the air and I looked the doctor right in his eyes and I said to him, “I am cured!” This was a test.

You see Dr. U never liked talking about anything negative. I was hoping that U3 would be a doctor that would handle the tough times with candor. I do not want a doctor who wants to avoid the hard questions and not provide the tough answers. I was a little surprised about what happened next.

There was a moment of silence as I watched the expression on U3’s face change. I have not seen that look on a doctor’s face since Dr. U told me that I had been misdiagnosed and that my cancer was much more advanced then I had been told and that he had great concerns for my welfare or health or something like that.

U3 had that bad news look on his face. He might also have been wondering if I was a little delusional, or maybe no one had explained to me what I was up against, and now he was going to have to tell me. Or would he? That was the test. I will paraphrase what he said. Now this is very close to a direct quote, maybe a few words different.

The doctor looked at me and said: You have metastatic cancer. Your numbers could blow up tomorrow. I am glad that you are feeling well. Enjoy this while you can, because it will not last.

WOW and DAMN…DAMN…DAMN!

You think maybe a little too much candor? No, in my situation I think there can never be too much candor. I wanted to see if he would level with me. I wanted to see if he could be trusted. He passed the test. Thanks doc.

Now I do think that in the future I am going to have to talk to him about his word choice. That word “metastatic.” That has got to go. I do not like it. It sounds sooo bad. I am thinking that he should use the word that other doctors have used and that word being, advanced. You know you can be an advanced swimmer, advanced student, or have an advanced IQ. Which I am none of those, but I have an advanced disease. I like that better. We will talk. Moving on.

I asked the doctor if he thought I could remain off treatments for all of 2019. I asked because I already have a lot on my calendar. A couple of fishing trips, Table Rock Lake trip, baseball games, Alaska, a trip to the homeland and who knows what other opportunities will present themselves (like visiting the newest baby Heger in KC).

I guess one of them will not be a Missouri football bowl game. Damn NCAA. Maybe my anger should be directed somewhere else. Let me think about that a moment….Nope. Damn NCAA.

I really cannot think of a good time to ever go back on treatments, but especially this year. I do not want to sit on my butt at home. I want to get out and live. Looking at my schedule I do not have time to be sick.

I was looking at the doctor waiting on him to answer my questions about treatments. He did not look very comfortable. I could tell that he did not have the answer that I really wanted to hear. I guess I should not have asked such a hard question. He was having a tough time with his answer.

He looked at me and then said, “Maybe.”

We exchanged smiles. I knew what he meant. I know that he wants me to be able to cling to a little bit of hope. I will.

Before leaving the office an appointment was made for April. Then we will do this all over again. We talked about a new set of scans to be done in April. Damn.

As we go forward moving through time I know that things will change because nothing stays the same in the cancer world. They say that time marches on, but for me and people like me, our fear is that time is running out.

That brings us back to the question that Amy asked, “Dad, have they told you how much time you have?”

I have an answer to that question. The answer itself raises other questions.

I have talked to Justin and Erin in the past about Amy’s question. Justin and I have probably talked about it more in depth than I have with the girls. Amy has never really brought it up. I would imagine they have talked to each other.

They could ask Winston. Winston and I talk so he knows everything. Winston is such a good listener and is never judgmental. You can learn a lot from a dog.

Amy’s question is one of those questions where you think you might want to know the answer, but you really do not. If you do not know then you do not have to face it. The answer cannot hurt you.

I asked Amy a couple of questions to make sure she really wanted to get into this discussion. She did not. She decided that what she wanted was to think that I was going to be around for fifty more years. We left it at that. You see Amy is a lot like me. Let me explain.

I have a book sitting on my bookshelf directly behind me as I am typing. The book is titled, “Tuesdays with Morrie.” I read this book several years ago. Or rather I read most of the book several years ago. Many of you are probably familiar with the book and know that Morrie dies. I enjoyed Morrie so much as I read the book that I did not want him to die. I found myself refusing to read the ending. In my mind Morrie would stay alive. He would still be teaching life lessons. I later finished the book.

I did not want to confront the ending of Morrie’s story, nor does Amy want to confront my last chapter.

In a few months we will be entering the fourth year of my life with Brutus. When you look into what I consider to be my timeline we have gotten really deep into this process.

Erin, Justin, Amy, and Christy are the most important people in my life. They experience their own pain and have their own fears as they try to deal with what has happened and what will happen. I want to help them get through the last chapter.

Take a moment to read these words from Morrie:

“If you hold back on the emotions – if you don’t allow yourself to go through them – you can never get to being detached, you’re too busy being afraid. You’re afraid of the pain, you’re afraid of the grief. You’re afraid of the vulnerability that loving entails. But by throwing yourself into these emotions, by allowing yourself to dive right in, all the way, over your head even, you experience them fully and completely. You know what pain is. You know what love is. You know what grief is. And only then can you say, ‘All right. I have experienced that emotion. I recognize that emotion. Now I need to detach from that emotion for a moment.'”

Amy, when you are ready with your hard questions I have answers. Remember that we will hope for the best, but we must be prepared for the worst. It will be tough, but we will get through this together.

Love,

Dad

I came down with the flu recently, and while I was recovering Amy
and Allie took advantage of me not being myself and ganged up on me to
win several uno games. Good thing they were not sanctioned games.

Giving Thanks

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13

Today is Sunday November 25th, 2018 and what started out as a simple Facebook post has turned into an essay. I did not mean for that to happen, it just did. Sometimes I get to typing and all of these thoughts start swimming around in my head and out they come. Sorry.

I guess my fingers just cannot shut up. I lovingly get that from my mom I think. She is a talker. At times I can be as well. Speaking of mom I recently noticed that for the first time someone had unfriended me on Facebook. So I call my mom and ask her why she unfriened me. She pointed out that it could not have been her. Hell we are not even friends. Point well made mom.

So I get up this morning and it is blowing snow outside. So I went back to bed. That reminds me of my college years. If it was raining outside I did not go to class. Bullshit melts you know.

When I did decide to get up I was sitting at the kitchen table watching the snow come down and drinking my coffee out of my Cardinal mug. My Tiger mug was dirty. I used it on game day Friday. Did you see the beat down put on the little piggies by the mighty Missouri Tigers? I loved it.

I do have to be careful and watch what I say. I have a lot of family who live in Arkansas. Others graduated from the University of Missouri and were able to escape.

I have to remind myself that we do owe Arkansas thanks for that great and needed invention called the toothbrush. Now if it had been invented anywhere else it would have been called the teeth brush. Just saying.

So while drinking my coffee I am smiling thinking about the past few days. All the kids and pets were home for Thanksgiving. Last year Thanksgiving was at Erin’s. This year we gathered back at that little house on Judith in Wichita.

So the kids had to travel over the river and through the woods. Sometimes you cannot trust that GPS. I keep telling them that it is a straight shot down I-35 out of Kansas City. Someday they will learn to listen to me, or maybe not.

Amy, Allie, Justin, Cheeto, and Kiki the cat arrived home Wednesday night. Kiki could not stay long. Erin is very allergic to cats. Kiki did not spend much time in the house. On Thanksgiving we welcomed Erin, Steven, Camden, and Dixie.

We have lived in this house almost 28 years. Two years ago was the last Thanksgiving we were all together on Judith. It was then that we all sat down at the kitchen table and we explained to the kids that I was sick. We spoke about Brutus.

Christy and I had known about Brutus for awhile. I had thought that I was going to be able to keep Brutus a secret. I had hoped to never have to tell them about Brutus. Then we learned that Brutus was going to be more of a big deal than we had thought. That led to the kitchen table discussion. The news was not taken well.

The kids made me promise that I would never again keep news about Brutus from them. They wanted to know the good, the bad, and the ugly. I think I have been able to keep that promise at least most of the time.

That discussion was long before this blog was started. Since starting the blog I have made it a point that they would know what is going on before it appears here. I do not want them to learn what is going on from these pages.

Since we were all together again I was grilled on what was going on and if they knew everything. For some reason I think they feel that I am at times holding back. They might be right. I assured them that for now they knew everything (they needed to know). At times they get very pissed with me. Go figure.

So while sitting drinking my coffee I am thinking about the Camden time I had the past few days. A bigger smile is now on my face.

Camden and I had many leaves to take care of. I mulched up most of the leaves with a mower. Camden followed along. It was 69 degrees outside.

This was the first time this year that I have mowed. I had to hire a service last year during midsummer to mow the yard. Dealing with Brutus was just too much at that time. I never knew from day to day how I was going to feel and found that doing yard work quickly zapped me of my strength. So this year I just started the season with a yard service. It bothers me that I cannot even mow my own yard. Damn!

So Saturday, yesterday, Camden and I decided that we are going to tackle those leaves. We got the little John Deere push mower to start and off we went with Camden right behind me.

I bought that mower when we bought the house. Nothing run likes a Deere.

Then we tackled the small garden area in the back yard where I grew a few tomatoes. Keeping up with the big garden and little garden were a bit much this year. The little garden did not get the needed attention. Hell neither did the big garden. Camden helped me pull up the tomato cages and take out the weeds. He was a very busy little man.

So we mowed and took care of the leaves. We fertilized and watered the lawn. We had to get all that done Saturday, because snow was suppose to move into the area Saturday night. After the yard work we spent time at a city park a few blocks away. We had fun. I even felt good.

Next year the plan is to once again to do my own yard work. I do not like the service. They just do not get the yard looking like it should. You know I am one of those guys that take great pride in his yard. I mow twice a week during the spring. I measure the grass to make sure it is the right height. If I see one goddamn Dandelion in my yard well all hell breaks loose. Yes I am one of those guys.

I am trying to change. I do know that there are more important things than keeping your yard looking great. The garden needs to look good as well.

Also Winston tries to help me keep things in perspective. He just pisses on my grass and kills areas. I have finally given up that fight. I just buy sod a couple of times a year and fix his destruction. I am anal.

So with the threat of snow moving into the area Saturday night, plans changed. All the kids left to return to KC Saturday evening. Cammy was the last to leave. They pulled out around 7:30. Cammy was crying. He did not want to leave his Papa. Or maybe it was because he had not had a nap in two days and he was hitting that melt down wall. He was asleep within five minutes of leaving the driveway. He slept for 12 hours. I think I wore the kid out.

So now I sit at the kitchen table. The house is once again very quiet. No little man pulling my hand or shirt wanting me to get onto the floor and play, saying “Papa wook at dis.” I miss him.

I am thinking how thankful I am to have my family. I am thankful for the time we are able to spend together. I am also thankful that they have their own homes to go to. I kinda like this empty nest thing.

All kidding aside having homes of their own is a positive. It tells me that we did good. We raised three kids who were able to eventually leave the nest and make lives on their own. I am very proud of them.

Sitting in the kitchen I find myself thinking about this last year. Things we have had to deal with and overcome. Victories we have had along with a few minor setbacks. A couple of those setbacks were two additional cancer surgeries. Damn!

I think of trips I have made this year. We went to Hawaii, Colorado twice, Wyoming once, Arkansas a couple of times, Missouri several times, and of course St. Louis twice. Been to Oklahoma, wait a minute I was just driving through Oklahoma thankfully. Now that is a flyover state. Okay, okay there are a few places there I want to go. Maybe next year.

One trip we are hoping to make next year is to Alaska. This trip has been at the top of my list. With a new grandchild due to arrive in February I asked Christy if she wanted to put this trip off a little longer so that we had more time to spend with the newest little Heger.

Christy told me that she did not think that was a good idea. She pointed out that I am feeling okay now. We do not know what tomorrow will bring. We need to do this trip now. She is right.

We have a two-week trip booked for the end of July into August. I am looking forward to the adventure.

Joining us for the first week in Alaska will be my sister-in-law Connie and my brother-in-law Brad. They drove up here from Arkansas a few weeks ago to have some fun, which means spending time with me. We also finalized the trip. They traveled with their toothbrush.

I enjoy spending time with them. We had the World Series of Spades while they were here. The teams were brother-in-laws against sisters. We were clicking. Our pitching was spot on and our bullpen was shut down. The women had no chance. We showed no mercy as they tried blind nil after blind nil.

We took them down 4 games to 0. Let me repeat that, 4 to 0. Connie commented that you win some and you lose some. I had to point out to her that they lost them all. She loves me.

I had to make sure there was some distance between us when I made that comment. She has been known to come after me with wooden spoons. Or putting pepper in my mustache while sleeping. You wake up and inhale then you find you cannot breathe. She has short sheeted my bed and put shaving cream on my pillow. I cannot remember all the shit she has done to me. She is just trying to get my attention. She loves me.

I get another cup of coffee and I am still thinking about how thankful I am for the people in my life. So many that I cannot mention everyone today.

I do want to talk about a trip I took in October back to my Homeland. I do plan in the future to have a blog post about that trip, but today I wanted to talk about it as well.

On this trip I was able to reconnect with people that I have not spent time with in 30 plus years. A few I saw last year when I did the “Let’s get Reacquainted with Kevin Tour.”

“It’s been said that everlasting friends go long periods of time without speaking and never question the friendship. These friends pick up like they spoke yesterday regardless of how long it has been or how far away they live and they don’t hold grudges. They understand life is busy and love is there.”

I do not know who said that, but from my experience I find it to be very true.

When I was told that I was sick I said to myself, “I got this!” When I learned that they were not going to be able to fix me I realized that “I might not have this.”

I was told by a friend in the medical field that I needed to figure out what I wanted to do and then go do it.

What I want to do is make a difference in people’s lives when I can. I think at times I am able to do that. I am thankful.

I wanted to travel and see more of our great nation. So far I have been able to do a little of that. I am thankful.

I wanted to reach out to people that have been part of my life. That could be a relationship from years ago or one that is more current. I wanted them to know that our relationship no matter how long ago meant something to me.

In my quest I have not been turned away. The outpouring of love and kindness I have felt I cannot explain. We picked up right where we left off.

This is Brenda with her grandchildren Isaac, Natalie and Libby. Isaac is a cool kids to talk to and he played the piano for me. He is good. I hope one day to be as good as he is now. Natalie showed me her Bicentennial Little Miss Contest Crown. She is a beautiful young lady. Libby I did not get to see this trip. Hopefully next time.

Rusty and I sat down for a few cups of coffee in Wellsville. Hours later we decided that we needed to do this more often. That is the plan.

Dave and I letting whiskey do what whiskey does. We have a long history with that.

Sharon and Jim are two of my favorite people. I cannot tell you what getting back in touch with Sharon has meant to me.

I did not get to spend as much time with Doug as I would have liked. I should have let him know I was coming. Next time.

Jeff and Carolyn are my Missouri brother and sister.

Robyn and Laurie are great friends. Grade school, high school and college. We have had some interesting times together. Spending time with them again was wonderful.

So as I sit here now with another cup of coffee. I want each of my past and present friends to know that you have shaped my life. You have made me the person that I am today.

For that I want each of you to know how truly thankful I am and will always be.

Kevin

Choices

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It has been several weeks since I have written any update to what is going on with Brutus. A few things have happened. I have had several doctor visits, and many tests to get an idea on what is going on right now inside my body.

I keep putting this conversation off waiting on the next appointment, waiting on the latest results. The results are in. Can I have the envelope please?

Now picture a beautiful young lady with brown hair walking into my study and handing me an envelope. My study was formally known as Erin’s bedroom. I moved a desk and a computer into the room. Oh and a refrigerator for beer.

Now back to the woman. Yes Christy fits that description, but it is not her. Now by young I mean a lady most likely in her 50’s, but 40’s or 60’s would be fine. I do not discrimination by age in my fantasies. I am getting older you know. I hope that aging process continues, so back to the envelope.

The brown eyed lady tells me that the envelope has been hermetically sealed, and that it contains the results tabulated by the accounting firm of Ernest and Tubbs. She hands me the envelope and walks away. History just repeated itself. Damn!

I open the envelope and it says: Dear Kevin – you still have cancer. It is not going away. Now deal with that. You have choices that have been explained to you. You now have to make a decision. That decision needs to be made now. It was signed: Sincerely, your medical team.

That is what this essay is about:  The choices and risks facing many cancer patients.   The pros and cons of those choices and the stress one goes through in trying to make that decision.

Camden as you grow older you will find that life is full of difficult choices and some that are not so difficult. Going to the pumpkin patch with you instead of watching football was not a difficult decision. We had fun. Spending time with you brings me so much joy.

While at the pumpkin patch you had to make the decision on which pumpkin you were taking home. I know you had your eye on a large one, but you could not quite pick it up. The one you chose and carried out of the patch looked great. You made a good choice.

Making a decision can be hard. You should be at my office around lunch time and the ladies want to know where I am taking them to lunch. I ask them why that is always my decision? They say, “Dah, because you are driving.” I throw out some choices and soon a decision is made. Sometimes I have to use my veto power and tell them to pick again if I do not like the choice.

Picking pumpkins and a place to go for lunch are normally easy decisions. Sometimes the decisions we are confronted with in life are much more complicated.

You see Camden there can be problems in trying to make a decision when you have difficult choices. When you make a decision you often do not know if you made the correct decision. Sometimes you know right then, but often it takes time to tell if you made the right decision. It might take a day, a week, a month, or even years to really learn if some decisions you made were correct.

You might wonder how a person goes about making these tough life decisions. I am sorry to tell you that I do not have a fool proof answer to that question. Many times I have learned that I was wrong and I must then correct myself and make things right. I know that is hard for you to believe that your Papa has ever been wrong. Just ask your mother.

I will tell you that you should never make decisions where you intentionally hurt innocent people. I say innocent people because unfortunately some people are evil and make decisions that hurt others and they must be stopped.

When all is said and done you must be comfortable with your decision. Sometimes you will find that your decisions will not be popular, and some might not agree with your decision. They can second guess you and they will. The bottom line is that you have looked over your choices you must make the decision that is right for you.

One day I was driving down the street and over the radio a robbery in progress call was broadcast. I was just seconds from the fast food restaurant that was being robbed.

I pulled into the shopping area and parked out of sight from the business windows. When I got out of my car an officer pulled up. I grabbed a shotgun and we walked up to the side door entrance near the front counter. The officer opened the door for me and I walked into the business pointing the shotgun at the robbery suspect. The safety on the shotgun was off and my finger was resting outside the trigger. The officer came into the business after me and was standing behind me. He was a smart guy, no sense in both of us getting shot.

When I walked into the business I saw the robbery suspect holding a handgun in his right hand. He was pointing the gun at the young female employee behind the counter. The gun was pointed at her face and she was crying.

I identified myself and told the suspect to put the gun down. The exact words I used I do not remember. I might not have been very nice.

I looked at this robber and what I saw was a kid. I mean a kid. He was short. Shorter than I am, and I am short. If he would have been standing next to me he may have reached the area of my chest.

He did not follow my instructions and put the gun down. Rather while still pointing the gun at the store employee he turned his head toward me and was looking at me. I again yelled at him to put the gun down. He did not.

Instead of putting the gun down he turned his body toward me and now was pointing his gun at me. I had to make a decision on what to do. I did not like my choices.

As I looked at him pointing that gun at me I thought to myself, “Kid you get the first shot. I hope you miss.”

Had that kid been a little taller I would have shot him. At that moment I could not do that. He looked so young that I could not bring myself to shoot him. I am not sure I could have lived with that decision the rest of my life. I decided not to shoot.

I again yelled at him to drop the gun. He did not, but he yelled back that the gun was a toy. That gun did not look like a toy to me or to anyone else in that business. I again yelled at him to put the gun down. He did.

The officer grabbed the kid. I grabbed the gun. It was a toy. It was a goddamned toy gun! The kid was nine years old. His father had been in or was in prison at the time for armed robbery. That kid came close to losing his life. I came close to losing my mind.

The gun looked very real to me. A picture of that gun was later on the front page of the newspaper. It was there to show just how difficult our decisions can be and how often our decisions are made in split seconds.

Some did not agree with my decision. Some felt that I put myself in too much danger and in so doing I was placing others in danger.

I made the decision that day on what was right for me. What type of person I was and what type of person I wanted to be. I was willing to take the risk of being shot. I wanted to give that kid every opportunity for life.

It worked out for me. It worked out for him.

Later that night I was called into the supervisor’s office. He sat me down to talk about what had happened. He told me that I had made the right decision.

When our conversation ended and I got out of my chair to leave the office he stopped me. He said, “Kevin, one more thing. I want you to know that if you had chosen to shoot that kid that too would have been the right decision.”

I understood what he was trying to tell me. He was saying that the law textbooks say that I would have been legally justified if I had shot him. I nodded and walked out. I will never forget that conversation. I will never forget that kid. I took a risk that day and it worked out. Sometimes you have to ignore the textbooks.

I have found myself once again having to evaluate choices and make a critical decision. A decision on how I want to live my life. Some believe that I am taking a risk in what treatment option I have chosen in dealing with Brutus. I understand that, but I do not think we can avoid risk in our lives. If I tried to avoid risk then I would not even go to work. Avoiding risk in my work is hard to do. You just deal with it, and try to minimize the risk.

Now in my personal life I have tried to avoid risk. I wear a seat belt when I drive. I look both ways when I cross a street. I refuse to be a passenger in a vehicle if Justin is driving. I do not jump off cliffs at Table Rock Lake. Okay, okay I might have done that. Justin made me. I can tell you that I will not ever do that again. My ass still hurts. Damn! Can you break your ass? I think I did.

We now know that Brutus is again growing. The question now is how far and/or how fast do we let the disease grow before doing something. With most men prostate cancer is categorized as a slow growth disease. Unfortunately with some men the disease is much more aggressive. I am one of them. Damn!

The velocity of growth is something that has to be closely tracked. Cancer grows exponentially. As more and more cancer cells are produced the velocity just increases. You can reach a point of no return. In that I mean that the cancer could grow to a point where it becomes much harder to treat. It might reach a point where it is untreatable. That is why my medical team would prefer that I am on continuous treatments.

I think of it like a game of “Whac-a-Mole.” At first the moles pop up slowly and you are able to control them with your hammer. The moles eventually start to pop up faster and faster. Then you find that you can no longer control them.

Dr. O’s philosophy is that you are either early with treatments or you are too late. His belief is that I need to be on continuous treatments because once you have stopped treatments it is very hard to be able to know the exact time when a person should once again resume treatments. The only way to be sure that you are early is to never ever stop. Now that Brutus is growing again he wants me on treatments.

Eventually the poison they are using will stop working. Brutus is not stupid and he will eventually develop a resistance to the poison. You spend your life going from one treatment protocol to another.

How long you survive depends on how well your body responds to the different poisons and the development of new poisons and treatments to extent your survival. Some work better and longer than others. Some you find out do not work at all. It can be different for each patient. What worked for one of your family members might not work for me, and vice versa. We might be diagnosed with the same type of cancer, but each cancer is so different.

Survival: I find the use of that word to be odd or even funny. Survival is a word often used by my medical team. They do not talk about living. They talk about surviving.

That is where I have this disconnect with my team on how we should be moving forward. When I explained to Erin that I was going off drugs she made the comment that the doctors were just trying to keep me alive. Yes, yes they are, and I greatly appreciate that. But there is one thing that must be understood and that is I have a different perspective than they have or most likely even you have. The only people who will understand what I am talking about are other cancer patients.

There is a difference between living and surviving. Modern medicine can keep you alive, but sometimes you have to ask if this is a life you want to live? Is it worth living?

I have often asked myself that if I knew before this all started where I would be today would I have done the same thing. That answer changes depending on my mood, but most often the honest answer is no. That is not what people want to hear so I never share it. If I had known from the beginning what was going on inside me, and what was going to happen to my body, and how my quality of life would be affected then my treatment decisions might have been different. My body, my spirit, my life has been broken. Just like Humpty Dumpty they cannot put these pieces back together again. But we are here so I will make the best of a bad situation.

I agree that the poison will work better when it has fewer cancer cells to deal with. The more cells the greater the risk that the poison will not be able to control them or they will spread to an area of the body that is not treatable.

I understand that. But I also understand this:

Right now I feel better than I have in years. I can work out. I can run. I can dance. I can sing? Okay, maybe I cannot sing, but I try. I mumble along while driving. I have a great shower voice. Maybe?

I am right now the most optimistic I think I have ever been on how my future looks. I believe that as we move forward things will work out and the treatments will work. I believe that new treatments will be developed. That is how I have to look at things. That is what I must believe. And I do. I do not plan on leaving this world anytime soon.

Now I have discovered one problem from coming off the drugs. That problem is that the discomfort I feel in several ribs bothers me more at times. When it hits I do not work out, run, dance, or sing. I pretty much do nothing. After awhile the discomfort decreases. It never goes away. I feel it right now. Sometimes it bothers me when I breathe. Exhaling does not bother me so much. It is that inhaling. I have been told in the past if something hurts then stop doing it. I am still trying to figure this one out. I will get back to you on that inhaling problem.

Drugs help, but I have told the team that I do not want to take narcotics. I would rather deal with the discomfort then take lortabs or oxycodone. They do work. I just do not want them. At some point they will become an issue with my employment. I wanted a non narcotic pain reliever if possible. They put me on tramadol. I do not know anything about tramadol. I take that back. I do know that shit is not working.

What I do not want to do is go back on treatments and no longer feel good. I do not want the poison in my body. I do not want to have a conversation with someone and then have to check out mentally during the conversation because I have to concentrate on trying to control the nausea that I am feeling and keep myself from throwing up on that person’s shoes. I am not looking forward to going back to hugging the trash can in my office on many afternoons. I am not looking forward to the headaches. I am not looking forward to the increased fatigue and weakness. Just having cancer you deal with fatigue and weakness. The poison just intensifies those feelings. I am not looking forward to the depression.

I went to see Dr. U and it was decided that I should also see another urologist to get his opinion on my situation. This will be my third urologist. I am getting confused. Should I call him U3 and then does that make Dr. U, U2? U1 was Dr. Richard Little or Dick. I fired him.

If Dr. U becomes U2 should I just call him Bone-O? An urologist called Bone-O. My juvenile humor is making me laugh. Ha Ha Ha. Yes Erin I am laughing harder than anyone else. That reminds me that I am about out of Trimix. Need to make a phone call.

(Okay this essay has been sitting around my house for about three days. I have decided that I might need to explain something to you George Strait fans out there so you get the reference. U2 is a rock band and Bono is their lead singer. Still not funny? Sorry I have been laughing for the past three days. You can continue reading.)

I have decided that Dr. U will stay Dr. U. Dick will forever be a Dick. The new guy will be U3.

Dr. U3 I am told is a specialist in advanced prostate cancer. He deals with the worst of the worst. Damn! He and Dr. U are colleagues in the same medical practice, but different buildings. I am told by a PA that U3 is probably more informed on different drug treatments that might help me.

So I am sent to see U3. I am moved into a waiting room where I sat for around 45 minutes. Dr. U3 finally comes in and introduces himself. He sits down at a computer and is reading about me. He then looks me up and down and the first thing he says to me is that I am much younger than most of his patients.

I really do not know how to take that. Is that good or bad or a little of both. I do not know. I am looking him up and down and thinking that he is an asshole. He is looking at me and I think he is sensing that his bedside manner is not playing well.

He then tells me that being younger is a good thing. It is? Really? That is bullshit! I do not think it is good at all. First off, if I had the choice I would never choose to go through this shit at all. But if it had to happen I would have picked a number much higher than my current age.

He then explains that I should be able to handle many of the treatments better than most of his patients. That is code for you are going to be one sick fucker before this is all over, but the treatments should not kill you. Damn! I think.

He then again turns to the computer and makes a comment about what he is reading. He talks about the spread of my disease and makes a positive comment about one of the scan results. The problem was that he was wrong. I did not say anything.

His PA was also in the room. She was a very sharp young lady, and pleasing to the eyes. Just saying. It became apparent to me that she had actually read my history before I came into the room. She corrected the doctor and gave him the correct results of my scans that were done at a hospital in Illinois. They were not positive results. He then responded, and I will quote him, “Oh.” I think that is pretty accurate. He continued to read and he made no additional positive comments. Nothing negative, but he no longer was waiving pompoms or being delusional with optimism.

Then we talked more. We talked about everything that had been done to me and my not wanting to go back on drugs just yet. I told him that since my cancer was again growing that Dr. O wanted me back on drugs right now. That he wanted me on continuous treatments. I explained that I wanted intermitted treatments where I would be on drugs for awhile and then off drugs to allow my body to recover.   I was willing to go back on drugs at some point. I had a number in my mind were I was comfortable with allowing the cancer to reach before going back on drugs. I had a risk level that I was willing to tolerate.

I explained to U3 that I was thinking about paring my medical team down and that most likely I was going to choose him or Dr. O to treat me. I wanted to know what his recommendation would be.

He then told me that Dr. O was right. That if you go by the medical textbook I should be on continuous treatments. He said that the most recent research showed that my survival would be better if I stayed on continuous treatments vs. intermitting treatments. Once again a doctor is using the word survival and not living. Damn!

I am thinking this is not good. What can I say to get him to shut up? Maybe I could throw my pocket square at him and whistle this recommendation dead. Maybe call him for roughing the patient or something. I needed a diversion, but it was too late to fall on the floor and fake a heart attack.

You see Christy was in the room. She has told me all along that she felt that by staying off treatments that I am shorting my life. Now she was hearing what this guy was saying. He was starting to make things more difficult for me. I did not like the situation and I was beginning to like him less than before, but boy that PA was cute.

We talked more and I gave him my reasons for not wanting back on treatments at this time. He was actually listening. I wanted him to understand that I was not a textbook problem. I was a human being and that I wanted to be treated as one. I wanted him to know that I understood the risks and that I wanted my opinion to matter. Once again there is a time to ignore the textbook.

You see I want to live and not just survive. To the doctor’s survival means being able to sit on the couch with drool running out of your mouth not really knowing what is going on, but still able to watch Vanna White turn letters for Pat. That is not living. Hey, I do that now. Never mind.

He then began to talk about quality of life. Thank God. He understood my quality of life issues. He told me that if I did not want to go back on drugs yet that he would work with me on that. He told me that he had a number in mind that we could not let the cancer pass. He gave me that number. It was my number!! It was the number I have said all along I wanted to reach before going back on the poison. I started to like him a little more.

Christy has told me that when I see the doctors that I am not very nice and I am grouchy. What I am is defensive. I do not mean to be, but I know that I am.

I cannot tell you how much stress is put on a person when they have to deal with cancer and also have to deal with a medical team that is not quite on board with your wishes. I have decided that if you are not on Team Kev then you are going to be gone.

I told U3 that I was not happy that Dr. U and Dr. O did not communicate better. I asked that he communicate with Dr. O. I told U3 that I would be seeing Dr. O the following week and that after that visit I would make a decision on who was staying on Team Kev and who was going.

We talked about future treatment options and made an appointment for January. Not so sure it is going to work. What I would like to do is hire his PA, but they come together. Will have to see how that works out.

I have to say that over the last few years I have seen many doctors. Both men and women, and I will tell you right now that I have been very impressed with the lady doctors. In my opinion they take more time in explaining things, and I feel that they are better listeners. The female doctors that I have visited with have been more upfront and blunt than their male counterparts. I appreciate that. U3’s PA knew my history, and she probably already has a treatment program in mind. I want her on the team. I guess U3 can join us as well. I will see them in January.

So I saw Dr. O a week after seeing U3. Dr. O told me that he has communicated with U3. After I picked myself up off the floor I told him that was excellent.

Then Dr. O said something else that took me totally by surprise. He basically said that he was caving to my request and was going to go along with me and the target PSA number I had chosen. I was stunned. Maybe now I can start being a little nicer.

Of course all of this depends on how fast or the velocity of the disease. If the velocity keeps increasing then I am back on the poison sooner than I had hoped.

It took a year of treatments to get the number down to where we wanted. I am hoping that it will take a year before having to return to treatments, but it might be nine months or even six months. I will take whatever I can get.

Taking everything into consideration I am happy. I am very happy.

Is it the most optimal plan? I do not know. I do know that it is the best decision for me. I know the risk. I understand the risk. I can live with the risk.

Some would say that what I am doing is allowing Brutus the first shot. That might be right. We do not know. If I am giving Brutus the first shot I only have one thing to say:

I hope he misses.

Kevin

Time

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Time is very precious to me. As you can see on Facebook I spent time with Erin, Steven, Camden, Dixie, Amy, Allie, Cheeto, KiKi (the cat), Justin, Christy, and Ed Sheeran in KC over the weekend. Not many better ways to spend my time.

Okay maybe I did not technically spend the weekend with Ed. Amy and Allie did take us to his concert at Arrowhead Saturday night. It was a great concert. I loved it. Thank you Amy and Allie for a great time. It was so excellent that I am going to suggest you take me to another show soon. You know Breaking Benjamin will be in Wichita in November. Just saying.

While at the concert Ed did not start until 9:00. The first opening act started around 7:00. The girls had heard of him. I had not. Some guy calling himself lauv which he pronounced love. Never heard of him, but I did recognize one song. Do not remember the name. Oh well. Then Snow Patrol played. I never have been a big fan, but they were good.

What I am getting to is that since Ed had two opening acts I had time to catch a little of the Tigers football game in a bar at the stadium. Mostly I followed the game on my phone. Well you know how that ended. Not well. Not well at all.

Oh well there is always next year, I mean next week. They are still playing for a decent bowl game. Going to have to knock off Kentucky or Florida or both, but I do not want to get too far ahead of myself. I predict that this next Saturday that the Tigers will win in Columbia. I just hope that it is our Tigers.

So what else did I do this weekend you might ask? Well we went to a haunted house in downtown KC. That was fun. Again Ed was Saturday night. Did I do anything else that I can think of? Let me think about that. Oh yes I spent time with Camden. We always have a great time together.

Before the Haunted House

We took some photos, and video. I hope you enjoy them. You know that if I spent time in KC that you were going to see Cammy photos and video.

Now if you are a grandparent you understand the joy and happiness you feel having grandchildren. It is not that you get to spoil the kids and turn them over to the parent and walk away. That is not it at all. It does at times feel good though.

No it is more like when you get your grandson to say “MIZ Go Tigers! “ Cammy’s mom and dad did not see the humor in our little cheer. Go figure.

No it is not even that. It is hard to explain, but I guess being a little older and wiser… you can stop laughing at anytime Erin. As I was saying being older and wiser you see the opportunity for a do over so to speak. Not in a negative way mind you. I am very proud of Steven and Erin and how they are raising Camden, and soon a second child.

Grandparents are there for advice when needed. As for me I still use the same game plan when my kids were little. “Go ask you mother” still goes a long way. Also I have to add that grandpas are great playmates.

If you are a soon to be grandparent I say congratulations and welcome to the club. It is hard for me to explain what you are going to experience. It will be one of the best feelings that you have ever had. It will rival any past experiences. Now it will not always be lollipops and candy canes, but what is. This is real life. Enjoy the ride.

Cammy, well he means the world to me. He brings so much joy. Just thinking of him makes me happy. Some days it is hard to be happy. He brings a smile to my face and warms my heart.

At times I have wondered how I am going to be able to hold everything together and move forward. Then I think of my moments with Cammy and I have a reason to live. I have a reason to fight. Those moments turn into beautiful memories.

I have had other memories in my life that I will forever cherish. Some of those memories have been with you. I think that there will be future experiences in my life that will also become great memories. I believe that some of those future moments could be with you. All I need is a little of your time, your precious time.

Every now and then I am able to make it back to the area in which I grew up. I will call it my “Homeland.” Monday the 15th I am again traveling back to that area. My plan is to be there seven or eight days. I have contacted several people who I will be spending time with during the week. I have others I hope to contact. I am sure that I will not be able to see everyone I want to see during this visit, which means there will be other trips. Unfortunately there will be some people that I will never see. That does not mean I do not think about you.

When I see you I want to see your smile, and of course I want a hug. We can talk about the past, present, and future. One thing I would prefer not to talk about, and that is cancer.

Another test was run last week. The results are available, but I have not asked. This is one time I do not want to know the results, at least not yet. I even moved my next doctor’s appointment to the 24th.

I moved the date so that I could go on vacation without having “Brutus” on my mind. So while on vacation I would not play over and over again in my mind just what they think is best for me. What they want me to do. I know the answer to that already. I have a very good idea what the test results will show. But if I do not see the doctor I can deny in my mind what is happening. They are going to want me back on medicine soon. I am still hoping to wait a little longer. I just want a little more time medicine free.

So if you live in the area of my Homeland or if you will be in Columbia for Homecoming maybe we will get to spend some time together.

If by chance you are on the road and you see a little red sports car pass you with Kansas tags well that might be me. I might be driving just a little fast. Not real fast… just a little fast.

I have places to go. I have people to see. I have memories to make. I do not want to waste time. See ya.

Kevin

How’s Your Cancer?

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I was stopped at a red light not long ago and a car pulled up next to me. I saw that the passenger side window was coming down and I glanced over and saw my friend Boomer behind the wheel. We had worked together in investigations, but since his retirement a few years ago we have lost contact.

We exchanged greetings and he asked how I was doing. I told him fine. I had no idea what Boomer knew about my situation since we have not talked. The light was going to change soon and he was turning left and I was going straight. Our brief encounter would soon be over. This I suspect caused Boomer to get more to the point with his next question. He told me that he has been following my blog. He then asked, or a better description would be he yelled: “How is your cancer?”

He caught me off guard for a moment. Few people are that direct. I liked it. No sense beating around the bush. Let’s get to the point.

I told him that I was good, and that cancer thing was good. Brutus and I thanked him for asking.

The light changed and I told him that I would post an update soon. That was several weeks ago.

Before I go into more detail let me apologize for not posting sooner. I have been busy this summer. Work, the garden, dance, music, and travel have taken up most of my time.

I also have to admit that I really did not want to talk about it. I have enjoyed my summer and did not want to think or talk about cancer. Now is the time to again have a conversation about what has happened and what the future looks like. As I have said before, writing this blog is in a way therapy for me. It forces me to logically organize my thoughts. It helps me make decisions. When I write it makes me face reality. These summer months I have not wanted to face reality. I wanted to run, jump, and play. Reality sucks! Also things have not gone as I had planned. That seems to be a recurring theme.

Now we are getting closer to my next round of tests which should provide feedback on the choices I have made and will have a big impact on the decisions I must make going forward. These conversations even if the conversation is just with me help. As I write my way through a problem I am better able to make decisions.

Sometimes I do not understand what is happening. Sometimes my medical team does not understand what is happening. I have to remember that they are practicing medicine. It is frustrating when so much is on the line. So much is at stake.

Each person’s cancer is different which is why it is so difficult to treat. Each person faces this monster in a way that is right for them. Who is to say who is right and who is wrong?

I have learned in the cancer world that many problems are not yet understood. No one will ever be able to answer all questions or understand why something is or is not happening. Sometimes doctors do not agree. I have learned to move on and stop banging my head against the cancer wall. The answers will come some day. But for now it is what it is.

The results from my surgery on May 22nd really did not help in explaining what was happening, and tests that were completed after the surgery in June were not good. I went into the June test feeling really good. Most of this summer I have felt better than I have in years, I am happy.

Since I have been feeling so good that also means that Brutus was enjoying his days. You see when I felt bad from the poisons that they gave me Brutus also felt bad. Parts of him were killed and the other cancer cells had gone dormant. He was beaten down pretty good for awhile, but so was I. I would rather never feel that way again. The test results in June showed that Brutus is starting to grow stronger. Damn.

I have gotten a little out of a logical order on what has happened the last few months so let’s go back to my last post and make some sense out of this chaos. I left you hanging last time. Let’s fix that.

Let me go back to when I arrived home from my fishing trip in Colorado and the next day, May 22nd, I was to have surgery. I will start there.

It was the night before my surgery and all through the house not a creature was stirring not even a …..wait a minute that sounds a little familiar.   Anyway a mouse might not have been up, but I sure was. I could not sleep and I was up almost all night. I had a lot on my mind. I went to bed around 2:30, but still could not sleep. I got up at 4:30 to go to the hospital. I guess I really did not need the sleep. I was going to be sleeping all day after surgery.

Lying in bed I was thinking about how long I was going to have to stay in the hospital. I was hoping to go home the same day as surgery. The doctor’s staff thought that might be possible, but I was more likely going to be staying at least one night.

I was also thinking about how I got myself into this position? I really did not want the surgery. Dr. O wanted me to have the surgery. Christy thinks that I should listen to Dr. O.

I was trying to figure out how to turn this into a positive. I said to myself: Kevin, I call myself Kevin when talking to myself. I tried Mr. Brown, but that does not sound right. Kevin, you have got to figure a way to use this to your advantage.

I decided that I could play the surgery card when discussing future drugs they wanted me to take. Yup, that is what I decided. I will be the farmer’s pig one more time to avoid having to take drugs. I am going to tell them that I did your surgery thing when I did not want to have surgery. Now you want me on drugs and I do not want them. So now we are going to do what I want. We will see how that goes.

So we get to the hospital and they are prepping me and a male nurse is there to shave my chest. He sees the surgery scar from the last time, and we talk about the last surgery. While talking the anesthesiologist (had to look up how to spell that) shows up. Yes, the same one from my rib surgery in March.

He wants to know why I was there again. I had to explain that my medical team, Curly, Moe, and Larry did not have the answers they needed. They needed evidence so today I was having another rib removed. I could have said something funny to him like hoping I make out like Adam, and wake up with an Eve, but at my age I do not need that drama.

My surgeon then showed up and Dr. S spoke to Dr. A. Typing Dr. A is so much easier than typing anesthes….you know.

They were a little lazy at the last surgery prep. They only shaved my chest on the side where they were cutting me open. I looked a little funny. I asked the man to shave the entire chest area this time. I told him that I did not want to look weird for swim suit season. He laughed then shaved not only my chest, but my stomach area as well. Good job.

While shaving he wanted to know my name. I told him Kevin Brown. He wanted to know my middle name. If I had been thinking I would have said “MF.” I did not say that. Not on the top of my game, probably from lack of sleep. I told him my real middle name. I never tell anyone my middle name. The name comes in handy for one reason only. There are thousands of Kevin Brown’s in this world. I can assure you that none of them have my middle name, and no I am not going to tell you what it is. If you are buying the beer I might tell you.

Anyway I told the nurse. I then told him that if he ever told anyone else that I would have to kill him. I don’t think he thought I was serious. He could make my list.

So I get wheeled into the operating room and Dr. A wants my name. I tell him Kevin Brown. I hear the nurse yell out, “His middle name is ****, and if you tell anyone he is gonna kill you.” I laughed. That is the last thing I remember until waking up in the cardio thoracic intensive care unit. I had never heard of such a thing. I was there I guess because I had thoracic surgery, and something about a partial lung collapsing. Hell I do not know. I have never fully understood why I was in the ICU, but I liked it there.

I have never been in intensive care before. They take really good care of you there. The only problem was people constantly in the room ever few hours all night long. I had to have pills ever few hours. They gave me breathing treatments every four hours. I could not get up and walk around without being hooked up to an oxygen tank and wheeling that around with me. But anytime I needed someone they were there. Hell they were there in my room even when I didn’t need them.

After about a day and a half I was moved to a regular room. I still had to be on oxygen. It was a big difference on a regular floor. Hell I could not get anyone to do anything. I waited over an hour for some water. I got up with my tank and walked way down the hall got the water and made sure I walked past the nurse’s station. They asked if I needed anything. I told them I could have used the water an hour ago when I asked for it.

I have another bitch as well. When I was in intensive care the nurses made sure I got ice cream. It was great. I go to the regular floor and I tried to order ice cream and I was told that had to be approved by my doctor, because it was not heart healthy. Well fuck that!! Hell I have stage IV cancer a little heart attack does not scare me. I would welcome a heart attack as long as it takes me quick. Sure as shit beats dying from cancer. I guess dead is dead. I still plan on being shot by a jealous husband. Anyway after making a complaint to the Geneva Convention I got my ice cream. It was not as good as what I got in intensive care. Damn.

So I get sent home and what I thought would be at the most a week off from work is now going to be longer. Someone was sent to my house to place a big oxygen pump in my basement. A very long tube was connected to the pump. It could reach anywhere in the house. They told me that I had to be hooked up to the oxygen machine at all times. I could not even sleep without it. I had this little gadget that I would put on my finger and it would tell me how my lung was doing.

After I got home I took a shower and I started getting dizzy and feeling weak in the shower. I realized that I had taken that damn oxygen tube off. So I grabbed it off the counter and put it on. Then felt better. They were serious about that oxygen shit. Imagine that.

After about a week my lung had recovered and I no longer needed the oxygen. I had all of these tanks around the house, and I was supposed to take one with me if I left home. Finally I got the company to come get them. They looked like missiles. I thought that I was going to blow the house up.

So let’s move on to the test result from my rib. Once again Christy knows and works with everyone in the pathology department. The guy in charge again looked at the rib as well as another doctor that Christy likes, a different doctor from the last time.

No cancer was found. Which you would think is good news. I took it as good news. But that brings up the question of what the hell was it? The pathologist could see the damage. Last time the surgeon saw the damage, but he had tore up the rib so badly that the pathologist could only check for the presence of cancer cells. They could not see the damage that the surgeon had found. This time the pathologist could see the damage. The doctor told Christy that it looked like cancer could have caused the damage, but no cells.

I will take that, because my thinking was that I now have a better case for going off all drugs. If the rib had tested positive then that was not going to happen.

So the first doctor I see during “Kevin’s Summer Tour of Medical Bullshit” is the surgeon. He says “You know that the test for cancer was negative, correct?” He knows that I have the hook up. I tell him that I did know that.

He is sitting on a stool just a few feet from me and he was looking straight at me. He then looks down to the floor and his shoulders droop. He then looks up at me again and I can see in his eyes and in his face that he feels that he has failed me.

He has believed from day one that the cancer had moved into my ribs. He tells me again that what he saw was cancer damage. I told him that I understood the situation. He again looks away from me. Then there was silence. We both knew that something bad had been going on or was going on inside my body. It was just not yet understood.

When he again looked at me the cancer conversation was over. We knew that there was no reason to continue talking about it. We then talked about how to put the medicine he was giving me onto the incisions to keep germs out. He showed me how to keep it covered so I could go on my upcoming lake vacation. He said lake water better not get into the wound.

Christy works closely with many of the cancer doctors at her hospital. She has worked with my surgeon on several occasions. Therefore that makes me part of the hospital family so to speak. Dr. S believes the cancer has spread and without evidence he feels that I will not be treated correctly. I understand that.

I want Dr. S to know that I greatly appreciate all his efforts. Even though there were times we did not see eye to eye I greatly respect him. Sometimes things are a mystery. At least until they are not. Time will tell.

So the next doctor I see is my oncologist. First thing that Dr. O does is thank me for having the surgery. He tells me that it was needed to help answer questions. I am thinking well what questions did it answer? I did not ask. You see I really have gotten to the point where I do not care anymore. I just want to move on.

Several months ago I was in a bad way.   I was in his office and I was not happy with how things were going and I raised my voice a little to let him know my dissatisfaction. He made a statement that I will not forget. He said, “My job is to help you manage your cancer. I have not been doing a very good job.” I thought to myself, no shit Sherlock as I was walking out the door. I did not say it out loud. I wish I had.

The words he used that day have meaning. He did not say that he was there to cure me. He did not say that he was there to help me have a high quality of life. He was there to help me manage. If he was there only to help then that must mean that I am in charge and I was going to make a decision that he was not going to like. No more surgeries and no more drugs.

It was not a popular decision. The biggest reason being the tests that I had a week before seeing Dr. O showed that my cancer was no longer dormant, and that Brutus was alive and well and growing. Being dormant did not last very long. That is very bad. Damn.

We had this discussion in March. He kept giving me reason why I needed to continue the drugs and never come off of them. I just kept telling him no. I will talk more about my reasons on my next post.

During the March meeting we had a very good discussion and I never raised my voice. Honest. He finally understood that I was done for now with the poison being injected into my body and taking pills.

Now I am not suicidal, at least not yet. I know that at some point I will need to be back on the drugs. I know that if I am not on the drugs that the cancer will kill me sooner. I just want for as long as possible to not feel sick. You have to recover from the disease then you have to recover from the treatments.

Christy was not at that appointment in March, but she was at this one. I was concerned that they were both going to gang up on me about the drugs. You see Christy does not like my decision about coming off the drugs.

She had gone to the kids and spoke to them in an attempt to get them on her side. I knew that was going to happen. I had this planned out for months. I spoke to each of my children in person before she got to them and told them what I was planning on doing, and why I was doing it. The kids understand why I am making this choice, and for now they support my decision.

Christy let Dr. O know that she felt that I should stay on the drugs. I thought oh boy here we go. The doctor has an ally and he is going to run with it. I was pleasantly surprised that did not happen. He knows my wishes and he did not throw me under the bus.

He looked at Christy and told her that I did not want them. That ended the conversation about the shots and drugs. I will remain off all medications for now.

He did tell me that he was concerned about my rising PSA numbers and that he did not want that number getting very high. He gave me a number that he felt my PSA should not be allowed to rise above. I thought that number is way too low, and I am going to be at that number in no time. There is no way I am going to agree to that, but I did not say anything. That will be a discussion for another day. I have already started planning for that day.

So from what I can tell Dr. O still does not have the evidence he needs to prove to him that the cancer was or is in my ribs or will return to my ribs. Whatever, it is what it is. I will deal with future problems when and if they occur. He wants me on drugs, but for now he will let me think that I am in charge.

I am scheduled to be tested and maybe scanned in September and October. We will see what happens then.

For now the cancer grows and I understand the risk I am taking. I will have more about the drug issues and the cancer growth in the next post.

The last doctor I saw was the wise old urologist, Dr. U. He had told me during our last visit that he believed the cancer had spread into my ribs. Last time we talked about the need for the second surgery. He told me that they would not find anything. When I saw him in June he did not know that I had agreed to have the second rib surgery.

You see my doctors do share information such as lab work and who knows what else. Unfortunately they do not talk. I wish they did.

When he found out that I had the second surgery he was a little upset. He flat out told me that I did not need the other doctors. He said that he alone could take care of me.

I let him know that I appreciated his concern, but for now I was going to keep things the way they were.

With multiple doctors I am able to learn about more options. I am then able to cherry pick from each doctor. Dr. U has a much higher PSA number in mind when he talks risk tolerance than Dr. O’s. I like that, because I think that it at least lets me know that I am not being totally irresponsible. That a well respected doctor agrees with me on how I want to handle my treatments.

But I cannot ignore Dr. O’s thinking on what needs to be done. He is a very smart man. You may have seen on the news or read in the paper the past few months about a new study involving breast cancer patients in which it was determined that women with the most common form of early stage breast cancer could safely skip chemotherapy. Well Dr. O was one of the researchers and is a co-author of the study. I think I will keep him on my team.

Going forward from here I am concerned that my numbers are going up. That should not be happening. I am concerned that very recently I have again started having discomfort in my ribs. I have tried to tell myself that the discomfort is caused by having been so active this summer. I know that I am lying to myself.

Overall I am happy. I have had a great summer, and I hope you have as well.

Well that is my update on how Brutus is for now.

We will see what tomorrow brings. Remember life is what you make it.

Thanks for listening. Okay, technically reading.

Kevin