Archive for April, 2009

On Scars, Langer’s lines, and Deafness

Posted in cancer, Cancer Life, testicular cancer with tags , , , , , on April 15, 2009 by lawler

I learned some new things today about the body, about my body. I visited a woman with a very cool name (Morel Stackhouse) who practices something called Ortho-Bionomy and spent an hour or so having my RPLND scar worked on to promote healing and reintegration of the scar tissue — or perhaps just integration.

When I stepped inside her home, just a few blocks from ours, she said “Blah blah leave blah blah blah here.” At least, that’s what I heard, my hearing still quite impaired. Nowadays, I’ve become half-way decent at deciphering what a person has said by hearing some of their words and applying context. I knew she had asked me to leave something by the door, and because my cell phone was in my hand I deduced that she had said “You can leave your cell phone here.” I took my bulky keys and my cell phone and set them on the counter and looked back to her silently.

“Your shoes,” she said, “I don’t care where you leave your phone and your keys,” and smiled.

As I kicked off my sneakers, I said, “I’m sorry, I don’t hear very well.”

“Too much loud music?”

“No,” I said, “too much chemotherapy.”

Dawn still marvels that I cannot hear the tea kettle whistling in the next room. It is too close in pitch, it seems, to the constant ringing in my ears, known as tinnitus. I’m still counting on recovering my hearing, and Dawn reminds me that it has not been that long. But not being able to hear people speaking to me — especially those who don’t already know about my condition — has grown tiresome.

On a brighter, more interesting note I also learned from Morel one of the reasons my first surgery was so simple and easy to recover from (in contrast with my RPLND) — and why the scar is so different, both in the way it looks, and in the way it feels. The reason is what are known as Langer’s lines and that surgeons take advantage of them. The lines represent the natural tension of skin, or how skin is held together on the human body.

My first surgery, an orchiectomy, was a small incision that followed the contour of the Langer’s line in that part of the body. My RPLND, on the other hand (as with most abdominal surgeries) slices right across several of the lines, as you can see in this diagram:

langers-lines

When I run my fingers down my scar, I can actually feel where these lines are because they have formed slight bumps in the scar tissue. I was quite happy to hear Morel say repeatedly, “Your surgeon was very, very good,” as she worked on the scar. At one point she said that one way to know this was by judging how well the Langer’s lines had been realigned when I was put back together. She said that sometimes they are not aligned properly and you end up with a scar that pulls against itself, causing even more discomfort and difficultly in healing.

She also got me thinking again about something that occurred to me a few weeks ago about my tattoos. In thinking about them in the context of this massive scar, I realized how forced they were — and how their meaning has diminished in my mind over the years, and especially now that I have been given (yes, it was a gift of sorts) this strange scar. Tattoos are artificial — albeit often beautiful — scars. Their meaning is frequently superficial, and is always imprinted with the owner’s subjective and sometimes misguided intent. They are, I must admit, affectations. They simply do not rise to the level of importance (or meaningfulness) of a scar of the sort that now runs down the middle of my gut. They were not really earned, and are merely art objects forever affixed to my skin. I never really understood that until now. The story that my surgical scars have to tell are so much more rich and inspiring than the tattoos on my body.

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Before I forget…Dawn and I took the plunge this week. It’s one little step toward starting a family: a new, safer, more fuel efficient, environmentally friendly vehicle (isn’t it cute?):

The newest member of the Wisconsin branch of the Lawler family - a 2009 Toyota Yaris.

The newest member of the Wisconsin branch of the Lawler family - a 2009 Toyota Yaris

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Looking for Easter

Posted in cancer, Cancer Life, testicular cancer with tags , , , on April 12, 2009 by lawler

Today was Easter. Dawn played a church gig in the morning and then we headed out to Bear Valley to spend the day with Dawn’s parents, her brother (up from Chicago) Andrew, and the Walton’s. As usual, Georgia made a wonderful meal, and then we all traipsed around the family acreage looking for twelve well-hidden Easter baskets that my father-in-law Hartmut placed carefully earlier in the day. All conversations about the Easter hunt that took place prior to the actual event were full of adolescent-like disdain. The fact is, it was fun. I trotted around documenting the event, but feeling as though I should try to find a basket too (it is a competition, right?). With some help from Hartmut (“You’re getting warmer…Andrew is very cold…Dawn is hot,” et cetera) I found one of the tiny baskets!

So, here is the most recent picture I have of myself (as promised yesterday)…still skinny, but not looking like a naked mole rat (aka cancer patient) anymore. That’s my Easter basket atop my head, by the way…

Proud of my easter basket. Easter, 2009.
Proud of my easter basket. Easter, 2009.

a finished product

Posted in cancer, Cancer Life, testicular cancer with tags , , , on April 10, 2009 by lawler

My brother Greg called me last week. He said, “I check your blog everyday, and you haven’t posted in a while, so I thought I’d call…” Yesterday Dawn said, “Mike, you really need to post on your blog because people are starting to email me with questions.”

I know, I’ve been bad about writing here — life has gotten busy again, since I started back full time with CTM at the beginning of March. It’s a struggle to not simply relax back into the comfort of the day to day life I used to lead. I don’t want to do that. I want to find new ways of living that support what I’ve learned through all of this cancer shit. I’m trying.

As part of my trying I have been meeting with a woman that initially got to know through my work on the Cancer Stories Project. She has helped me determine some of the positive actions I can take to help my body (and mind) heal from what it has been through over the last several months. One of the first steps is something called Ortho-Bionomy. It is a form of massage that can be applied to major scars to help them heal better. I had no idea what an incision like mine would feel like once it had “healed” into a massive scar. Having a scar like mine is like having some kind of knotted rope fused into your body — you know it shouldn’t be there, and so does your body. I will be having my first session of “scar work” next week, and am curious to see how it helps.

I’m also planning on taking up Yoga in a structured environment soon — although at the moment I don’t think my body is really ready for it. I’m wary of pushing myself too much. I’ve also been (for now) talked into trying acupuncture. Oy vey. Really? Yes. I’ll keep you posted on that as well.

In the meantime, here’s the latest: I will not be taking the oral VP-16. My white blood count tested low for three weeks in a row, and while my local oncologist was encouraging me to continue to have it tested, Dr. Einhorn advised that I not continue and that I not take the oral chemo. I was already leaning in this direction — and so was Dawn. We felt that my body was simply not prepared to endure more toxic chemicals, and that it was time to stop. Considering how the two rounds of high dose chemotherapy and the RPLND have changed me, affected me, it was a bit scary to think of taking yet more chemo anyway. I’m relieved.

In a recent email from Dr. Einhorn’s nurse, Jackie, she said, “Congratulations! You’re a finished product!” I said to Dawn, “that’s a strange way to say it, don’t you think?” Dawn said, “Not really, considering that’s how they think about people in the medical world.” It was telling, even though I know that is not how Jackie meant it — she is a very caring and competent nurse. It’s also a strangely ambiguous phrase: you’re finished. It has two opposing meanings, and they are purely contextual; that is, I could say to you with identical tone and inflection, “you’re finished,” and without knowing what was inside my head (let’s pretend I’m a doctor), you could either think I was saying, “you’re a dead man,” or, “you never have to come back to my office again.”

So, I’m finished. Like a fully restored piece of antique furniture — not quite the same, but in pretty good shape. I’m still having some residual trouble in my abdomen, mostly in the form of pain that sometime radiates into my back, and a still occasional uncomfortable emptying of the bladder. Considering that (from at least one account I’ve read) an RPLND involves the lifting and setting aside of one’s intestines, I guess that goes with the post-RPLND territory. Recently, I asked Dr. [name withheld] via email about these continuing side effects, and he replied simply: “Both of these issues will resolve over time.” Isn’t that reassuring?

Greg also asked that I post a picture, because he didn’t realize that I was looking back to normal with hair. Here is one that was taken shortly after my surgery. I’ll post a more recent one soon.

Self-portrait, February 2009

Self-portrait, February 2009