There are three kinds of men. The one who learns by reading. The few who learn by observation. The rest of them have to pee on the electric fence for themselves. Will Rogers.
In the quote above, I would like to think that I am in the first group, and only occasionally fall into the second group. However, in terms of my medical life, I often fall into the third group (although Will Rodgers seems to be unnecessarily harsh on this group). The past, almost three weeks, is no exception.
By way of background and explanation. After being diagnosed with bladder cancer and having two painless operations – painless, I think, because they are deep inside my bladder where, I’m guessing, there are no pain receptors – and after waiting for the damage caused by the removal of the cancer to heal, I started a six-week BCG-TICE regimen to kill any remaining cancer cells in my bladder.
The BCG part of the BCG-TICE refers to Bacillus Calmette-Guérin, which is another term for a weakened strain of Mycobacterium bovis. Mycobacterium bovis is the bacterium that causes tuberculosis in cows. TICE is short for Transintestinal Cholesterol Excretion, which, after a lot of searching, the internet tells me, is a physical process in which the body excretes excess cholesterol through the feces.
I have only the vaguest idea of what all this means – although I do know the meaning of the individual words – but the BCG-TICE concoction, itself, is sort of an old-timey remedy, having been first used in 1934. The mixture is inserted into my bladder through my penis (an unhappy penis at this point, believe me). The immune system senses the foreign concoction inside my bladder and kicks into overdrive, immunizing like crazy, killing any stray cancer cells that it presumably hadn’t noticed before.
After mt first treatment on Monday, three weeks ago, it seemed like the treatment would be shockingly easy; I had a runny nose on Tuesday and felt a little achy, but otherwise, by Wednesday, I felt good. By Thursday, I felt great. That weekend, I was still feeling great, flying high, until my right shoulder started to hurt, then my elbow, followed by my hand. For a couple of days, I couldn’t touch my mouth with my right hand. (Try brushing your teeth with your non-dominant hand; it is way harder than you would think.)
In the meantime, I felt not exactly tired, just feverish and weary. Worn out. Oh, and scared, I have enough old-age problems, and I don’t want another system going on the fritz. At about that time, after consulting the internet’s infinite wisdom, Michele said, “You have reactive arthritis, a rare but real thing.” We called my doctor and had a semi-bizarre conversation with a nurse, who was about four corporate levels above my doctor. He called back, and after listening to my whining, he agreed with Michele. Having a name for what was going on and a cause made me feel much better.
The cancer treatment has been put on pause, which is not a good long-term strategy. The long-term plan is now to take a two-week break and then try a half dose of the BCG-TICE mix. Strangely, even though this treatment has been around since the last century, the thinking on dosage size and timing is still pretty loose. It turns out that a half dose is considered as effective as a full dose.
In the meantime, when I don’t feel shitty, I feel great.
* I say semi-bizarre because the nurse on the phone asked all the appropriate questions, with no accent, but had no idea who I was or what the doctor’s specialty was.
