The second PSA test came back as a 40. In just two months I had gained 8 points, which was huge. We later learned of men having surgery with a PSA of 8, let alone 40. This was becoming more than surreal and it was apparent that it had to be dealt with and quickly. Although we both still felt that it was an infection, doubts started to creep into our thoughts.

Choosing our Doctor

Choosing who would potentially treat my problem was a rather daunting task. We did not feel comfortable with the Urologists in the local region and did not know who to turn to. The best that I could remember the last time that I had seen a doctor was in 1996 when I need a physical to attend a Scout Camp as a leader. We were fortunate to have a close family friend who was a retired Orthopedic Surgeon. He went to college with my father and I was partially named after him and a great, great grandfather. My earliest recollections of life included both him and his family and we had many memorable experiences with them. We often did turn to him for advice and now was no different.

Not knowing what to do I once again called Jim to ask if he had any recommendations for us. He had bailed us out of medical situations before and once again he came to our rescue. When I called I explained that we did not think that I had cancer and that we wanted to keep this information confidential. Jim and my dad talk often, sometimes weekly and I did not want to unnecessarily concern my parents at this point. Fortunately he did have a recommendation as he also had gone through the search for a good Urologist to help him with prostate cancer. He had found a doctor that he really liked, felt comfortable with and shared similar values. Dr. B. is the Director of the Intermountain Urological Institute and is a member of the Huntsman-Intermountain Cancer Care Program. In researching his background and training it was obvious that he was highly qualified to handle whatever the diagnosis turned out to be.

It was now Friday, August 23 and school had started, a very busy time of the year for me as the bulk of my income was from doing IT work at two separate school districts. Typically it can take from 2-8 weeks to be able to see a specialist, a fact that I had already experienced in July when I was planning on seeing a local doctor (local as in only 60 miles from home). I was very impressed with Dr. B’s office staff as they were professional and yet compassionate. Typically you have to be referred to see a specialist and I did stretch the truth just a bit. I told them that Dr. Jim had referred me, which was true but not quite what will constitute a referral. When I told them what the PSA was the receptionist talked to the doctor and in a few minutes called me back. They were quite concerned the direction and speed that my PSA was rising and wanted to see me as soon as possible. We were able to make an appointment for the following Thursday and could have even gone two days sooner if Maili hadn’t already had a previous obligation. They did ask that Dr. Jim send the results to their office and I told them that I had the results and would bring them in with me. They accepted this and we were able to go without an official referral.

My First Doctor Visit

The next week we researched and learned quite a bit about prostate cancer. Even though we both still felt that I was dealing with an infection I wanted to go into the appointment informed just in case. The appointment was in Salt Lake City Utah, about 2.5 hours from our house. We left early and arrived almost an hour before we needed to be there. It felt good to be there and I was looking forward to putting this PSA issue behind me and getting on with life.

The waiting room was filled with patients, some who looked half dead and some who looked quite concerned. I was glad not to fit into either category. Once again we did like the staff and felt that they were quite competent. Of course the Doctor was the one who mattered most. After the pre-exam with a PA and answering a bunch of questions, some personal in nature, we finally were able to see Dr. B. I immediately took a liking to him and felt quite comfortable in his presence and with his competency. After looking at the records that I had brought he wanted to do an exam, which is when they try to tickle your tonsils from the bottom up. Without getting too personal as this is a very uncomfortable procedure, I will say that I had to thank him for his small hands and fingers. We were thrilled after he finished when he reported that the prostate felt fine, nothing of concern. He did recommend that due to the abnormally high PSA that we have a biopsy and verify that there was no cancer. Typically this would have been done on a subsequent visit but due to the distance that we had to travel he suggested that we do it in a few hours. Although I had wanted to get back to work Maili and I both felt really good about this option as we did want to treat whatever the problem was and put the cancer possibility behind us. This is where things got interesting, now I can even say humorous.

I was given a prescription for a muscle relaxant and an enema. Who knew that you need a prescription for an enema? He suggested that I get them from the pharmacy on the first floor and then use the restroom there to apply the enema. After an hour or so for the enema to work, I was to come back for the biopsy. I have since wondered why he did not offer their restroom as it was much more private than the one on the first floor. Minor as it was this was really my only complaint with my experience in his office. It did take about 45 minutes to get my prescriptions filled and I was getting concerned as he had to leave by 3:00 and he wanted time for the muscle relaxant to work prior to the biopsy.

As I knelt of the floor of a public restroom, albeit in a stall, I recognized the humor of the situation; a half naked man with his rear stuck up in the air trying to give himself an enema. I am incredibly grateful that no one came into the restroom while I was in my precarious position and situation. After this self-procedure we went back up to his office on the fifth floor and I was given a cup for a urine sample. Since I had just spent 45 minutes trying to empty myself out this became a rather difficult task. After drinking a half gallon of water and running the tap for 20 minutes I was finally able to fill the bottom of the cup, barely.

I didn’t know if they would put me out or just give me a local for the biopsy but I painfully found out that it was neither. After sticking half of Salt Lake City up my rectum he proceeded to insert what felt like a needle gun in there also. He would position the gun and pull a trigger. The needle, that must have been slightly smaller than a basketball, would then quickly insert itself into my prostate and grab a tissue sample. He then moved to another area on the prostate and repeated the procedure. After the initial shock of no anesthesia, the first half dozen samples I did fine on. After that it became quite labored as I anticipated the click, felt the needle and tried to relax. He took 13 samples as he wanted to make sure that he had a clear picture of my prostate. He later said that he only took 12 but it was 13, believe me I know as I counted every one of them.

After he finished he once again said that the prostate looked good but we would not know for sure until we had the results. This was a Friday and Monday was Memorial Day. Normally we would have had the results by Monday or Tuesday but the holiday could push things back a few days. We were instructed to call him by the following Friday if we did not hear from him before then. Meanwhile we were given plenty of information to read and websites to go to. And then we were done. If any of you ever have to have a prostate biopsy my only suggestion is to grin and bear it. It is not pleasant, even painful but tolerable, at least until the last couple of samples.

The Waiting Game

I have been fortunate to always be able to attend all of my son’s football and basketball games as they were growing up. We left the doctors office much later than we had planned on due to the biopsy and my youngest son had his first football game starting in an hour. When we had decided to stay and get the biopsy we knew that we may miss it and frankly this upset me more than anything at this point. Even though the doctor did not think that I had cancer both Maili and I knew that it was the right thing to do to get the biopsy even though it was more of a formality. We hurried back and was able to make it to the second half of his game. I felt bad missing the first half but loved watching him play in his first game. He is a scrapper and he had fun which is the most important thing in sports, having fun. Although they lost it was great to be there to support him. This game was important to me as I was feeling that my future may be uncertain.

The next week was a long week but we kept telling ourselves that the tests would come back negative. Both of us really felt that this would be the result but it would be a relief to know for sure and put this chapter behind us.

Thursday I was asked to go with the Scout troop that my youngest son was in. They had a 12 mile hike and campout planned. Although I wasn’t real excited about it I felt that I needed to support my son and so agreed to go. The plan was to leave at 3:00 on Friday. I had decided to call the doctor at 11:00 Friday morning since we had not yet heard back from him.

The Call

Friday morning was the start of a beautiful day. There were no clouds and the sky was a deep, vivid blue. I was going to work for a few hours in my online business and then spend the next 18 hours with my son. It was going to be a great day.

My cell phone rang at 7:55 AM and as I answered I saw that it was a Utah number. This was the call that would change everything.

Hello Jim, this is Dr. B. I’m sorry for the delay but the Labor Day weekend slowed things down (no problem, I’m not worried about it much anyway). One hundred percent of your biopsy samples came back positive for cancer (ok, you have my attention now). We have discussed your case and feel that we need to do a radical prostatectomy and remove the prostate, lymph nodes, seminal vesicles and surrounding nerves to remove any chance of cancer that may have left your prostate. We need to move on this fairly quickly, can you come down next week?

This 5 minute conversation was the longest of my life as I was point-blank told by one of the best doctors in the region that I had cancer. Not just a little bit but that my prostate was completely full of cancer and that it needed to be removed. It wasn’t more than a few months ago that I didn’t even know what a PSA was, let alone even remotely think that I would be dealing with cancer. That always happened to other people, not me. And yet here I was, looking at my life changing forever.

As I told Maili the news we looked at each other in disbelief and still discussed the possibility that they had made a mistake. Were the samples accidentally switched? Did they read them wrong? As we discussed it the uncertainty of our future became clouded. I quickly went from denial to a fatalistic philosophy. Dr. B. was very straight forward and pointed during our conversation. There was no mixing of words just the facts and a strong sense of urgency. He made it sound very serious for indeed it was. We were left to wonder if I would survive. How long did I have to live? When would my health get bad? What about my family? All of a sudden I had a ton of questions and no answers. Per his instructions I did call his office and scheduled an appointment for the following Tuesday, four days later. We were scheduled to see different specialists for 3 hours in the morning; they called it a multi-disciplinary clinic. We were to see other urologists, oncologists, nurses, health specialists and other specialists and then have a Bone Scan before lunch. That afternoon we would meet with Dr. B again for a final consultation and to make plans on how to treat the cancer. It all sounded very expensive.

I spent the next several days agonizing over a few choices that I had made the previous year. My entire life I had been very debt averse and went to great lengths not to go into debt. If I could not pay for something outright I would not buy it. In November of 2012 though I made my first real exception and that was when I purchased my new online business. In order to get the financing with a good interest rate and quickly, I took out a home equity loan, the first time in 14 years that I would be in debt. In theory it looked good; buy the business, run it on the side and put all profits into paying off the loan. Then we would have four years to save money from it to be able to serve our mission. That plan went well for six months but a small change in Google’s search algorithm disrupted this plan the previous Spring and the three years looked to turn into at least five. To say that I was worried would be a gross understatement. I was petrified. How could I saddle my family with this debt? How could Maili possibly handle this? What if we lost our house because I was not here to run the company?

I had an incredible sense of fear but interestingly enough not for me. I was at peace when I thought that I may not be on this earth much longer. My fear and feeling of literal panic was for my family. They needed me and I needed to be here to fulfill my obligations to them. My youngest son needed to have me here to watch his football games and cheer him on. At the time he was struggling in school and he needed the direction and support that I could offer. My wife not only needed my financial support but also my emotional support. She was too young to be a widow. More than ever before as I thought about each of my five children I realized that I needed to be here for them. Without doubt though the biggest thing that I struggled with was the very large debt that Maili would inherit. I was in a panic over this financial burden that I had chosen. I felt as if I was in a narrow canyon with a rapidly flowing river running through it and out of control. I always tried hard to be in control of situations and now unseen forces were at work that I had no control over. I felt helpless.

It was during this time that I turned to my faith and a loving Heavenly Father. Through prayer I found great peace. As I earnestly prayed for guidance, help and comfort, the feeling that I had was that I should put my faith in Heavenly Father and everything would work out. I should point out that I did not have a feeling that I would be healed and survive but rather than God, our Heavenly Father, was mindful of me personally and my family and our situation. Things would work out. As I had mentioned earlier I knew that I had a purpose for this life. If I were to die I knew that I would be separated from my family but that we could be together again in an eternal setting rather than an earthly one.

I was at peace.

This did not mean that I did not worry still as I did but as I trusted my Heavenly Father I knew that things would be taken care of. I just hoped that meant in the way that I wanted. I still had an incredible sense of responsibility to my family. I can’t emphasize strongly enough how real and powerful this feeling was. I had to survive for them. I found that I really didn’t care as much about me but they needed me. I do believe that this sense of obligation was instrumental in my battle. My family needed me.

The Scout Hike and Campout

Seven hours after receiving the news I was with Clint the Scoutmaster and the scouts. It ended up that the scouts consisted of my son and one other scout for a total of four of us. I have to admit that Thursday night I did not want to go even a little bit. I had agreed to go to support my son. What a difference a phone call can make. I now was grateful that I would be able to spend this time with him. Keep in mind that we still had no idea how long I had to live if things did not work out and I was looking at a very finite period of time to be here on the earth. We would later learn that prostate cancer is a slow cancer and even though the cancer in my case was much further along than it should have been that I would have several more years at least. The prognosis for prostate cancer is usually very good as long as it is caught early enough.

Clint is a military man and wanted to take the boys hiking to help wear them out. He said that it made them go to bed sooner and sleep better. I think that he forgot that I was half a century old. We hiked from the valley to the top of the mountain and then back down to the Bear River, a total of about 12 miles. Running several times a week paid off on this trip as I was able to make it without a lot of trouble. It was really nice to be with my son and I was able to appreciate and enjoy his goofishness (yes I am good at scrabble as long as there is not a dictionary around!) I had a nice visit with Clint but the entire time I was running possible scenarios through my mind.

We set up camp late and I was exhausted, part physical and part emotional. I decided to sleep under the stars and just put my sleeping bag in a bivy.  The boys did nod off by 10:30 and I was left to my own thoughts. The stars were beautiful that night and I enjoyed staring up at the heavens.

The 12 mile hike that we went on was very familiar to me as I frequently rode on that very trail. In the summer it was a 4-wheeler and in the winter it was our favorite snowmobile trail. My boys and I have traveled it hundreds of times together. It seems that each area on the trail had strong memories associate with it: rattlesnake ridge or Scout Camp corner or Scout Camp ridge. While hiking I saw where my son ran over a fairly large tree with our snowmobile or where he did a peter-pan over the front of it or where another son ran off a cliff with a snowmobile. There was the spot that my oldest son was quietly crying to himself as a five year old when he was so cold on one of our rides. We had stopped, made a small fire and warmed him up. I tried to be more careful with my sons needs after that experience but still have feelings of remorse about it. There is the shady grove towards the top of the mountain where we slept out and wondered if the early Indians in the area stayed there hundreds of years before. And there was the infamous steep stretch that 23 years previously my wife and I tipped a 4-wheeler and we both fell off. Had she not been pregnant at the time it would not have been so bad but the next 6 or 7 months was rough as she knew that she had caused damage to our unborn second son. It would be 15 years before she would drive with me on a 4-wheeler again.

These and literally dozens if not hundreds of other memories flooded through my mind that evening. At this point the family obligation was at the forefront of my thoughts. Have I done enough for them? Did I live a good enough life to be able to live with my family and Heavenly Father again? Regrets? I had many but as I laid out under the stars contemplating these many questions I had a calm assurance come over me that “it is good enough.” My life was acceptable to my Heavenly Father. Two words kept coming into my mind and that was “No Regrets.” Never in my life did I ever think that I would be able to say those two words but during that sleepless night that feeling came to me over and over again, no regrets. Once again I was at peace.

If I slept more than an hour that night I would be surprised. Morning took forever to come but finally it did and we broke camp. It took a couple of hours to hike back to the truck and then we were home. I was grateful for the time with my son and also for the time to contemplate that night. It was time well spent.

The next few days were spent studying even more about prostate cancer and planning out contingency plans. We decided that after the bone scan in a few days we would tell our children, a very few close friends and then my parents. As a very private person I simply did not want others to know. Cancer is such an ugly thing and it has the potential to define who are. I did not want this to happen to me. The tagline of this website came about after thinking about this for many, many hours and I tried to follow it: “Trials will refine not define me.” There were many iterations of it but it came down to those few words. I feel that it is not as important as to what happens to us but how we respond to what happens to us that matters. I wanted to respond to my latest trial appropriately. One of my early goals was that no one at work would know what I was going through as I did not want to be treated any differently. If someone needed help at work I wanted them to ask and not feel sorry for me and not get the help that they needed. Although one of those that I had confided in told others that I had a problem that I was dealing with, almost no one knew that I had cancer. Keeping it private was difficult but successful.