Wednesday, July 31, 2013

The Big ?

The last few of weeks have been full of surprises. I found out that my company is being acquired which places a big question mark over everything. It's too early to know what that will mean for me and that's probably the most unsettling thing about it. This could turn out to be a good thing, it could be a great new opportunity, or it could be just the opposite, and only time will tell. It's the uncertainty that is the terrible oppressive fog that puts everything on hold and makes you feel frozen in place. Knowing what comes next, even if its the worst possible outcome, at least allows you to put together a plan for moving forward but planning for the unknown can be maddening.

Life is full of uncertainty and we usually deal with it by planning for the most likely outcome. Sometimes, if we're smart, we also plan for a less likely outcome at the same time. We call that insurance. Sometimes I feel like I've lived under the cloud of uncertainty for most of my life and though I've always managed to get through it ok, it doesn't get any easier whenever the cloud returns. About a year ago I thought that I was in the clear, things were going well for me and my family and I didn't see any clouds on the horizon. Then, just like a Texas summer thunderstorm, the cancer came up out of nowhere, a wall cloud promising heavy rain. Though I feel like the heavy stuff has passed, the cloud remains. The uncertainty of what is to come hangs over me making it difficult to plan for the future. Now this new cloud drifts in from another direction and I don't know whether it brings rain or just simple shade but it does seem to freeze things in place. 

I feel like I should preserve finances in preparation for the worst possible outcome and avoid any unnecessary spending. It's funny, but the weekend before the acquisition announcement I went out and looked at a Ural motorcycle as a possible solution to my motorcycle conundrum. The hearty Russian made bike comes with a side car that makes the possibility of falling over unlikely and would provide an option to take the girls along with me. After a test ride, I decided to think it over. Even though I could afford to buy it, it's still a lot to pay for the occasional joy ride. Would those opportunities come often enough to be worth it? With summer winding down, should I wait until next spring? I was weighing these questions the following Monday morning when it showed up in my inbox. Another cloud had rolled in out of the blue. Now I look at every expense as money that could be needed down the road.

The prospect of being unwillingly placed in the job market again is always a daunting proposition, one that has never really concerned me greatly, but I was single the last time that I found myself there and had less to be concerned about, and no one depending on me to land that next opportunity. I did not have this cloud hovering over me putting limits on the options that I may entertain. I hate uncertainty and everything that doesn't go with it. I'm a problem solver, it's what I do, but the first step to solving a problem is to evaluate your options and having all of this uncertainty floating above not only obscures the options, but it obscures the problem as well. For all I know, there could be no problem but I don't like operating without a contingency plan. I hope that at least one of these clouds burns off before madness begins to set in.

Speaking of uncertainty, I went to NIH again on Monday and am now enrolled in their study. After a long the day getting irradiated, poked several times, and scanned twice, they arrived at the conclusion that I qualified for the study, the one that is supposed to be for people whose treatment is no longer working. Though I'm not convinced that's the case, they had the data points that they needed to satisfy the entrance criteria. My PSA was up again since the last time I was there, at 3.2. Supposedly they only use that as an indicator and rely more on the scans and other factors to determine progress, but the radiologist's report wasn't complete at the time that I saw the doctor and he was fairly vague on the question of whether or not the scans showed any regression.

Acting on my oncologist's advice of "If I were you, I'd do it", I went ahead and signed up for the study. There seems to be little risk, falling under the category of "it may help, but it can't hurt", though it is also unclear to me how they will actually determine success since the goal of the study is increased life expectancy and considering that most, if not all, of the other participants are septuagenarians. There were two groups that I could be randomized into, the control group, and the experimental group. The study is to determine whether the drug abiraterone combined with another called amg386 is more effective than abiraterone alone. I wound up in the control group which means that I get just the abiraterone. This is in addition to all of the meds/treatment that I'm already taking. 

In some ways I was relieved not to get into the experimental group as that would have required me to drive down to Bethesda once per week to get the amg386 injection and would have made holiday travel plans a little tricky. Instead, I just take four horse pills every morning an hour before breakfast. Then I have to take a prednisone pill with breakfast, along with the calcium supplement and 4 different pain relievers that I was already taking. I am hopeful that this additional treatment will lead to a lessening of my need for the pain pills if not removing the need altogether, but then there's that uncertainty thing. Who knows how my system will respond to it?

Uncertainty has become my new status quo. I don't like it, but it's the hand I've drawn. I really don't need any more and could use a little less. Here's hoping the current clouds move on soon.

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