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    43 Days: A Surgeon's Wake up Call
    43 Days: A Surgeon's Wake up Call
    43 Days: A Surgeon's Wake up Call
    Ebook91 pages1 hour

    43 Days: A Surgeon's Wake up Call

    By Thomas Calhoun MD MS FACN FACS

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    About this ebook

    Black men get prostate cancer more than any other male group—and it is their second leading cause of death.

    Even so, Dr. Thomas Calhoun was still surprised when he we diagnosed with prostate cancer in 2004 after a digital rectal exam that revealed an irregularity not present during his prior annual exam.
    Calhoun underwent forty-three days of external beam radiation therapy as an outpatient. Throughout this time, he recorded his daily activities, which he describes in this book.

    As a retired general surgeon from the Washington D.C. area working as a full-time Medical Director in the District of Columbia Department of Health, the author provides a different perspective on what it’s like to be diagnosed with prostate cancer. He presents an overview of the prostate gland as well as methods for diagnosing and treating the disease.

    He also shares how he leaned on his Roman Catholic faith to sustain himself during this time, even while having to respond to several unusual events in his capacity as Medical Director.
    The author hopes that any man over age forty-five who reads this book will be evaluated by their physician and urologist to screen for prostate cancer to detect it at an early stage.
    LanguageEnglish
    PublisherAuthorHouse
    Release dateApr 21, 2022
    ISBN9781665557498
    43 Days: A Surgeon's Wake up Call
    Author

    Thomas Calhoun MD MS FACN FACS

    Dr. Calhoun was born on October 6, 1932, in Marianna, Florida. He attended Elementary and High School at St. Pius Catholic School in Jacksonville, Florida, graduating in June, 1949, from Stanton High School also in Jacksonville. In September 1950, he enrolled in Florida A & M College, and after a name change of the College, graduated from Florida A & M University, Tallahassee, Florida in 1954 with a Bachelor of Science Degree in Pre-Med. He served as an Officer in the US Army Artillery for 2 years, with specialized training in Chemical and Biological warfare and was honorably discharged as a First Lieutenant. He entered Meharry Medical College in Nashville, Tennessee in 1959 and graduated with a MD Degree in 1963, then Interned at Homer G. Phillips Hospital (now closed) in St. Louis Missouri for one year, then began a General Surgery Residency at Howard University in Washington, DC, 1964 through 1968. He is certified by the American Board of Surgery, a Fellow or the American College of Surgery, and a Fellow and Emeritus member of the American College of Nutrition. He holds the position of Emeritus, Clinical Associate Professor of Surgery, at Howard University Medical School in Washington DC. He has published over 20 articles, and has a Chapter in a major Japanese Textbook on Clinical Pathways. In February 2003, he began working as Medical Director in Emergency Preparedness for the District of Columbia (DC) Department of Health (DOH), and in October 2004 with the Addiction Prevention and Recovery Administration (APRA). He was a Principal Author of the Districts All Hazards Infection/SARS Disease Plan, a primary contributor to the Districts Pre- and Post Small Pox Prevention Plan, and a principal contributor to the Districts All Hazards Mental Health/ Substance Abuse Plan. In May 2007, he received a Masters of Science Degree from Georgetown in Biohazardous Threat Agents and Emerging Infectious Diseases, as a Scholar Studiorum Superiorum ! He was the Physician Chair of the Nutritional Support Committee of Providence Hospital, Physician Advisor for Case Management, working extensively with the Intellectually Disabled. Doctor Calhoun has been married to Shirley Kathryn Jones from Charleston, West Virginia for 55 years. They have 3 adult children, Thomas Jr., Christine and Kathryne, and five grandchildren, Their youngest daughter Maria, was killed on August 19, 2003 by a hit and run truck driver.

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      Book preview

      43 Days - Thomas Calhoun MD MS FACN FACS

      © 2022 Thomas Calhoun, MD, MS, FACN, FACS. All rights reserved.

      No part of this book may be reproduced, stored in a retrieval system, or

      transmitted by any means without the written permission of the author.

      Published by AuthorHouse 04/18/2022

      ISBN: 978-1-6655-5750-4 (sc)

      ISBN: 978-1-6655-5748-1 (hc)

      ISBN: 978-1-6655-5749-8 (e)

      Library of Congress Control Number: 2022907521

      Any people depicted in stock imagery provided by Getty Images are models,

      and such images are being used for illustrative purposes only.

      Certain stock imagery © Getty Images.

      Because of the dynamic nature of the Internet, any web addresses or links contained in

      this book may have changed since publication and may no longer be valid. The views

      expressed in this work are solely those of the author and do not necessarily reflect the

      views of the publisher, and the publisher hereby disclaims any responsibility for them.

      CONTENTS

      Introduction

      Chapter 1

      Chapter 2   Start of 43 Days of External Beam Radiation Therapy (ERBT)

      About the Author

      To Wil Jenk Jenkins, my best friend, who died from metastatic prostate cancer on July 7, 2020, at age eighty-eight, and to my tennis buddies and medical colleagues and their families who also died from prostate cancer.

      INTRODUCTION

      Dr. Calhoun, can you hold for Dr. Fangonil, please?, the voice on the other end of the phone asked. I sometimes answered the phone myself as there were occasions when the office manager and receptionist were tied up with other patients (or more likely with insurance offices trying to get authorization for consultation or surgical procedure), but I had no problem holding.

      Alex, Dr. Alexander Fangonil, who has graciously given me permission to use his name and his experiences in writing this book—and I had been practicing in our respective fields of surgery for over twenty years, he in urology and I in general surgery.

      It was interesting I thought in that short time I was holding—less than fifteen seconds—how with flashbacks one can recall so much information.

      The phone had rung at about 3:00 a.m. The caller said, Doctor Calhoun, this is Annie Fangonil. Alex has an incarcerated inguinal hernia. It happened during our flight from the Philippines last night. We’re on the way to the emergency room at Providence Hospital.

      Annie, Alex’s wife, had worked in the office with Dr. Fangonil since he started practice twenty years earlier, so she was quite familiar with medical terminology, and I am sure Alex told her what was happening. I told her I would meet them at the emergency room, a fifteen-minute drive from our house.

      Providence Hospital is one of two Catholic hospitals in Washington, DC, having received its original charter from President Lincoln in 1861. (Georgetown University is the other.) Providence closed in August 2018 and began offering urgent outpatient care services later that year.

      I arrived at the emergency room around 3:30 a.m., spoke with Annie briefly, and proceeded to evaluate Alex. Indeed, he had an incarcerated right inguinal hernia incorporating the right testicle. He told me the hernia had been present for some years but asymptomatic—that is, causing no pain or discomfort—and he had decided not to have it repaired surgically.

      Hernia is a condition in which part of an organ is displaced and protrudes through a weak spot in the surrounding muscles or connective tissue. We discussed the planned surgery, and he initiated the thought that the right testicle might have to be removed. The operative permit stated that a repair of the right inguinal hernia and possible right orchiectomy would be performed.

      By 5:00 a.m., we had moved to the operating room, where following appropriate general anesthesia, the hernia was repaired.

      Assisting me was Dr. Tomas Thomasian, who had been a surgeon for the shah of Iran before that regime ended and was at that point working as a surgical assistant at Providence Hospital here in northeast Washington, DC.

      Dr. Thomasian expired in 2019.

      Alex and I were residents in our respective fields at Freedmen Hospital at Howard University in DC from 1964 through 1968. Before the surgery, he told me he remembered an article I had published some years earlier about megaherniae (Meg).¹ Alex has been my urologist for the past twenty years, and I have annually made the visit to his office for that dreaded digital rectal exam (DRE) to evaluate the status of my prostate gland. There was also a referral to my primary physician for the annual bloodletting to include the prostate specific antigen (PSA). My last PSA was 4.0 (0.0–4.0 normal range ng/mL), but over the past year, it had increased to 8.0. I will say more about the PSA later, in the prostate section.

      Several years earlier, I had developed enlargement of the gland consistent with benign prostatic hypertrophy (BPH). I had been taking Hytrin (terazosin)² for several years but had changed to Flomax (tamsulosin), both alpha-1 blockers specifically for BPH that basically help relax the muscles in the prostate and bladder and make it easier to pee.

      For the academically oriented, alpha blockers keep the hormone norepinephrine or noradrenaline from tightening the muscles in the walls of the smaller arteries and veins.³ From my review of the literature, the only beta blocker used for treatment of BPH is Carvedilol, primarily used for treating heart failure.⁴ Beta blockers target epinephrine or adrenaline.

      After the DRE, during which Alex felt some irregularities in the prostate that had not been present in the past, and due to the increase in the PSA from 4 to 8 in one year, we decided on a biopsy of the gland.

      As I waited for Alex to pick up the phone, I wondered what the call was about because I did not know the results of the biopsy.

      Tommm … There was always a prolonged enunciation of my first same, which was Alex’s way of a friendly greeting. Alex here. How are you?

      After pleasantries and inquiries into how our families were doing, he asked if Shirley, my wife, and I could come in to see him. I knew from that request and his wanting to see both of us that the biopsy was likely

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