It began like any other morning. I don’t remember the exact date, but it was during the last half of July in 2019. I had just finished my third big trip of the year. The fiords of Chile, the dunes of Namibia, and a total solar eclipse in South America were all under my belt. I was living large and I had big plans for the remainder of the year with more travel, my first image processing workshop, some work obligations, and some family time. I was also planning to keep my momentum into the new decade with four trips outside the US in 2020. I was recovering from arthroscopic surgery to repair a torn meniscus cartilage I had suffered in my left knee during the trip to the Chilean fjords. I had delayed the surgery until July to accommodate my travel schedule and I was at home with my knee packed in ice and my bloodstream filled with prescription anti-inflammatory medicine designed to speed my recovery.
Coincidentally on this particular morning I began to experience some strange symptoms unrelated to the knee surgery. They were minor at first and, as people do, I ignored them thinking they were nothing or, better yet, a figment of my imagination. However, they quickly escalated over a couple of days to the point where even I couldn’t ignore them. And trust me, I’m good at ignoring things when I want to! In this case, however, I soon found myself in my doctor’s office to explore these new symptoms. My left knee was still wrapped in ice and stiff as a board.
I soon learned during this doctor’s visit that I was beginning a new journey that included the possibility of bladder cancer as the final stop on the road. Not to worry, I thought to myself as my doctor explained the options. He noted that there were many exit ramps along this road well before getting to bladder cancer. Surely I would take one of these exits before getting that far! Exit #1 was a potential infection. Nope. That was an easy one to cross off the list. Exit #2 was kidney stones, but that diagnosis was not as easy. This exit required a CT scan, which in turn required scheduling and waiting and contrast agents that made me feel like I was wetting my pants while an electron gun swirled around me shooting x-rays through my body to ultimately create a nice pretty 3-D image of Steve’s kidneys. Surely this miracle of modern physics and medicine would provide an exit ramp before I arrived at bladder cancer. Instead, my radiologist soon happily reported that my kidneys were healthy with no signs of calcifications that would cause my symptoms. I was happy to know that my kidneys were fine, but I just passed Exit #2 on my journey.
I turned to the internet to research the remaining possibilities. Bad idea. Sure, knowledge is power, but I have to admit that I preferred the ignorance is bliss strategy. Nonetheless, the next step in my journey was a lovely examination known as a cystoscopy. That’s such a benign word, isn’t it? I’ll spare you the juicy details of that exam and instead encourage you to google it if you’re interested. Suffice it to say that a cystoscopy is a mainstay technique in the medical subspecialty of urology. I will also say that, as a photographer who thrives on images and as a scientist who thrives on technology, I was fascinated by the cystoscopy exam technique, as long as it was someone else’s cystoscopy! The emotional toll of my journey was starting to weigh on me and the idea of my own personal cystoscopy creeped me out. Moreover, this test was the gold standard that would ultimately reveal the endpoint of my journey. Either I would have symptoms from an unknown cause or I would be condemned to a diagnosis of bladder cancer. My list of options was growing thin and the cystoscopy was a major fork in the road for Steve’s bladder.
However, before reaching that point, I still had one possible exit remaining. In the midst of the urology workup, I had a follow-up appointment with my orthopedic doctor to check on the recovery of my left knee. Remember? This whole urology journey began with an ice-packed knee and a bloodstream filled with anti-inflammatory medications. During our follow-up, the orthopedic doctor quickly declared that my knee was fine. Excellent! Now, what about these other symptoms? He suggested they might be due to the anti-inflammatory medication he prescribed. Yes! This is exactly what I wanted to hear! I had one more possibility before the cystoscopy examination. Of course, I immediately ceased the anti-inflammatory medication and voila! my symptoms disappeared within 36 hours. This was the exit ramp I needed. It was now obvious that my symptoms were caused by the anti-inflammatory medications. No bladder cancer for me! I also did some research on the internet and found a peer-reviewed scientific paper reporting that 50% of patients with my symptoms were taking anti-inflammatory medications. Slam dunk. I finally had something to hang my hat on besides the potential for bladder cancer. Knowledge truly is power. As you can imagine, I was elated!
But I still had a cystoscopy scheduled three days later. Remember, that’s the gold standard for finding bladder cancer. I considered cancelling my appointment. Why subject myself to this yucky exam if I already knew I did not have bladder cancer? Ultimately, I opted to go through with the exam just for the peace of mind it offered. Three days later, I was face-to-face with my urologist and a tiny camera that looked like a medieval torture device. The exam didn’t take long and he quickly told me I had bladder cancer. No fucking way! was my immediate response to the urologist. But I was awake during the exam and I saw the images from inside my bladder at the same time he did. That is an image this photographer will never forget, and it didn’t take a urologist to know that the leafy, pink, 1.5-centimeter mass did not belong there. I almost threw up. Needless to say, the journey that began on a morning in July ended with a very unwanted diagnosis.
It seems like the diagnosis should have been an answer. Instead, I now had a million questions. Questions I never imagined would apply to me. Can it be treated? Is it localized? Will I lose my bladder? How would I pee if I did? Will it kill me? Answers came slowly. They wreaked havoc on me emotionally and I spent the next six months trying to figure it all out. My loved ones and friends immediately and heroically came to my aid. They kept me from going off the deep end. I have a friend who is a urologist and he was a lifesaver. I would have been lost without him.
The good news — and there is plenty of good news — is yes, the cancer was quite treatable. Less than a month after my arthroscopic knee surgery, I was again under general anesthesia, this time to remove the creature-like mass that had invaded my bladder. And, yes, it was localized. And no, based on the fact that the cancer had not infiltrated the bladder wall, I would likely not lose my bladder. We caught it early, but now I will have to be a diligent advocate for my bladder for the rest of my life. My fingers are crossed that I’ll never learn what it is like to pee with a reconstructed bladder. The best news is there is a really good chance that this will be merely a speed bump on my life path. Many people have taken this journey before and shown me the way. I’m optimistic. Something else will have to kill me.
So, that is my story. But there are a million stories like mine. Many are depressing. Many make you smile. Many make you cry. Some are especially difficult. Some not so much. All of them are inspiring. We all know someone with a story like this. I don’t know where mine falls within the grand scheme of things, but I hope by adding it to the choir of stories like it, we will increase the volume on the commonality of what it’s like to be human.
I feel great. I’m doing great. I just finished a series of immunotherapy treatments that I tolerated very well. No complications or serious issues. I’m now a proud lifetime member of the urology medieval torture club. It’s not a bad place to be. Don’t feel sad for me. Be happy that emotionally, medically, socially, and lovingly, I have had some wonderful people who have taken care of me on this journey. It is humbling beyond words. Again, don’t feel sad for me. Instead, consider the million other inspirational stories out there. Consider how these stories are more about how we are alike rather than how we are different. And celebrate the commonality of humanity.
Thanks for listening. Now please enjoy some images I’ve collected so far in 2020 along the Foothills Parkway!