Cancer is Scary, Running a Startup with Cancer Can Be Terrifying

Not All Wounds from War Manifest on the Battlefield, Some can Appear Unexpectedly Decades Later

On the western edge of the battlefield of Desert Storm an unending mist of partially burned oil from nearby wells that had been set on fire permeated everything.?

Your skin, clothes, sleeping bags, food as you ate it, all became conduits for carcinogens to enter your body.?

From this, a small but imperceptible change occurred in the cells of the interior of my bladder.?One that would lurk unannounced for decades only to make itself know 25 years later through a river of blood erupting into a urinal at the Las Vega Airport while I was returning from a business conference.

Its Amazing How Elastic Your Perception of Life Expectancy Can Be

All of us have in the back of our minds a running account of what we've done and what we want to do, and mix it in with some Kentucky windage on how long we think we have to live, and use that result to plan what we want to do with each day, month and year of our lives.

But what happens when that equation becomes a lot more dynamic??You eat healthy and exercise and think you have decades to live and then a day later you are maybe looking at several months, then you get tests done and have procedures and months turn back into at least years, then again morph back into decades only to cascade back down to months and then slowly back up again.?Talk about being on a roller coaster.?

A New Bladder a New Normal

Sometimes to get those extra years you need to take drastic steps.?

Bladder cancer can be one of the "better" cancers is what you hear from doctors, lots of treatment options if caught early, but nothing will ever be the same again.?

You have quarterly cystoscopies to worry about, each time wondering "is it back?"?Then finally you get the word that it is indeed back and some of the initial treatments are off the table and now its time to think hard.?How much do you want to see kids grow up? Grandkids, nieces, nephews? Versus how aggressive you want to be in treatment??Go with more of the same treatment and if it eventually escapes the bladder you go back to months of life expectancy or while you are still relatively young and healthy go for the cure and try and regain those decades??

I am an entrepreneur, of course I want the years, I want to be with my family, I want to see what I have been working on for so long and so hard come to fruition.?I want the cure! But at what cost??

The particular price for this "cure" is one bladder, one prostate, a few nerve bundles, one hell of an abdominal incision, a bunch of lymph nodes, a couple of feet of small intestines disconnected, reshaped into a pouch and tucked back between ureters and urethra…Set oven to high, bake 7 hours in the operating room, remove from oven, wake up and OMG!?How many tubes can you have sticking out of your abdomen???

And I Need to Walk Now??How??

?My catheter is as thick as my pinkie.?Urine draining into bags all over the place, discharge from the abdomen into some freaky looking egg like suction device, IV's delivering pain medicine.?How can I even hope to move, I'm attached to a pole?

?Step by step pole and all, getting use to the new normal.

The first few laps around the ward are painfully slow, but not painful…yet…that comes later when they take away the pain relief being pumped directly into your arm.

Another step.

A few days later IV's start coming out, the egg drain comes off, they pull the stent from your abdomen and "Wow that was an unpleasant feeling but one less thing attached!"?

Take a few more steps each day, more laps around the ward.?Hey, still have the catheter in and the two stents draining urine from my side into a bag but moving forward.

Another step.

I had actually been stupid enough to bring my laptop to the hospital thinking I am strong enough to jump on a few teams meetings from my bed, I wasn't.

Going Home

4 days later I was on my way home.?Still with urine bag on my side and what appeared to me to be the world's largest silicon hose stuck someplace I would rather it not be.

Another step.

You know someone really loves you if they are willing to get up several times each night to flush your catheter.?I cannot imagine going through this without my wife.?The things that she saw and was gracious enough to not tell me about are numerous.

A week has gone by since I last talked to anyone on my team, now its time to start getting back into something of a routine.?I am exhausted and can only talk to one or two a day for 20 minutes or so, but it is a welcome relief from my miseries.

Another step.

A week and one half later, the urine bag and stents are removed.?Imagine two thin white hoses sticking about an inch out of your side for a few weeks, and then the doctor says, "Ready?" and I am like "For What?" and he pulls and pulls and pulls, and takes about 2 feet of hose out.?OMG!

Another step.

Finally, the Catheter

Another couple of weeks, and back to the doctor and the catheter comes out and life will be back to normal!

Yeah, right….

I have to admit not having that hose stuck up where you definitely don’t want it stuck up is a giant relief.?But what was to come next was possibly the most devastating.

Total incontinence.?Not even the least bit on control over a bodily function that I took for granted.

Another step…backwards.

Time is passing, the world doesn’t wait just because of your cancer, business goes on, the team needs leadership, but now the leader is in diapers.?Not just controlling an occasional leak but an ongoing flood.?Not just a few diapers a day, but sometimes a few diapers an hour.

Meetings and work take on a whole new dimension as you manage fluid intake and diaper changes around them.?Talking to a potential customer as a diaper fills is an other-worldly experience.

Another step.

The New New Normal

No more feeling like "ya gotta go."?All the nerves that tell your brain that you need to relieve yourself are in your bladder, so you always have to be one step ahead.?Track fluid in and calculate when you need to go next.

Apparently you have to train or condition your new bladder.?It use to be intestines, and now it’s a bladder, but no one told it so.?Initially its small and when it fills it wants to expel its contents under pressure.?Pressure your newly recruited continence muscles don't have the strength to resist.?Continence becomes a balancing act of your new bladder expanding to its "operational" size and your muscle conditioning.?Lots of variables to manage.?Not unlike your company, trying to keep everything in balance.

Another step.

Your new bladder is flappy, it's not a muscle.?So now you need to learn to expel urine manually by apply pressure to your abdomen.?Oh, and as I mentioned it was an intestine and intestines make mucus, and you need to pass it…push harder.

?Another step.

Continence Comes Slowly

90% of people will regain continence within a year after going through this procedure.?But no matter the odds, when your diaper is filling, you start to believe that maybe you are the 10% that won't. Keeping the faith is so hard sometimes.

You don't even notice it at first, 13 diapers instead of 15, is it because I drank less or the mucus plugged it up??

The first rays of hope are again like a roller coaster.?Is it real or is it imagined.

Monitoring urine output like you monitor database DTUs, trying to see patterns and hoping it goes in the right direction.?

Fighting Cancer is Like Running a Startup.

I wish I could tell you it was all grit and determination and I never lost faith and "just push on my friends push on, follow me!" Far from it, I was and am scared, frustrated, overjoyed, confused, emotional, crying at times, in pain, jubilant and more than once wished that I would not wake up in the morning.?

But each morning I did.??

Another step.

And time to time, when you look back and see where you started from its amazing how far you've come.