Hallelujah!

[ksaves2]

Am starting day one of retirement after practicing geriatric medicine for 32.5 years. I was offered medical insurance and took it. Only quitting 1.5 years early as I planned on going to 65. I got too tired of working after being treated for prostate cancer in 2016. Found out after the surgery though the tumor was small in the specimen and couldn't be seen on imaging, it was peripheral and a little leaked into the bed next to the prostate. Sheeeeoooot! I was scared witless. Yeah they can slow to process of metastatic prostate cancer down and one can live a long time with it, I'd prefer to be rid of it. I was scanned from stem to stern and the radiation oncologist suggested a choline PET scan. I had to drive 100 miles to go to a center that had one. Decatur, Illinois of all places. Sure enough, the only place they could find a bit of tumor was right next to where the prostate was. No place else. Armed with the coordinates the radiation oncologist boosted that spot after a total of 45 external beam treatments and 4 Lupron shots over two years. The Lupron is what wrecked me and turned my muscles to mush. But one has to do what they have to do to beat this thing. I had patients that blew off the Lupron and they did not have a good outcome meaning that they had tumor recurrence when they possibly could have cleared the tumor if they took the recommended therapy the first time. Ummm, the Lupron turns one into a chemical eunuch. Actually chemical castration is more complete than surgical and is more effective at slowing a prostate cancer. My PSA is staying undetectable. So you can see why I bugged out a little early. I've also posted my dad died after a good, well spent life in 2017 and my wife died at age 57, January 25th, 2019 of radon induced lung cancer. She never smoked a cigarette in her life. We didn't know radon was a problem in central Illinois but I bought a meter when she was diagnosed and saw levels 2 to 4 times higher than what is considered safe. It's been mitigated and the levels run .2 to .5pCi/L which is very low.
Am guardian to our 26 year old autistic spectrum son who stopped having meltdowns when he got out of puberty. Police had to come to the house to calm him down about 20 times when he was in puberty beside the mental institutionalizations about 16 times. Retrospectively he couldn't handle the hormones and when he turned 22, the behavior just melted away. I'm so glad my wife got to witness that miracle. Chris has an 8 year old mentality has speech, can't drive and can print really clearly. I can take him to rocket launches now and will be able to travel with him to overnight launches. Gets along well with people. Unfortunately his only quirk is he has a bad fear of dogs. I scratch my head over that one as we never owned a dog because we didn't have the time to care for one. Chris has never been bitten by a dog. My best guess it's the wolf characters in Disney movies that might have instilled that fear.

So, one can see I have a lot on my plate. A good reason to quit working. I'd hate to retire and drop dead in 6 months though it can happen unexpectedly. I had a nurse working with me who was in her early 80's. She didn't look it, liked being an office nurse and did a good job. Was in excellent health, didn't require medications and had regular checkups. One week before she was going to retire her husband and her were going to go for a local visit. Bob went out in the car and Elizabeth said she'd be right there and just wanted to check her hair. She didn't come out and Bob went in and found her dead on the bathroom floor! Sudden death without warning happens sometimes in
seemingly healthy people. Elizabeth used to mention she was blessed with good health and wasn't plagued with the usual aches and pains one would expect from a person in their 80's

It's likely going to take a year to get the house cleaned and "declutterized". I still have to go through my wife's clothes and take them to Goodwill. There's not many women around here who wear a size 4 petite like Sally did. That's her in the Avatar with the purple rocket. I'm really looking forward to this as I don't mind domestic chores and I should be able to get my two small workshops, one in the garage and one in the basement cleaned up and organized so I can get back to rocket building. God willing and the creek don't rise, I hope to be able to have some fun. Oh, once Covid is controlled, I'll be heading to the gym as exercise is the only thing that can battle Lupron induced fatigue. I just had no time when I was practicing. Kurt

 

[dhbarr]

Well done, that's quite the race you're running.

 

[tim cubbedge]

Congrats! I retired 3 years ago and never looked back.

 

[Bat-mite]

I'm at least a decade off, but looking forward to it. Congrats!

 

[o1d_dude]

Congratulations, good sir!

I retired 13 years ago and have not looked back either.

Stay active. Stay involved

We only get about 30, 000 sunsets so watch them all or as many as you can.

 

[Cl(VII)]

Congrats. Sounds like you are in a good place despite the hard road. Enjoy the next phase.

 

[Peartree]

My wife and I were talking about retirement during our walk this morning. I'm not yet 60, but I've nearly had enough. We're trying to decide how soon we can afford it but as soon as the lights on the panel turn green, we're punching the button. Best of luck to you.

 

[boatgeek]

Congratulations and many happy returns on your retirement anniversary!

 

[aerostadt]

I retired almost 10 years ago. I have long since realized that the company did me a favor by saying it was time to go.

 

[ksaves2]

Message to hospital president:

I'll leave the desk chair as it's clinic property. I don't want it anyways. I've farted in it so much I've left enough DNA you could clone and make another me if you want to! Wait 30 years and you could get another doctor.

Shoot, I wished I could think more of this stuff up consistently, I might have been a gag writer for a living. Kurt Savegnago

 

[BABAR]

Congrats!
My best to you and your son.


I came late to the party. Stage 4A, one year out from XRT, PSA 0.2 (Which is pretty good since I had XRT and still have a prostate, although a relatively charred one.) Tolerating Lupron okay.

You guys out there over 50, don't listen to USPSTF task force recommendations, news is out they blew it on PSA recommendations. Get your PSA, and don't just look at the number, look at the TREND if you have priors. By the numbers, I went from Normal to Abnormal (8.0) in one year, and was diagnosed stage 4. If your curve starts steepening rather than linear, get an MRI or biopsy.

 

[Blast it Tom!]

Congratulations, (ex) Doc! It's really sad about your wife; I am blessed to still have my beloved with me, and we have our autistic son as well. I'm hoping to make the step you took in the second half of next year when she hits 65 (I'm 9 months older to the day). My son is communicative and takes care of his personal hygiene, makes his bed, cleans his room, etc. But funny, the other day he asked me what it woudl be like if he lived here by himself for a couple of years, and by the time I was done listing all the stuff he's have to do (he knows this, he just likes to hear me say it), I was kind of amazed myself. He kept saying "Oh, my gosh!" "Could you imagine?!"

Now, with practicing geriatric medicine, it seems like you could set up a little side consulting thread here... many of us are in your age range, I gather, you're actually a little younger than I.

 

[ksaves2]

Congrats!
My best to you and your son.


I came late to the party. Stage 4A, one year out from XRT, PSA 0.2 (Which is pretty good since I had XRT and still have a prostate, although a relatively charred one.) Tolerating Lupron okay.

You guys out there over 50, don't listen to USPSTF task force recommendations, news is out they blew it on PSA recommendations. Get your PSA, and don't just look at the number, look at the TREND if you have priors. By the numbers, I went from Normal to Abnormal (8.0) in one year, and was diagnosed stage 4. If your curve starts steepening rather than linear, get an MRI or biopsy.

Ditto ditto BABAR. The USPSTF is F.O.S. on this one. I've had a lot of patients under in their 50's and a small number in their 40's (youngest 44) with prostate cancer. I elected surgery as I wanted the SOB out and if I had a centrally located tumor, the PSA would go down to zero and I would have been done with treatments. As it turned out it wasn't 0 and radiation/Lupron was the salvage option and so far is working for me with NED (no evidence of disease). PSA is .01, the limit of detection so essentially zero. If I had been 80 years old rather than 58, I would have done the radiation option up front. Man, Lupron gives one the hot flashes from Hades! I've been off of it for 2 years now and I still get mini hot flushes every now and then. Lupron also gets into the brain and in my case blunted the emotions. On June 9th 2019, the levels dropped and left my brain. I cried non-stop in my bedroom an entire weekend. I wasn't able to mourn when my wife died as I was still on the Lupron at the funeral. I kept my composure due to the drug but paid for it later.
Since I'm retired, I'm going to start exercising as that is the only way to combat the Lupron induced fatigue. It's going to take one more day to complete medical records and then I'm gone. Malpractice insurance runs out in two weeks and since I'm retiring they cover the tail. September the medical license comes up for renewal and I've already emailed the state I'm retired and won't be renewing. I will officially be a "civilian" but I won't take offense if friends still call me "doc".
Kurt Savegnago

 

[ksaves2]

Congratulations, (ex) Doc! It's really sad about your wife; I am blessed to still have my beloved with me, and we have our autistic son as well. I'm hoping to make the step you took in the second half of next year when she hits 65 (I'm 9 months older to the day). My son is communicative and takes care of his personal hygiene, makes his bed, cleans his room, etc. But funny, the other day he asked me what it woudl be like if he lived here by himself for a couple of years, and by the time I was done listing all the stuff he's have to do (he knows this, he just likes to hear me say it), I was kind of amazed myself. He kept saying "Oh, my gosh!" "Could you imagine?!"

Now, with practicing geriatric medicine, it seems like you could set up a little side consulting thread here... many of us are in your age range, I gather, you're actually a little younger than I.

I learned if one wants to be an "expert", just get the disease!

 

[boatgeek]

September the medical license comes up for renewal and I've already emailed the state I'm retired and won't be renewing. I will officially be a "civilian" but I won't take offense if friends still call me "doc".
Kurt Savegnago

Engineers have an option to take retired status on their license. You pay a small fee for the rest of your life and you agree that you aren't going to practice professionally, but you get to keep the PE after your name. Do MDs have something similar?

I learned if one wants to be an "expert", just get the disease!

And then you learn all the stuff the doctor didn't tell you because it wasn't ever important to them!

 

[Blast it Tom!]

To both of you, I couldn't agree more with regards to the PSA. Just get it. A dear man in our office, I've known him for at least 25 years, had to retire because they stopped checking it and suddenly, at age 77, wham! Hopefully treatment can extend his retirement years so that he can enjoy himself.

But here's a PSA: CHECK YOUR PSA's!!!

 

[ksaves2]

Engineers have an option to take retired status on their license. You pay a small fee for the rest of your life and you agree that you aren't going to practice professionally, but you get to keep the PE after your name. Do MDs have something similar?

And then you learn all the stuff the doctor didn't tell you because it wasn't ever important to them!

Nope it's not necessary for us. The medical degree says M.D. so the doctor appellation can stick for life even though we don't renew the state license.
There is a DEA license that has a fee too. To maintain a medical license if one is not practicing takes beaucoup bucks so I can do without it. One has to take periodic tests (every 7 to 10 years) and do continuing medical education courses/hours. The medical malpractice insurance to cover the tail is about $30,000.00 for my specialty.

The tail is coverage of the statute of limitations time someone can file a malpractice suit against a doctor. The statute of limitations where I'm at is generally two years from the date the claimant knew or reasonably should have known of the injury. Most malpractice providers waive it when a doctor retires and promises not to practice medicine again.

In social situations where I've met people I generally use my name without using "doctor". I do that at rocket launches when I sign in. Folks call me by my first name in those cases and doesn't bother me at all. If they ask me what I do/did for a living and they want to address me as doctor thereafter that's fine with me. If they want to continue using my first name that's fine too.

In social situations I find using my name helps with inhibiting medical queries from people (unless they find out what I did). If I get a barrage of medical questions I try to do my best at answering but you know, a doctor is technically on the hook for malpractice with any advice they give verbally. Many times
I've coached folks for the best questions they can ask of their own doc or specialist and couched my answers with the caution that they should get any advice I give confirmed by their own doc.

On the questions of psa's, there are guys who have elevated PSAs without prostate cancer. Chronic infection and simply enlarged prostate can be a reason for an elevated PSA. In order to get that sorted out though these guys have to have gone through multiple imaging studies and biopsies in order to come to the conclusion there is no malignancy present in their cases.

I was hoping I was in that boat of a benign psa elevation but a blind 12 quadrant biopsy showed a Gleason 6 tumor. When I had the biopsy done in 2016 they weren't using any imaging modalities other than an ultrasound probe at the time of biopsy. The tumor I had was anterior and lateral up against the prostate capsule though that wasn't known until the prostate was removed. I asked the urologist to take a picture of my prostate after she got it out but she told me later she forgot. (Darn I wanted to see it! ) A small amount of tumor had leaked out next to the prostate bed hence my PSA did not go down to 0 at 5 weeks after surgery. A choline PET scan that is specific for prostate cancer detected a very small area next to where the prostate used to be. The volume of tumor was small enough that external beam radiation was able to fry it along with Lupron shots (at about $16,000.00 per shot for 4 shots!) They also hit all the lymph nodes below the renal arteries to pre-emptively kill any cancer that might have spread there. Thank heavens I had good insurance and thank heavens my psa is staying at the lowest limit of detection <.01. I might be in the position of no evidence of disease which is abbreviated as NED. I have to get psa's every 6 months for 5 years and then yearly thereafter. Kurt