June 6, 2026
Week 4 Status Report: Tracking Progress, Tuning the Engine, and Fighting the Thermostat
We have officially closed the books on Week 4 of my 39-session radiation marathon. Because of the Memorial Day holiday, this was a short four-day treatment week, but it delivered some of the most fascinating clinical clarity I’ve had since this journey began.
A Quick Calibration Update
As many of you know, we have been closely monitoring some internal tissue irritation and plumbing restrictions over the last week. After a highly productive consultation with my radiation oncologist, Dr. Greenfield, we were able to pinpoint the cause: my prostate is dealing with some significant historical calcifications from past injuries.
When the daily radiation beams cause standard, temporary tissue swelling, the prostate cannot expand outward because of these rigid spots. Instead, it pinches inward. Think of it like a temporary clamp on a garden hose.
To break this cycle, Dr. Greenfield started me on a daily “baby dose” of a targeted anti-inflammatory steroid (Dexamethasone). We are still dialing in the perfect timing window to prevent it from interfering with my sleep, but the mechanical results are already showing a improvement. Even better, a quick addition of daily over-the-counter MiraLAX corrected the digestive side effects. The plumbing is normalizing, and we are maintaining 100% treatment momentum.
Fighting the Thermostat
While the local side effects are calming down, the systemic side effects of the hormone therapy (the Orgovyx/ADT baseline) are making themselves known. Specifically, the “hot flashes” are becoming a regular part of my daily routine, peaking with precise convenience right after each radiation session.
Fortunately, my truck’s air conditioning works flawlessly. Leaving the clinic and turning the AC to maximum blast has become a highly anticipated ritual.
Managing the Short Fuse
There is one more side effect I want to be candid about, mostly because it impacts how I interact with the world right now. Between the hormone therapy blocking my testosterone, the steroid medications altering my baseline chemistry, and a cumulative lack of sleep, my patience has worn incredibly thin.
I find myself having to consciously keep a firm grip on my anger, especially when dealing with everyday inefficiency or stupidity. If I seem a bit more direct, blunt, or less inclined to make polite small talk over the coming weeks, please don’t take it personally. It is simply the chemistry of the medications talking under the hood, and I am working hard to keep that short fuse firmly anchored. Or maybe it is just the real Rich escaping his confines.
Despite the internal adjustments, the weekend is here. The boat is ready, and getting out on the water with Patty is the absolute best medicine on the map. We are officially rolling into Week 4 with an updated map, a clear strategy, and the engine running smooth.
Thank you all for riding shotgun with me.
Onward.
“Whether you think you can or think you can’t, you are right.”
Henry Ford
Hey Rich,
I have missed a couple of posts. Your narrative about your current experiences is thoughtful, well written, and informative. Thank you for sharing your story. Also the picture of the falcon diving for food is superior. Take care and hi to Patty.
You have the trifecta of whammies-hormone treatment, steroids and radiation! It’s hard work trying to keep the lid on that bubbling cauldron, but it sounds like you have some good strategies to cope. I know that for me, knowing there is an end point to the present travail helps me to cope-and you do have end points for these tx. Hang in there! ❤️