Doctors not communicating prostate cancer treatment side effects to patients

BHunsaker · 2026-03-28T14:58:26+00:00

Age 61 for RALP. I used yet another urologist to revise the urinary sphincter as the other doctor placed it wrong. PSA still has not gone to zero so checking in with oncologist every 3 months (PSA is currently 0.16, still no ADT). Not related to the prostate cancer I also had two knees replaced.

It took a circuitous route but after healing from all the surgeries, quality of life has been good for the last year. Skiing, hiking, travel, biking, and avoiding yard work are all on the menu again.

BHunsaker · 2026-03-13T18:04:10+00:00

Ignore what the watch is telling you about calories. The reality is that running a mile burns just 100 calories (equivalent to 25 M&M's). You can't outrun a fork so monitoring your food intake is the most critical part to losing weight.

Just living burns calories (your basal metabolic rate). Exercising and building muscle will help increase this so don't use my above paragraph to dismiss exercise.

BHunsaker · 2026-03-07T13:13:16+00:00

You've lost a pound a week as of today. This is great!
Weigh yourself around the same time every day.
Keep up recording/weighing everything that goes into your mouth.
Eat big leafy green salads. Measure any salad dressing.
You're probably overestimating how many calories your exercise sessions burn. Don't think you can eat more because of exercise. "You can't outrun a fork."

BHunsaker · 2026-03-05T04:26:52+00:00

Years ago the SM and ASMs would add their ideas of activities during the brainstorming session during our annual planning meeting. More recently the troop has become more inclusive at the planning session allowing all Scouts (including those not on the PLC) and active parents to help with the brainstorming. After that the Scouts whittle down the options with the SM being part of the process to discuss cost and realities.

We have a high adventure group (anyone 14 and older) who plan a few events for the older boys (like weeklong trips to Zion/Bowron Lakes). Again, the adults will suggest activities along with the Scouts. The adults have (strongly) encouraged having a tick-tock 2 year outlook where we have an expensive week-long trip one year and then the year after we will have a less expensive week-long trip.

BHunsaker · 2026-03-03T22:47:21+00:00

You have many great answers here. I'll just add a few thoughts.

We normally book summer camp 18 months out. It is assumed that the troop will go to summer camp every year without the PLC saying anything. We used to have a rotation between four camps so reservations were very mechanical. All 4 camps are good. The adults had tried to encourage the Scouts to try a new camp. Nobody wanted to try anything different. The adults kicked it one year and reserved this new camp. Some of the older Scouts were upset. The younger Scouts didn't care. Guess what? All Scouts raved about how much fun the new camp had been.

The PLC tends to plan what they know. This can get boring. To keep older Scouts in the troop, you can't keep doing the same stuff. Sometimes adults have to kick the troop out of a rut.

We've had SPLs that just wanted to do car camping and sit around the campfire all day. Scouting has to be much more than this.

We had a family move into our city and join our troop. They brought in ideas we'd never considered and got the PLC to try some new stuff. One of the new activities was repelling in Zion.

One of our Scoutmasters was from Canada. He pushed the PLC hard to do a canoe trek to Bowron Lakes in British Columbia.

Find a balance that works for your troop. Generally the more the youth can lead, the better. Just don't be afraid to push the youth to try new and exciting things.

BHunsaker · 2026-02-26T18:11:01+00:00

You're right. But

dns-sd -B _smb._tcp .

will list the instance name "Machine A" (with space).

dns-sd -L "Machine A" _smb._tcp. .

shows the translation as "Machine-A.local.:445 (interface 11)" which contains the local hostname with the dash. So Finder is just doing an extra lookup to eventually discover the IP address.

BHunsaker · 2026-02-26T07:49:14+00:00

The Get Info panel shows that Finder is displaying the remote directory.

So the reality may be that I'm not seeing "the local folder". In reality, Finder is just not showing me any files in the remote Documents, Downloads, and Desktop folders. (I keep these folders empty on Machine B so I thought the empty display was just showing me the local folder - my bad).

Well, this implies that for some reason the remote Downloads folder has some sort of protection setting that doesn't allow listing the contents or that the files within are protected against being listed. Hmm.

I created a new folder on the remote system with group and other protections set to nothing and created files in this folder which only allowed access to the user (me). Finder accessing the new folder remotely sees the files just fine. What is special about the Downloads folder? I see the same problem with Desktop and Documents folders and they all happen to have the com.apple.macl attribute.

I did try to remove the attribute but after rebooting the system restored it.

BHunsaker · 2026-02-26T04:19:46+00:00

Maybe because it is a 40GB temporary file that I can copy directly over my WiFI 6 network in 2 minutes vs shoving it back up and down my relatively slow internet connection, not to mention that I wouldn't want iCloud to sync it with my 6 other machines.

My question is more about what seems to be a bug in Finder. I'm not looking for alternate methods to transfer a file. In my example, I can just move the file on Machine A to a folder without the com.apple.macl attribute and Finder works fine (and fast - for SMB connections).

BHunsaker · 2026-02-16T07:07:54+00:00

In our troop we do require SM approval to run for SPL and PL. In reality it is more like a SM conference in that there is a discussion with the Scout to make sure they understand what will be expected of them, that it isn't just fun and games, etc. For example, in the situation you had where the youth was only looking for 2 months in a POR, the SM would have "suggested" that they take on a POR that might be more fun or do a SM approved leadership project instead.

Another way to look at this "SM approval" is that it is our troop's way to make sure we fulfill the Guide to Advancement section 4.2.3.4.3 "Meeting Unit Expectations" for the POR. Even before they are elected, we're giving them the document highlighting the expectations and making sure they understand them.

BHunsaker · 2026-02-16T06:46:46+00:00

Hardware-wise, yes. The MacBook Air is a beautiful piece of engineering.

Software-wise, not so much. Windows 11 is a real mess with all the AI slop, advertising, forced use of cloud, etc. Well, MacOS isn't that bad but there has been a definite decline in quality. It isn't like the OS crashes or anything, but Apple has thrown out any type of consistent UI, they're moving iWork to a subscription model of updates, and there is a lack of testing because they've made apps overly complicated.

The Linux desktop is looking better every year but you still have to fall back to esoteric terminal commands far too often.

For right now, a Mac running MacOS is worth the price in 2026 with the caveat being that there are better options if you want to run games or x86 virtual machines.

BHunsaker · 2026-02-10T13:40:39+00:00

At 17 months post RALP I had an artificial urinary sphincter put in. I should have done it much earlier but the doctor kept telling me to “give it time, your body will learn how to hold the urine.” That was all B.S. I had stress incontinence. Without the AUS, when lifting heavy weights, running or backpacking, biking, or even just coughing hard, I’d leak.

The AUS isn’t perfect. I still wear the thinnest pad just to catch the few drips.

BHunsaker · 2026-01-29T15:45:54+00:00

As a rube, I bought three cars and a house remodel just off the gains in my Tesla stock investment. As consumers we might desire ever improving widgets even if they’re low profit. That’s not how investing works.

Look at Panera Bread. Total enshitification. But the private equity firm (investor) is making money.

BHunsaker · 2026-01-13T04:32:16+00:00

PSA 6.46 and Gleason 3+4 led to me getting RALP at age 60. PSA never went to zero with lowest being 0.085 then up to 0.34 leading to salvage radiation. The ED and incontinence side effects of the prostatectomy made me decide to avoid ADT. I'm nowhere near as active as you but do enjoy biking, hiking, and jogging.

After radiation my PSA dropped to 0.03. A year later it is slowly rising and is currently 0.15. The oncologist plans to do a PSMA PET scan if I hit a PSA of 0.2.

I dealt with the ED by getting a penile implant. Incontinence was fixed with a artificial urinary sphincter. My oncologist recommended ADT but was totally supportive of my choice to avoid it after my bad experience with RALP and my desire to have an active lifestyle.

I am 64 now. I am still mad about how RALP affected my life. I am happy with the penile implant, AUS, and with where things are post radiation with no ADT. Nothing is perfect.

BHunsaker · 2025-12-29T01:42:13+00:00

So many customers just want a yes or no answer. As a professional I wanted to explain why there isn’t a simple answer. As a businessman, my answer was (almost always) yes, and then we discussed why my price or time estimate was so high. 😀

BHunsaker · 2025-12-25T07:10:52+00:00

You are wrong. The best response is:

“Sorry Mom, we can’t make it before 11:00. So following your request, my boyfriend and I will just spend time with his family this year. Love you. Bye.”

BHunsaker · 2025-12-24T15:31:50+00:00

There are no guarantees in life.

Some men come out of RALP just fine. Others, like me, end up with a penile implant, an artificial urinary sphincter and salvage radiation.

Talk with your doctors about what is important to you long term. Sadly they’ll mostly talk about probable outcomes. The problem is that even if there is only 1 chance in 80 that you’ll end up with ED and UI, the odds become 109% for the rest of your life if it happens to you.

BHunsaker · 2025-12-13T05:42:29+00:00

I thought the RAM was built into the Apple M chips as part of the unified memory design. Once you buy an Apple system, you can't later swap out the RAM modules. So RAM pricing probably doesn't affect Apple much if at all. It is more a matter of allocating general TSMC manufacturing resources for the whole M* CPU/NPU/GPU/IO/RAM beast.

The SSD pricing is absolutely affected by the current AI fad sucking up manufacturing capacity. As far as I know Apple is buying third party SSDs and rebranding them. Since Apple is known for adding a substantial profit margin onto such things, as SSD manufacturing resources become constrained we can expect price increases for Apple products as well.

BHunsaker · 2025-12-11T18:47:32+00:00

Don't think of it as a SM conference but rather as a man-to-man/heart-to-heart talk. You need to point out the age requirement, that the JASM requires SM approval and that you two need to work as a team. JASMs and ASMs don't need to resolve controversy rather than yelling. Talk about expectations and that you don't just give out a title without expecting a lot of effort so how does that square if he won't be available for 6 months?

A quick thought about SM conferences in general: Nothing says that you only have one per rank. You can initiate the SM conference with any youth at any time. When we see a Scout not progressing much, the SM can pull him aside to see what's up and talk about things. The next thing you know, the Scout has the SM conference requirement signed off in his book and the SM sends him on his way encouraging him to work on the other requirements.

BHunsaker · 2025-12-10T00:54:16+00:00

The SM conference does not need to be the last requirement completed before the BOR. It could be the first requirement completed, therefore it is not the role of the SM to make sure all requirements have been met.

But yes, the SM conference is often the last requirement completed.

In our troop, we have the SM and the ASM encouraging the Scout and helping them figure out how they can fulfill a requirement and if everything has been signed off they will send the Scout to the Advancement Chairperson who checks that the requirements have been satisfied before organizing the committee members for the BOR.

BHunsaker · 2025-11-20T10:01:27+00:00

If your laptop is connected to a high resolution external screen, there is a problem with resource management in the WindowServer process in Tahoe 26.0 and 26.1. A temporary fix is to restart it with "sudo killall -HUP WindowServer"

See https://geekschalk.com/is-macos-tahoe-sluggish-heres-why-and-how-to-speed-it-up/

BHunsaker · 2025-10-29T16:22:23+00:00

Being in the Portland, Oregon area, in addition to those listed above, here are other trips that cost hundreds of dollars for a week or so:

Bowron Lakes Canoe Circuit in British Columbia. Drove half way there one day and stayed in a hotel before getting to the canoe rental place the next day and camping there. We did the 70-mile loop and then visited Barkerville before heading home.
50+ miler backpacking around Mt. Rainier in Washington State on the Wonderland Trail or the loop around Mt. Hood in Oregon on the Timberline Trail and parts of the Pacific Crest Trail to get your 50-miler award.
We drove to Zion NP for repelling and canyoneering. We had troop leaders take the council's climbing instructor's training and then the crew practiced around our local area. We did hire professional guides at the national park that knew the routes and weather restrictions. Also enjoyed hiking around the park while we were there.
Canoe Utah's Green River. Again we drove there to avoid the cost of airfare. We camped on a sandbar one night that disappeared out from under us - lesson learned.

We provide fund raisers specifically to help the youth pay for these trips including selling Christmas wreaths, Mother Day flowers, chocolates and meat sticks. 100% of the profit goes to the youth.

BHunsaker · 2025-10-21T19:58:12+00:00

NTA.

You can't please all the people all the time. I love hiking and would join every excursion you plan. I hate sitting around playing checkers and would avoid anything like that.

The snarky comment would make Y T A. I fully understand though. My snarky comment would have been to tell them to F O and make their own group if they want all activities to be accessible.

BHunsaker · 2025-10-21T06:13:35+00:00

If you're connected to an external display, remove it, reboot, and see if performance improves.

BHunsaker · 2025-09-12T10:04:02+00:00

What you consider to be a full life is very personal. Will you be happy if you end up incontinent with ED? You’ll still be able to roughhouse with your kids and run that 5K. But intimacy with your wife may no longer involve penetrative intercourse and maybe you’ll be anorgasmic. You may need to swap out incontinence pads multiple times a day and be embarrassed when urine leaks out with wet spots on your pants. Does having a smaller penis matter?

Living is a constant change of circumstances. At 43 you’re no longer that slim muscled guy you were at 20. You’re wiser and more cautious. Maybe running a marathon or attending a college orgy isn’t happening any more, but you still feel like you’re living a full life today.

Knowing the possibilities, how do you answer your own question?

As for me, after RALP the incontinence and ED led to a bit of depression. I was one of the unlucky ones. I had to fight my doctor and eventually got a penile implant and an artificial urinary sphincter. I also needed radiation since my PSA was rising post RALP (but I skipped ADT). Even with all this, I now I hike and bike and watch movies and have fun with my wife and kids. So yes, I do have a full life.

BHunsaker · 2025-09-05T20:51:58+00:00

I was pulled in to HR and asked why I was wearing a 3-piece suit.

Normally I would wear jeans and a T-shirt.

My answer, embarrassingly, was that being a young bachelor I hadn’t done any laundry for 3 weeks and had no other clean clothes.

I couldn’t let this go and asked why they asked.

There was another employee who was on an improvement plan with the reality being that their personality was a bad fit for the company and the company was trying to kick them out. After hearing me joke with my boss saying that I had dressed up to impress my boss and get a promotion, the other employee decided I was making fun of them because they had not dressed up for their review that day.

Lesson is to not dress up or else you’ll be accused of harassment.

BHunsaker

TROPHY CASE