Mets Day 302 - early retirement

Since the start of the year, I have been working less than 20% of a full-time schedule.  I go into the office once or maybe twice a week, rarely for a full day.  Other days I can check my emails from home.  It's been a strange transition, going from a mindset of trying to push myself on a full-time schedule, to a minimal schedule.  I've been surprised at how, on some days, I have little motivation to do much.  Then I realized that there is a correlation between those nights were I get a lousy amount of sleep and the days I feel lethargic.  I'm still trying to puzzle out why that is so. 

Last fall, one of my treating physicians, as well as the sleep disorder psychiatrist, wondered if my inability to sleep was in part caused by the stress of trying to work full time, the nature of my work, the worrying about my metastatic cancer, as well as my nighttime incontinence.  I didn't think there was much to that -- I have learned to not get to stressed out about stuff I can't control -- but I accepted that there was a possibility that, in a subconscious level, there might be some validity to that observation.  I decided, however, I would try letting go of the work-related stuff and see if that made any difference.  So far, it hasn't.  I'm going to give it some more time and see how it goes. 

As far as my options go for treating the incontinence, it appears the artificial sphincter is not appropriate for me.  I have an appointment with a urologist late this month who will do another cystoscopy and see if there is more scarring.  I am still able to self-catheterize -- I did so last night -- so if there is scarring, it is not as bad as it was last July and August, when my ureter was nearly completely closed.  But I also find that my urine flow is weak and fitful, going in stops and starts.  This tells me that my neobladder is not operating as it should. 

There is a possibility that the valve from my original bladder, which was sewn into my neobladder, is the culprit, by not staying closed when I am laying down.  My sleep issues are magnified by the fact that apparently have a hyper-sensitive nerve that waves me up when I leak.  I am learning that both of these issues are uncommon, and so far I have not found anyone who knows how to solve both, short of changing from a neobladder to an ileal conduit.  Unfortunately, the specialist that the doctor from the University of Chicago was recommending -- recently moved from the University of Maryland to Yale, so that local option no longer exists.  I'm continuing to poke around and see who can best teat my unusual set of symptoms.