Friday, August 14, 2015

Delayed MRI

A little stumble along the way to getting my MRI done.  After more discussion with Dr. Zhang and the urologist at Duke we have decided to delay the MRI by 4 weeks.  Not that there is a problem, however since the biopsies there has been blood in the prostate (a very typical response to the biopsy procedure - you can Google it, I did).  Because of the blood, the doctors were concerned that the MRI picture would not be clear.  No need to do an MRI if going into it they know there will be an issue.  Not to mention, insurance will NOT cover 2 MRI's in a short period of time and I don't want to add that expense.  (check pricing folks if you don't have an idea of what they cost)  Therefore, we have moved my scheduled MRI from August 24th to September 29th.  That should be plenty of time for the blood to be gone.  Just a minor glitch in the plan, but otherwise moving forward.  On the plus side, that that means that my cancelled vacation plans for the week of August 24th are now BACK ON!  WooHoo!!!!!!

I'm still feeling fine from all of this with the exception of this dang ringing in the ears from tinnitus.  That is more disconcerting at this point that the cancer.  At least with the cancer there are treatment options.  This ringing is just grin & bare it!  Oh well, we all have our trial and tribulations.  My shoulders are broad enough to carry it.

Thank you for all the words of support & encouragement.  Your well wishes are greatly appreciated.

Wednesday, August 5, 2015

Duke Cancer Center 1st Visit - Reboot

I had my appointment with Dr. Zhang at the Duke Cancer Center yesterday and it was very informative.  I got lots of information on treatment options, other than surgery and also make an appointment to have an MRI.  Reason, when my urologist did the physical exam, he noted there was a nodule on the right hand side of the prostate however, the biopsy that came back positive for cancer was on the left side.  This inconsistency needs to be clarified and the best way to do that is to get a better picture, literally, with an MRI.  Should there be something that shows up on the MRI that looks "sketchy", then we will have another biopsy but this time MRI guided in the area(s) in question.  Seem logical?  It did (does) to me.  Therefore in a couple of weeks I will have the MRI and then a follow up appointment with Dr. Zhang.  All in all, it was a very productive day.

The Duke Cancer Center has changed much at all.  The systems & procedures still appear to be the same except for the little "due to HIPAA regulations" signs that make you stand back from the check in desk.  Didn't have those back in 2012.  Otherwise, same buzzers, same departments in same locations, same food court & cafe in same locations.  Spent the better part of the afternoon there and I didn't even go over to the hospital and have the chicken fingers!  Did I show restraint or what????

Right now the more pressing issue, at least with what is bothering me is the tinnitus.  It is driving me crazy.  If this ringing gets much louder I won't be able to hear myself think!  ARGH!!!

Thank you for the prayers, well wishes and comments of support.  They are much appreciated and I am so very grateful.

Monday, August 3, 2015

I got lucky

I heard from the new patient coordinator at Duke this morning at 8:40am.  I have a noon appointment with the oncologist, Dr. Zhang tomorrow (8/4/2015).  Obviously I am pleased as punch that I was able to get in so quickly.  I also spoke to my urologist this morning, Dr. Huang, so my records at Triangle Urology will be sent over to the Cancer Center so that Dr. Zhang can review.

Forward movement...that's what it's all about right now.

Thank you for the outpouring of well wishes, prayers and voices of support.

Peace-

Jeff

Saturday, August 1, 2015

Prostatic Adenocarcinoma

And the beat goes on.  I was up until 2am researching…well sort of.  Basically I was reading and getting more and more anxious about the decisions I need to make.  However, I did finally make a request of my urologist to refer me to an oncologist at the Duke Cancer Center to at least get more information on alternatives other than surgery (that was at 1:30am).   Not that I’ve made a decision to pursue another option, but I do want to make sure I have explored all information I can get before the decision is made.  Of course, I’m sure I won’t hear anything from my urologist until the first of the week with regard to this, and even then it will probably be days, if not a couple of weeks before I could get in to see the oncologist.  Even so, it’s forward progress, at least in my mind.

At my appointment last Thursday, we went ahead and made a 3 month appointment for another PSA, DRE and possible ultrasound (automatically in the “active surveillance” mode), so any information I can ascertain prior to that would be a plus.  That isn’t to say that between now and then I won’t make the decision to go ahead and have the surgery, which is a real possibility.  I’ve talked to family and friends about the information I got from my urologist and the prevailing opinion is that I go ahead and have the surgery.  The thought of the surgery isn’t pleasant, however it’s not the actual surgery that has me hesitating, it’s the after effects of the surgery that give me pause.  Am I rambling?  I think I am.

Anywho, I am going to be in a holding pattern until I hear back from my urologist or Duke.  Maybe I’ll get lucky and this will be done quickly (because we all know I am a really lucky person….please note the tone of extreme sarcasm in that).  I’m scared, I’m anxious, I’m nervous, I’m spending way too much time in my own head!

Thank you for the outpouring of notes of concern, optimism, prayers and support.  It means so much and is very helpful knowing so many people are “in my corner”.

Peace-

Jeff

10:37am P.S. - and just like that, after maybe "overstepping" what is proper protocol, I will be hearing from a patient coordinator at Duke the first of the week.  Sometimes it pays to know someone there who is an awesome, awesome doctor and person!  Thank you Yousuf.

Thursday, July 30, 2015

... and the answer is....


Yeppers.....it's positive, prostate cancer, Prostatic adenocarcinoma.  However, it appears to be early.  There are several "ratings" of the veracity of my cancer and so here they are:

Gleason grade: 6 (3+3)  That puts me at the "low risk" side of the scale.
TNM staging system: B1
Prostate Cancer Stage Groupings: T2, N0 M0, G2
Stage: II

Options:
Watchful Waiting- Monitored with periodic (3 mos) PSA & DRE, X-rays
Active Surveillance-Periodic PSA, DRE's but definitive therapy is instituted when pre-defined changes occur.
Surgery- Radical Prostatectomy (3 methods of same surgery: Retropubic, perineal or laparoscopic)
Brachytherapy (Interstitial seed placement) - percutaneous placement of radioactive seeds in the prostate
Cryotherapy- Liquid nitrogen or argon gas administered through probes in prostate
HIFU- High intensity focused ultrasound
Radiation therapy - usually used as a palliative treatment for pain caused by bone metastases.

The only "real" options to consider right now however are watchful waiting, active surveillance, surgery, HIFU or radiation.

And I have to make this decision.  We all know how good I am at making bad decisions!!!!
So those are the facts folks.



Monday, July 20, 2015

Prostate Biopsy (ies)

Ok.  It's been a few days since I had the biopsy.  First off, let me stop referring to it in the singular.  There were actually 12 biopsies taken.  Yep, 12.  Now, I didn't go into it with the thought that there would be ONE sample taken, however I didn't really think about that there would be separate samples taken.  I of course had Googled prostate biopsy and read about it and the whole experience was pretty much what I had read online.  However, reality is not the same as reading.  Without going into too many details, lets just say that between the 6 shots that preceded the biopsies and then the 12 samples that were taken, the whole experience was not pleasant.

However, I do have to say that Dr. Huang was very considerate and wonderful during the whole procedure.  He talked to me, constantly inquired about how I was doing and did everything he could to minimize the pain and trauma of the whole thing.   Thursday night was though one of the most painful nights I have ever spent. ....and Friday was not picnic either!  I even took a pillow with me to work...not that it helped much.  More psychological assistance than anything else.

Results will not be in until sometime this week.  What the steps are once we get the pathology results,  that remains to be seen.  Positive: surgery and/or oncology.  Negative: We didn't even discuss that.

Waiting...waiting...waiting...and we all know I am not a patient person!

Wednesday, July 15, 2015

ABR results in

At least today I got some good news...or at least I think it's good news.  The ENT called with the ABR results and they were normal.  So at least with the first test there is no indication of a brain tumor.  Not sure if the ENT will now want to have a brain MRI or what.  At least this test says nothing growing, but of course that doesn't stop the pain.  So even though I got a "normal", I'm still no closer to feeling better.

Another added negative this week: I haven't been able to take anything for pain, not even my allergy meds because I can't have any NSAIDS to reduce the bleeding risk heading into the biopsy tomorrow.  If I can just make it to 5pm tomorrow, hopefully the biopsy will be done and I can come home and chew on a whole bottle of Tylenol!

One down.