48 hours

So by noon tomorrow I should have had one of the most interesting 48 hours of my life.  It started on Tuesday morning when I had my MRI at the Duke Cancer Center.  An MRI by itself is not that "interesting".  I've had one before, in 2011 when I fractured my left foot in 2 places and tore a tendon.  However, an MRI for a man's prostate is not quite so simple.  Yes, the time frame of 45 minutes is about the same.  Yes, you get in the same type of MRI machine.  Yes, you listen to music while the machine buzzes and thumps and shakes.  And yes, you have to lie completely still during the various scans.  But there is one big difference.  If you are interested in details, just Google "prostate MRI coil" and read the description.  Imagine an inflatable portion filled with Barium as well.

So after that humiliating and extremely uncomfortable 45 minutes, I was done for that day.

Tomorrow I go back to the Duke Cancer Center for my followup appointment with Dr. Zhang.  After that I am very hopeful that I will know where I stand, for better or for worse.  Hopefully I will have treatment recommendations.  I am hopeful that the MRI did not show anymore cancer that we already knew was there, but that is a distinct possibility.  If it does, I know that another set up biopsies will be in order.  If that does have to happen, I pray it is no worse than the first procedure.  But I will have some type of pain medication for afterwards.  No more brave crap for me.  Give me drugs!!!!!

Regardless of what the news is, I will share.  Steve will be with me tomorrow for the appointment so I am not facing it alone and I am extremely grateful for that.  Say a little prayer.

September 2015

The month of September is coming to a close and what a month it turned out to be.  On the positive side, my outlook on life was re-energized due to someone special.  I got a new pair of glasses, look to the left.  <---  Also, all in all I have felt pretty good most of the month.  On the negative side, I've had the MRI that is next week hanging over my head the entire month.  As hard as I have tried, I haven't been able to completely block that from my mind.  The MRI is Tuesday of next week at the Duke Cancer Center and then the follow up appointment with my oncologist is Thursday.  So a week from now I should pretty much know what the whole plan is, or at the very least have all the information to make a final decision.  Nervous, a little.  Anxious, a lot.

September also brought one of the worst colds I've had in a long time.  I was completely without my voice for 2 days and very raspy (as the cold came and went) for another 10 days.  It's only been the last 3 days or so that I've sounded like myself.  I'll let you decide whether sounding like myself is a good thing or a bad thing.  The tinnitus has remained a problem.  Once I have a decision made with regard to the cancer, then I can move my focus to the ringing.  Getting old and being sick sucks!

A positive note on September has also been the fact that I have gotten back to the gym.  I tried my old schedule but it just doesn't seem to fit me as well so I've been "playing" with alternative ones.  The last couple of weeks it has been a combination of lunchtime workouts and evening workouts.  That has worked, but isn't ideal.  Therefore I'm going to try a morning schedule.  If I can get up 15 minutes earlier just 3 days a week, I can get to the Y, have a full hour workout, and still have time to shower, change and be at the office on time.  That way I actually get a lunch AND I can have FREE time of an evening after work.  The only thing I would really be giving up is sitting and watching TV for an hour before work.  I can live with that....or I think I can.  So, tomorrow I will start my "new"est routine and see how it works.  Then next week I should be able to put it into complete practice.  Monday: YMCA  Tuesday: MRI  Wednesday: YMCA  Thursday: Oncologist  Friday: YMCA.  The following week, no doctors and extra sleep!  This is all in an effort to get rid of the poundage I have put on this summer and to get the waistline back to 2014 size!

To all the well wishers, thank you.  I'm in a good place and doing well.

Vacation Ramblings

Although I named this "Vacation Ramblings" it really has nothing to do with my vacation other than the vacation has given me lots of time for thinking and reminiscing.  The funny thing about reminiscing is that even though my life has been filled with lots and lots of incredibly wonderful times, it's the not so incredible ones that always seem to spring to the forefront of my brain.  I guess some would say that it's just my pessimistic outlook on life.  While that might be true as I don't argue with my somewhat dour perspective, I have had plenty of time as of late to contemplate so many things.

I know some may say it's because of my cancer diagnosis, however that would be incorrect.  While that is in my thought process, it's not the center.  I do think about it, but what I think about more are the other health issues that are going on with me.  The ones that aren't life threatening, but yet, are felt every hour of every day.  Those issues spend more time in my brain than the cancer.  But even more than my health, it's the memories that fill the vast emptiness that is my brain.  I was watching (actually just half listening) to a show on TV over the weekend and although my attention was on the game of Spider Solitaire that I was playing, all of a sudden I heard someone on TV say something to the effect of, "what is the point of life if you don't have something to look forward to?" (I'm paraphrasing).  Even though I wasn't paying attention to the show, it stopped me in my tracks.  The show continued, but I just sat there, thinking.  Now don't go getting alarmed or anything like that.  I'm not suicidal.  It just stuck with me and I started playing over my current life.  What do I have?  I have a job.  Although I like it, it's hardly a "reason to live".  I have a small family.  I love them, but I can't "live for them".  I have friends.  Again, I love them, but I don't see them all that often, so no reason there.  My life consists of sleeping, working and watching TV.  My former life consisted of so much more.  Yes, the center of that was Joe.  But he was a pretty darn good center.  He centered me.  He made me want to get up each day.  He made me happy.  Again, I know, you don't count on someone else for your happiness.  You make your own happiness.  That's what I did.  I made a life with and it was happy one.  That's where my focus needs to be.

So what do I do?  I can't pretend away the physical problems.  I can mask the aches/pains with medication, but then that's all I will do as I can't function very well.  So do I need to just suck it up and work through it?   Do I pretend that I'm fine being alone?  That's more sucking it up.   Or do I change everything?  That means lots of doctors visits.  The cancer?  I either radiate it, slam it with chemicals or cut it out.  At this point, any of the options are ok.  They don't scare me.  They don't worry me (much).  What worries me is all the other crap.  All the other aches, ringing and pains.  No one told me as a kid that just getting older brought all these aches & pains.  Arghhhhhhh

And then there is the real cruz of the matter.  The being alone.  If you hurt and there's someone there to rub your shoulders it helps.  If you're sad and there's someone there to put their arm around you, it helps.  If you're emotional and there is someone there to listen, it's awesome.  I can't "do" anything about the health woes other than make a decision based upon the doctors advice.  What I can "do" is follow my heart when it leads me to someone who is kind, gentle, funny, and loving.  Truly open myself up to the possibility.  I think I might have just done that.

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 trials 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.

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 made 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 hasn't 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.

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

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.

... 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, 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.

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!

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.

1 test down, just biopsy to go

I had the ABR (Auditory Brainstem Response) test on Monday.  However I won't know the results for several days.  The description that the ENT gave me when she told me about the test wasn't exactly accurate.  There were a few factors that she didn't tell me about.  1- the fact that these tiny ear buds would be crammed into my ears with a thunderous clicking sound that would drone on for 20 minutes.  2- the relax in a recliner actually was sit uncomfortably in an exam chair.  With my height, those things never fit right, especially the head rest which usually just comes up to the base of my skull.  3- she never mentioned that during the entire test I have to remain stone still.  But I made it through and now I wait.

The biopsy is Thursday afternoon.  I have to admit that I'm not sure if I'm more nervous or just freaked out.  Hard to tell the difference at this point.  I thought I had been handling all this quite well except for the whole lack of sleep thing until Sunday afternoon.  I let my emotions get a little out of control while watching a silly TV show where a character died.  Funny how something inconsequential can set you off. So I cried for a little while.  A little for me, a little for Joe, a little for Aimee.  Sort of spread it around some.

I find all this so strange.  In the weeks & months following Joe's death, I thought about what I would do if I were to get sick.  I was grieving so much, I wasn't sure that I would even want to seek treatment.  However, when you get sick and you're hurting, it's a different story.  I never really thought about the aspect of possibly hurting.  Sick, not hurting, no real ailments...maybe no treatment is an option and just pass along quietly.  However, sick and hurting...you want treatment.  Or at the very least, REALLY good pain meds!!  So I'll wait and see what the ENT recommends and I'll wait and see what the Urologist recommends.  But those that know me, know I am not a patient person and I most definitely am not a patient patient.

Pray for me.