Sunday, October 29, 2017

Cardiac Catheterization Update

Dear Diary,

Well, we had an interesting day yesterday.
Spent nearly the entire day in the St Joseph's Hospital cath lab.
We went in at 1 p.m.for what should have been a 20 or 30-minute procedure at 3pm and wound up getting out around 7pm.
Apparently, they had several heart attacks come in on an emergency basis so I was sort of left to last.
When I finally got in, I had the best suite they had available. The whole procedure took about 15 minutes and it was no more traumatic than getting a dental cleaning.

The real good news, however, is that the pulmonary artery pressures are down, significantly from the last procedure in January.
The pressures in January were in the low 70s and they are now in the low 40s which is very good. We still need to get them lower but this shows that the sildenafil is definitely working.

They did some special testing to find out whether the pulmonary vessels were reactive or nonreactive. Apparently, they were at least mildly reactive which gives me the possibility of being able to use different medicines if necessary.
At any rate, the wife and I are both very pleased with the results, so pleased in fact, that we stayed at the hospital and had dinner at the cafeteria.
We almost never go out to eat you see! :-)

The other good news is that the wife's hands are healing perfectly and the numbness in her fingertips is going away much faster than we expected. She is ecstatic!

All this excitement is being posted a few days after the fact due to server issues with blogger. Anyway, the wife and I are now back to sitting out on the front porch in 100% wonderful weather so I really don't give a rat's ass!


Cheers!


"Every day above ground is a good day".  -- Scarface

Sunday, October 22, 2017

I'm Still Here!



Dear Diary,

Well! It looks like I haven't posted anything for two months! Consider yourselves blessed.

The wife just had carpal tunnel surgery which appears to have been very successful. She is off work for up to six weeks and I'm encouraging her to take all of it. She deserves it.
When she returns, she should be able to do her job much more comfortably.

No idea what the damn cancer is doing. I'm not due for a PSA for 2 or 3 months. I've been on ADT for about three months now with no major side effects. Makes me wonder sometimes if it's working at all! The interesting thing is that the bladder bleeding stopped about a week after I began ADT and has never recurred. Weird!

I go for another right heart cath this Thursday to see how the PAH is responding to the sildenafil.
The PA pressure last time was a whopping 70. With any luck, maybe it has gone down a bit.

My weight is holding in the low 260s. I'm currently on another diet push to see if I can get to 250 this time. I went off plan for a few weeks out of boredom and gained a little weight back so now I'm back on the wagon. At least my diabetes and blood pressure are doing great and under tight control. :)

A bit of sad news.
Our beloved kitty, Pumpkin passed away peacefully of old age early Wednesday morning, Oct. 18th. He was here with us at the foot of our bed when he passed. As much as we miss him we know he is better off.
We had anticipated this as he was 20 years old. He was our fuzzy baby for 17 of those years.
R.I.P. Pumper!

Pumpkin 1997-2017
I'll update more as I think of it. Right now, I have a bout of fatigue setting in.



Cheers!


"Every day above ground is a good day".  -- Scarface

Thursday, August 17, 2017

Odds & Ends

Dear Diary,

Well now, let's see. What's been going on here in Paradise lately?
Not too much which is why I haven't posted anything in a while.

The wife and I just got a nice, free, pre-owned Serta queen size mattress to replace the futon mattress that we've been sleeping on since we came to Arizona in '94. (no, it didn't come with pee stains)
We've both been sleeping better since. "Beggars can't be choosers".

Our 2002 Chevy S-10 just started leaking oil from the rear differential a couple of weeks ago.
Took it to a brand new garage that we just discovered. Turns out the pinion seal was bad. They had it fixed by the next day because they had a problem finding the part.
So, we got that fixed and finally got the oil changed (it's been a while) for a very reasonable price.
We will be using them from now on for anything I can't do.

Health wise, no noticeable side effects from the ADT (Androgen Deprivation Therapy) that I am on to slow or stop the progression of the cancer. I keep waiting for the other shoe to drop but so far, I'm feeling fine with the exception of a little transient fatigue now and then.
I guess the more severe stuff comes on after months of treatment. I can wait! ;)

I think I mentioned in a previous post that I succeeded in losing 49 pounds over the past six or seven months. I've started cheating quite a bit lately, probably due to boredom with the menu, which bothers me. I've gotta get it under control soon before I start gaining again.
It's not an issue with quantity this time but more with what I eat.
Ketogenic dieting works but it is difficult. You really have to stick to the plan.

The bladder problem has at least temporarily resolved. There has been no pain or bleeding for several weeks. I'm still 100% incontinent but that will probably never change. It's just really nice to be able to take a vacation from blood clots and catheters for a while.

I can't really tell if the new stuff (sildenafil) is having an effect on my lungs or not. If there are changes, they are very subtle. I really need to remember to ask Dr. O what he expects as far as effects on the O2 saturation and what time frame we're looking at.
Regardless, I continue to very gradually improve which is unusual for arterial pulmonary hypertension. It's usually just the opposite.

*sips on a bourbon*

On another note, the wife has now signed on with my cardiologist (on my advice) for a baseline evaluation. She just had a Doppler ultrasound of her carotid arteries which was recommended by our optometrist. She has a 60% occlusion of the right carotid. Probably not a serious issue but why take the chance? We want to see how much this increases her risk for stroke.
She also has fairly severe carpal tunnel syndrome. We saw an orthopedic specialist today for an evaluation and she got a set of wrist braces. She will have a nerve conduction test in the near future and, depending on the results of that, be evaluated for possible surgery.

And with that, I'll sign off with one last comment. It is very obvious that we, (the world) are in the so-called 'end times' and we are very grateful to be on the way out and not on the way in!
Does that smack of religion? Not to this old boy! It smacks of reality.
We don't need religion or blind faith to see the obvious!



Cheers!


"Every day above ground is a good day".  -- Scarface

Friday, July 28, 2017

A Little More Good News

Dear Diary,

Just had another Doppler echocardiogram on the old ticker to re- evaluate the left atrial myxoma.
It's been a year since the last one when it was first discovered.
Good news! It has barely changed at all! This news buys us more time for me to get in shape for cardiac surgery.

Weight is still decreasing (despite my cheat days) and lab values are good.
No apparent side effects from the ADT either.

Not 24/7 O2 dependent either. Maybe sildenafil is working on my lungs but it sure isn't giving me a woodie! LOL!


Cheers!


"Every day above ground is a good day".  -- Scarface

Wednesday, July 19, 2017

Officially In The 'Lupron Club'

Dear Diary,

Just got my first dose of Lupron yesterday, in the form of an injection in the butt. The area is a little tender but that should resolve shortly.
As mentioned previously, the goal here is to literally "starve" the cancer of testosterone in hopes that is will retard, or even stop the progression for a certain amount of time (the longer the better)!
The average effective range is 18 to 24 months, sometimes less and sometimes much more.
We will have to be content to wait and see.
There are a host of common yet unpleasant side effects associated with hormone therapy and I will be updating if and when they happen.
One of the more common ones is 'gynecomastia' or enlargement of the male breasts. I guess it's fortunate that I've always enjoyed wearing women's apparel! LOL!

I got another Doppler Echogram done on the old ticker today. We need that to keep track of the progress (or lack thereof) of the myxoma. I will know the results of that in about a week. I really hope it hasn't progressed much because I'm still not ready for surgery.

Things are looking much better with the lungs. I was prescribed sildenafil at my last visit to my pulmonologist but haven't been able to get it filled yet due to an unexpected pre-auth.
Apparently, the stuff is really expensive!
Sildenafil is a potent vasodilator and we hope it will be able to relax and open up my pulmonary arteries resulting in at least a modest reduction in pulmonary arterial pressures.

I think I'm gonna go lie down for a little while 'cause I'm getting fatigued

More dirt later!


Cheers!


"Every day above ground is a good day".  -- Scarface

Thursday, July 13, 2017

Some Good News For A Change!

Dear Diary,

So, it's been an eventful past couple of days!

On Wednesday, we saw Dr. M, my cardiologist for a routine follow-up. He is pleased with my progress with my weight and the respiratory issue. We are going to schedule another Doppler echocardiogram for this coming week to check on the size of the myxoma. My last one was about a year ago. The new information will help organize our priorities regarding the heart surgery.

Today, (Thursday) I went to St Joe's for a six-minute walk test and pulmonary function testing.
Apparently, I did very well and there is an improvement from the previous testing 4 months ago.
It was also officially confirmed that I have lost 30 pounds! They were impressed.

After the testing, we met with Dr. O, the pulmonologist to go over the game plan.
He is finally going to start treating the pulmonary hypertension with drugs. We have been waiting a long time for that.

We are going to start with low dose sildenafil aka Viagra as a first line treatment and see if we get a good response. If we do, they will do another right heart cath to check the pressures.
The goal here is to actually reverse this process that is causing the PH. I hope he's right because PH is usually a chronic progressive condition and not reversible.
Cardiac and pulmonary auscultation was unremarkable save for a few fine crackles in the left base.

*sips on a neat bourbon*

As far as the cancer goes, I'm about 2 1/2 weeks into bicalutamide (Casodex®) to see if we can reign in the horses that have escaped the barn. I expect to be starting leuprolide (Lupron®) in about a week.
This is not a cure but it could theoretically delay the onset of metastases and hopefully buy me a few more years.

Any chance of a cure is no longer on the table but long term control is very possible. I am always grateful that I am a Gleason 7 and not a 8, 9 or 10. My heart goes out to those who are.
At this stage, pain control is not an issue but I am very concerned with this current nonsense about opioid regulation. If I live long enough, eventually I will require them. If they become over-regulated, I may face the death my father had and I don't even want to go there!
For folks in my position, opioid drugs are our friends.

*sips a little more bourbon*

We are now into monsoon season here in Paradise with triple digits and high humidity. Hoping we'll get a little rain this year. Every year we seem to get less and less.
Outside conditions are less than optimal for any kind of exercise so, once again, I'm kind of confined to the house.

Well, enough for tonight. Keep the faith!


Cheers!


"Every day above ground is a good day".  -- Scarface

Thursday, June 29, 2017

ADT Update

Dear Diary,

I'm now 8 days into ADT with bicalutamide (Casodex) and still feeling ok.

I've had a few bouts of depression and now there is a sense of generalized fatigue. We didn't do a baseline serum testosterone level but I assume it must be dropping.

All I feel like doing now is lying around. I sort of wish we still had a TV.

Some say these symptoms will significantly increase when we start the Lupron in a couple of weeks.

Finally managed to get hold of the kids in Italy. Good to know they're all doing well.
I'm a very proud Grandpa!



L to R  Abbie, Arabella, and Chris


My appetite seems to have diminished a bit in the past few days. I guess I shouldn't complain. Having a real hard time losing the last 4 or 5 pounds to hit 260.

The back pain is still there and I'm still treating it with acetaminophen and Tramadol but it really doesn't seem to help that much. That probably contributes to the fatigue.


Cheers!


"Every day above ground is a good day".  -- Scarface