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

Saturday, June 24, 2017

I Feel Like I'm Falling Apart

Dear Diary,

The past two or three weeks have been pretty rough. My lower back is acting up again to the point where sometimes I can barely walk. It seems to be a pinched nerve (possibly sciatic) that is causing all this pain and numbness in my feet. I'm currently trying a daily regimen of 1300mg of acetaminophen chased with 50mg of Tramadol three times a day.
It's a good thing we kept that walker from a year ago because I'm really concerned about falling, especially when I'm here alone.
It's unlikely that the pain is associated with the cancer as I've had it off and on for many years.
It gets very wearing though, after a few weeks.

I've also been dealing with untreated dental issues including a huge cavity in one of my front teeth. The tooth finally broke off today. I need two extractions. At my age and income, restoration is not an option. I'm looking into local dental schools who might be able to do it for discounted prices.
Turns out, In America, the health insurance industry considers basic dental care a "privilege" and not a necessity. Therefore, they get away with not having to offer it in basic health plans. Sux!

I'm into day 4 of hormone therapy for the rising PSA. No side effects as yet except the strange urge to dress up in my wife's clothing and hang around in ladies' lingerie departments.
No...wait, that's not a side effect, I've always done that!   ;)

*takes 7 pm meds with water, not bourbon*

Last of all, a shout out to my son Chris, in Italy. Your Daddy's trying to reach you on FB but I get no response. Been awhile since we talked. Call me.


Cheers!


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

Thursday, June 22, 2017

Joining The 'ADT Club'

Dear Diary,

A brief update to my last post.
Saw the Uro today and am now officially in 'Club ADT'.
Took my first dose of Casodex 50mg and have a follow-up appointment in 30 days.
At that time, we will start Lupron as well. I hope this will 'reign in the horses' for at least a good while.

As far as the bone scan, he agreed that there was nothing there that was obvious at the present time.
We talked about the merits of additional scans and his opinion was that yes, we could do that, and we would have additional information, however, the
treatment would be the same regardless of the results. Opinions?

Lupron will be about $1500 per injection twice a year. Insurance shouldn't have a problem covering that...I hope.
If they do, we will have to resort to bilateral orchiectomy to hopefully achieve the same goals.

It's not confirmed yet but it's apparent that I have graduated to stage 4 and there is no stage 5 so you figure it out.

* sips bourbon*

All I can really hope for now is that something else takes me out before the cancer does.

It's been a trying week as I am also suffering from excruciating lower back pain unrelated to the cancer. Got some Tramadol from the Uro so maybe that will help. The pain is wearing me out!

*sips more bourbon (no Tramadol involved)*

On the good side, my weight is closing in on 260lbs which is wonderful. I look and feel so much better. Even the wife notices! LOL!

Nothing more to say until I get depressed again.



Cheers!


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

Sunday, June 18, 2017

Wednesday, June 14, 2017

PSA Update

Dear Diary,



I forget whether I mentioned this earlier but my PSA is now increasing by leaps and bounds.

The last 5 PSAs are shown below.

0.8 as of 9 months ago.
1.8 as of 6 months ago.
1.6 as of 3 months ago
7.3 as of 05/15/2017
9.3 as of 06/14/2017

Because of the size of the jump, I had another PSA done to rule out an error. Unfortunately, there was no error. In fact, it went from 7.3 to 9.3 in four weeks. Not good!

Uro appointment next Thursday. I will have A DRE and we will discuss the pros and cons of

Casodex and Lupron.

The cat is definitely out of the bag. We just don't know where it is.

I'm thinking we need to start ADT ASAP and worry about the PET scan later.

I'm still thinking that this may be local recurrence in the prostatic bed.

Definitely not a happy camper right now! 😞
 
Cheers!


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