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

Friday, June 09, 2017

Update On Bone Scan

Dear Diary,

A quick update.
Just got the full body bone scan today and the tech said there was no sign of metastatic disease.
Uro still has to see the results but hopefully, he will agree.

The next step, hopefully, is a PET scan to see where the activity is located and find out if treatment options
other than HT are available.

The really good news is that the bone scan fulfilled my entire annual out of pocket so for the rest of the
year, I'm covered at 100% Yay!

Won't know much more till we get the PET scan so I continue to be nervous.


Cheers!


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

Thursday, June 01, 2017

Urologist Appointment Update



Dear Diary,

Just got done with the appointment with Dr.F. He spent a lot of time with us and was encouraging but he agreed it is time to act.

He wants to start with a full body bone scan which I will have on the 8th.

Based on those results, we will then look into more sophisticated imaging.

He is a little frustrated because, as always, he has to go "toe to toe" with the insurance to get this stuff authorized.

If the bone scan is positive, we will initiate ADT. Casodex followed by Lupron.

If it is negative, we will have to make the decision of whether to start ADT anyway or to watch the PSA a little longer.

I imagine this is where the MO (Medical Oncologist) comes in. I flat out forgot to ask him if he felt it was time to bring one in!

The options regarding more sophisticated types of scans/imaging are all on the table as far as he is concerned. It's just a matter of getting them paid for.

If there is no visible spread and the disease appears to be still localized, I am interested in taking this to the next level to try to locate and isolate the active area(s) and possibly looking into HIFU (High-Intensity Focused Ultrasound) to try to clean up whatever is left.

I don't know if that will be an option for me in the future but right now I want to concentrate on proving what exactly is going on in there and treating it accordingly.


Cheers!


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