The odyssey begins....or continues??

First, an update on Wednesday. We met with Dr. Sheehan for about an hour and left feeling blessed we found another good one! I won't go into all the details, just the conclusion. We are proceeding with chemotherapy. The schedule looks like this:
> Today: I have a bone scan and an MRI at 11:15. This is not a big deal, unless you consider having radiation injected into your body something of concern!

> Jan 6th: we have to meet with the Nurse Practitioner and the Financial Manager at the oncology office. We were very impressed with the fact the doctors office actually calls the insurance company and gets the details of all the expenses we can expect to incur. As for the NP, they will go over the schedule, procedure and side effects. Here is what we already know from the doctor and research we did:
- the treatments are once every three weeks for 6 to 10 treatments
- the day before, the day of and the day after treatment I'll have to take oral steroids. (helps the bone white blood cell count)
- fatigue does not happen immediately, usually 3-5 days later.
- 10-14 days post treatment is a critical time as white blood cell count is at it's lowest (white blood cells help fight infection)
- hair loss will likely occur
- nail discoloring might occur
- mouth sores are possible
- there are other drugs I may be given; anti-nausea and possibly Nuelasta. One of the side effects of the later is temporary bone pain so they might have to give me Vicatin. Nothing like taking a drug to deal with complications from a drug and then taking a third to deal with the second! Isn't modern medicine grand! Yes, I know, at least there are options!!

> January 9th (noon) treatments begin. Apparently it is a 90 minute IV drip and again there are no immediate side effects. I really wanted to start this upcoming week. I see no reason to put this off any longer. If we are going to do this, let's get it started.

So for now it looks like our trip to the beach (Spring Break) and Italy are on hold. However, that is not to say we won't try to work them in between treatments!
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
While we waited in the Oncologist office there were two men who came into the waiting area. One was in a wheelchair and I would guess in his mid 70's. The other man was probably in his mid 60's. Both were going through Chemo and looked very frail. It was just a reminder of how abnormal this condition is for a 42 year old..........I think a blue FLHW bracelet will fit perfectly upon each of their wrists.

Did I miss something…..??

Christmas has come and gone and aside for being spoiled by my wife (once again) I must have missed it? I guess being a little bit distracted, caused me to miss it. Was I being selfish not to stop thinking about me for a few minutes? At times I question my constant selfish thought, but I'm convinced there is no right answer. Mass was not as emotional as I thought it would be.
The church was bursting at the seams and in retrospect, I think because of the number of children and my family being there, it was much easier than I anticipated.

For the first time in over six months we had a meal containing red meat. For the past six or so years our traditional Christmas dinner has been a beef tenderloin dish served with a of these incredible roasted red onions in a balsamic vinegar glaze. As with past years, it was incredible! I savored each and every bite. I must have consumed at least eight ounces! Want the recipe? Just let us know…..

What lies ahead tomorrow is perhaps one of the most frightening days we will experience since this ordeal began. Last week with Dr. Davis, our disappointing trip to Houston last April, the initial meetings with Dr. Davis after the biopsy and x-ray; these were all bad in their own right, but each offered choices and hope. I am not sure what to expect tomorrow - Chemo might be the last treatment option for now….perhaps? I pray that once the treatments begin it is a semi-painless experience. I wonder how I'll look without hair? What other side effect will I experience?

I started reading a book on cancer survivors this morning. It was published by the Lance Armstrong Foundation and a gift from my niece (a wonderful young women). As I reflect on the situations that Lance and the young women in first story experienced, I'll repeat something I have said here before; I would trade places with these people in a heartbeat. In their cases they began treatment immediately, versus our current ten month drama. No one wants to have cancer but once you do, treating it and attempting to be cured immediately are critical. There is no cure, my treatments just keep putting off the inevitable.

Why me? Why now? Why oh why God are you testing me in this way?

Ships passing......

On April the 4th I wrote about a young man named Mark Holt. We met briefly at a mutual friend's bachelor party. Mark lost his battle with Hodgkin's and passed away on Monday. I find myself sitting here at my computer, fighting back the tears. I met this man one time and only spoke with him for about an hour, but I felt like I knew him forever. We discussed the emotional stages of cancer and how he had exhausted most of his options. He was remarkably upbeat. We left promising to stay in touch (we lived less than a mile from each other), but besides a few emails, never met again. I have felt very comfortable from the beginning that help is right there if I need it. I pray at this time that he was surround by a support group of similar strength. My heart goes out to his wife and his family. Mark would have turned 33 this Friday.

A partial answer....and some hope....

We just left Dr. Davis, as I said before, he's an awesome doctor, I challenge you to find one with a better "bed side manner".

After discussing my situation with him we agreed that the next step should be Chemo. Radiation is not required at this point because my back pain is not constant, not debilitating. Additionally, radiation is used as a pain reliever, not a curing agent.
We discussed Mayo, Sloan-Kettering, etc. with Dr. Davis but Mary and I are not real comfortable with those options. The reasons are this; 1) the "standard" next step is chemotherapy using a drug called Taxotere. This can be administered locally here in Kansas City. If we went to one of these other facilities it would be to explore any clinical trials. However, as a participant in a trial there is no guarantee I would receive anything other than Taxotere, especially at this stage. A clinical trial is basically a crap shoot, a lottery, a chance we don’t want to take at this point. 2) Based on my case and history, I might not even qualify for the trial.

Given these two items, we are meeting with an Oncologist here locally next week. After that meeting I will have bones scans, CT Scans, possibly MRI's again and then begin a chemo regiment. The timing of all these events and our schedules for the next several weeks are now in flux. However, nothing happens until after Christmas!!
~~~~~~~~~~~~~~
One item to note is that there are documented instances where Taxotere has been very successful in managing cancer at my stage! This was news to us both! We are not getting too far ahead of ourselves but finally a small speck of encouragement!

The dichotomy that is my life, today.

It's Christmas, the birth of Christ and all that represents, new life, new beginnings etc. and so on. Tomorrow we go see my Urologist to discuss next steps; chemotherapy, radiation, experimentation. Both are full of unknowns; one you look forward to the discovery of and living through, the other you dread and pray to God that it's ultimate conclusion is one that is positive.

We managed to get through the weekend without issue. We agreed that though it's not good, we won’t know anything until tomorrow. So it was a "normal" weekend of disc golf (25 degrees and a light snow - it was beautiful).

So, it you are interested, here are the two avenues that lie ahead. This is likely not an either/or, both will be administered:

Radiation therapy: a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated. Impotence and urinary problems may occur in men treated with radiation therapy. [in my case external beam is about the only thing that will help]

Chemotherapy: Taxotere® belongs to the taxane class of chemotherapy drugs. The active ingredient in Taxotere® is derived from the needles of the European yew tree (Taxus baccata). In 2004, Taxotere®, in combination with prednisone, was FDA approved for the treatment of patients with androgen-independent (hormone-refractory) metastatic prostate cancer. In addition, Taxotere®, in combination with doxorubicin and cyclophosphamide, has been approved by the FDA for the adjuvant treatment of patients with operable, node-positive breast cancer. Taxotere® continues to be tested in clinical trials for various stages of many types of cancer. As a testament to its potential, in 2004 alone the American Society of Clinical Oncology accepted over 200 abstracts of studies with Taxotere® regimens for its annual meeting. Numerous studies are ongoing, that may offer promising new therapeutic options for healthcare professionals and their patients.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Sounds exciting! As I told Mary last night, I am not scared, seriously. Worried, oh course but I don’t have time for fear.

Not very good....

7.18 was the number
We have an appointment with Dr. Davis Tuesday to discuss next steps.
~~~~~~~~~~~~~~~~
I'm not shocked
I'm not sad
I am worried
I am strong
I am a fighter
I will beat this thing
~~~~~~~~~~~~~~
Hail Mary, full of grace,
The Lord is with thee.
Blessed art though amongst women
and blessed is the fruit of they womb, Jesus

Holy Mary mother of God,
pray for us sinners,
now and at the hour of our death.
~~~~~~~~~~~~~~~
Peace to you all and Merry Christmas
~~~~~~~~~~~~~~~~~~~~~~~
In nine minutes I have the first of two meetings to end my day,
do you think I'll be engaged and productive?
Perhaps I better - at least it will make time pass quicker........

Pins and needles

Tomorrow is the date of my next PSA test. It's just the beginning because we'll likely not know the results until early next week. Therefore, we will have a weekend filled with anxiousness and anticipation. Not that we haven’t already been experiencing this for most of the past week. We did a pretty good job of "moving on" over the past 5 weeks, but time has caught up with us.

Sleep over the past week has been restless. Between hot flashes and worry, I've been tossing and turning more than usual. Over the weekend my back/neck acted up. I was having more pain than usual. Up to that point, my pain was usually something that flared up at the end of the day. Sitting on the sofa would clear things up every time. On Saturday the discomfort would not go away for the most part, it increased on subsequent days peaking yesterday afternoon. The good news is this morning it was virtually gone. We were getting quite concerned. Let's hope it continues the rest of the day and beyond.

What's next, beyond this test? Let's all pray (please) my PSA number comes down. If that is the case we just continue in this watch and wait mode. If it's up, we have a very difficult choice to make - which of several treatment choices do we make? All are experimental, all are risky, all are only moderately promising? What a great position to be in, what lies behind door 1, 2 and 3???
Where all three are not good…….

I just noticed I used the word "usual" a number of times in this entry, what part of this entire experience is "usual"????

Mary and I were looking at some old photos the other night and I created a little "before and after"!!! In the one on the left, that's me in the white....almost 60lbs lighter and feeling better than ever! The one on the right illustrates the old David who regularly enjoyed cheeseburgers and pizza!!!

Is this effective?

From time to time I wonder if there is anyone out there reading this? Is it having any effect? Is it helping anyone at all? Just about the time I start thinking that way I get a comment posted, a phone call or as the case was this weekend, an email from a complete and total stranger.

John (from Austin, TX) doesn't even have Prostate cancer, he is battling Leukemia. He ran across the Blog and found the time to thank me for encouraging him, for making him look at the positives and not the negatives (something that as a reader you know I struggle with all the time). John offered his prayer and wondered if as a Catholic having a Baptist pray for me was appropriate? I'll just say this, at the time I find myself at St. Peter's gate I pray that that the entrance criteria has nothing to do with Catholic, Baptist, Methodist etc. - I hope it's something as simple as:
1) Do you believe? 2) What did you do for your family, friends, neighbors and strangers?

So my questioning of the value of this has been put to rest (at least for awhile). It's all a big circle, I encourage you and you encourage me. I prop you up and push you, and you return the favor as needed.

It's the second week of Advent, the emotional pressure of Christmas grows heavier. It's such a wonderful, beautiful time of year…….Ho, Ho, Ho!
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ P.S.: I promised someone I would refrain from my shot by shot accounts of Disc Golf so I'll just add this; yes it was 25 degrees on Saturday, yes we played and yes I improved by one more stroke (two over for the day!).
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
P.S.S.: Friday marked 10 months since the Blog began! This next week marks the one year anniversary of my first doctor visit and my first PSA test.

Long Overdue

Tonight on the way home from work I made a long overdue phone call. I called my best friend from high school. The oversight was not planned, I had actually thought about making the call and telling him many times. Like happens so often, one thing led to another and I kept forgetting to call him and tell him.

We talked for 10 or 15 minutes, I got his email address and plan to stay in touch. We even discussed getting together when we are in St. Louis over Christmas. We spent a lot of time together the last two years of high school and beyond. For the past ten years or so we’ve not stayed in touch, unless you count the annual Christmas card exchange. I know this is not a unique way for friends to grow apart. I felt better for finally calling him – I felt bad for not doing it sooner.