May 24, 2012

Now what? You have got to be joking.

So just when we were ready to resume a somewhat normal, quiet couple of weeks with no events, visitors, or major plans, things took an unexpected turn last Tuesday at 1:00am, when I began to experience increasingly and severe pain in my mid to lower back and both thighs. It reached the point that Mary had to call the hot line for the Oncologist in the middle of the night. I ended up checking in to the hospital and connected to a morphine pump to deal with the pain. By 4:00am I was able to sleep so I told Mary to go home and get some sleep herself.

I was already scheduled for a bladder scope on Wednesday (the 16th) to see if they could determine why I was continuing to experience blood in my urine, and perhaps if the bladder was the source. While performing the bladder scope they cauterized a few smaller, older lesions on my bladder and completed an additional procedure that took  pressure off my urethra that was being caused by my prostate. During our consultation with the surgeon, Mary asked if they could also replace the stents during the procedure, to give us an additonal three months before they have to be replaced. (I have had them for one month). They said if it did not cause too much bleeding, they would do it, and they did. Wednesday morning was filled with test after test (vitals, blood wor,k etc) and more discussions with Oncologists, Urologists, residents, nurses and more. What little sleep I had gotten was interrupted and short intervals. Though the back pain and leg pain had gone down considerably over night, I was weak from the general anesthesia and unable to have an MRI, as I could not lay flat on a table for 45 minutes to an hour. Even with the morphine, the pain was too intense to lay flat. The doctor had ordered an MRI to try to determine the root cause of the increased bone pain. We tried again on Thursday morning but the results were the same as before, too much pain. What made matters worse was Thursday morning they gave me a steroid (Dexamathasone) hoping this would help alleviate the pain. All it did was make me unable to sleep Thursday night. I would guess in total I may have gotten two hours of sleep Thursday night. I did doze off every few minutes during the day, as Mary sat at my bedside. Apparently, the combination of the anesthesia and the morphine made me very lethargic.

By Friday we threw in the towel and the doctor proposed that we have a CT scan to attempt to find the source of the pain in my back. Then, if there was an area they needed a closer look at, then we could try an MRI on a smaller area that would not require so much time on the table. The CT scan showed some increased activity in my lower spine but no consolidated area in the vertebrae that warranted radiation as an option to relieve the pain. The plan by Friday afternoon was to insure any remnants from the surgery were healing and then to go forward with pain medication to manage the pain.  My PSA has been steadily decreasing since I started the Zytiga. It was at 2,770 mid April, and Monday was at 1300.  Obviously, still way too high, but moving in the right direction. What gives us hope is that we will continue to see a response from the Zytiga, consequently some shrinkage in the cancerous tumors and then less pain and then less pain medicine! That is our hope.

The next challenge was to transition me from morphine to oxycotin. They increased the dose of oxcotin and started to reduce the morphine. The doctors monitored this closely, as we did not want to go home and then have a relapse of severe pain. By late afternoon on Sunday Mary was driving me home and I felt like I couldn't get there fast enough. It is so good to be home!

Over the last three days, my sleep is getting better. I am trying to limit the amount of pain meds I need for the break through pain. I am taking extended release oxycotin around the clock. I continue to have edema, so I have to keep my legs elevated a good part of the day, but feel a little stronger each day. Mary and I even went for a short walk around the block on Tuesday. There is a lot that lies ahead of us, but for now, we are focusing on recuperation and taking it one day at a time.

May 16, 2012

Roses and little flying plastic things

On the May 4th, we had our 4th annual greenhouse event. I spent the evening in a comfortable chair with my foot elevated but that allowed me to visit with all the wonderful friends that stopped by to visit.

My sister from Ohio was here for a visit, so she was able to enjoy the event as well. She was with us from Thursday until Tuesday and between Mary and her, all the gardens were planted!

Last Saturday was our 5th annual disc golf tournament. This year was extra special, as we sold out with over 100 players! The weather was perfect and the event went off without a hitch. I can't thank the Board enough for all of their help. Like all the events we have, help from Mark, Rich, Steve, Chris and Mary are key to the overall success. I appreciate each of them more than they know.

May 01, 2012

I'm still here

It's been over a week, and since things have been rather hectic, I'm just now getting it all written into a blog post..

After being discharged from the hospital on the 14th and spending the following weekend getting the pain under control, I spent the early part of last week getting used to the pair of bags attached to my sides. They made getting around difficult and sleeping even more so. Mary helped me work my way through it and by last Thursday I was back at the hospital having the out-patient procedure necessary to have the ureter tubes internalized.

Aside from laying in the prep area for ninety minutes, the procedure went fine and I was back home by late afternoon. It sure was good to no longer have the bags of urine in my pockets but sleeping did not get much better. The first few nights I still was unable to sleep on my side and continued to wake up during the night. It has slowly gotten better and now after a week, last night was the most sound sleep I have had in weeks. Typically, being able to sleep for a solid 3 hours is considered good for us.

Of course in the midst of this we had to take a step back before we could move forward. Last Friday, the day after the procedure, I noticed swelling in my left leg. It was mid-afternoon and because we didn't want this to get worse over the weekend, Mary called the Oncologist's office right away. They asked that I come in as soon as possible so they could perform an ultrasound on both legs. Being that I have a history of blood clots, we were prepared for the worst. It turned out it was bad, but not that bad. I have edema ( The pictures in the link are much worse than my case!

Dr. V prescribed water pills hoping that they would help a little before we had our monthly meeting with him on Monday. There wasn't much change over the weekend and by the time we met with Dr. V on Monday morning the swelling was relatively unchanged. The edema is being caused by the location of and number of swollen lymph nodes in my abdomen. The best way to address this would be with chemotherapy. The issue we had with moving on to chemo is that I am just getting my strength back after 7+ months on XL-184. All the side effects have subsided and my appetite is great. It is wonderful to be able to enjoy food again. That being said, I still have a way to go to gain overall strength.

The other option we agreed to try was to go back and try Zytiga (Abiraterone) again. This is the drug I was receiving when I was traveling back and forth to Atlanta last year. We know it is a long shot, but I experienced minimal side effects so if it helps to stabilize me and I can continue to get stronger, than it will be a success by our standards. I started taking the medicine on Monday and agreed to meet with the doctor again in a week to check the progress. We met with the doctor yesterday. Although the swelling is still an issue and I am forced to be on bed rest, I am feeling better over all and the swelling improves when I am laying with my legs elevated. Now, many of you know me, and know that if I am feeling ok, to be laying around all day is not an easy task.

Ideally, the Zytiga will start to impact the cancer tumors, shrinking my lymph nodes and the swelling will diminish. Then we can put chemo off for a while. We do have another treatment option that we would prefer to chemo. It is called, MDV 3100.  Currently the manufacturers of this drug are attempting to get an 'early access' trial approved. EA trials are basically a Phase III trial with no placebo arm. Designed for patients in my situation that are desperate for treatment options. There is no telling when the availability will happen or which locations across the country will enroll patients. Ideally, it will be sooner rather than later and the real home run will be if KU Cancer Center is an approved site.

First things first, I continue on Zytiga and we keep fighting the fight.