Sunday, October 22, 2006
My tests of October 10th have all come back clear. That's quite a relief, as these tests are used to determine the extent of the cancer. For example, if a bone scan shows that tumors are established at distant sites, then there's very little reason to continue with the surgery, since the primary tumor would no longer be the main source of cancerous cells. Not that I'm looking forward to the surgery, of course, but I think I'd like the hormone therapy or the chemotherapy even less.
The two procedures were a pelvic/abdominal CT scan, and a whole body bone scan. As medical procedures go -- and I've had a couple now -- they're not so bad. I had to drink a barium 'smoothie' before I went to the hospital, so that my guts would be visible for the CT scan. When I arrived at the hospital, I began my procedures at the nuclear medicine dept., where they put an IV into my arm and gave me an injection of radioactive dye, so that my bones would be nicely visible, too. The nurse putting the IV in labeled it as 'hot'; this meant that it would be considered hazardous radioactive waste afterward.
We waited for a couple of hours until I was glowing. The CT scan came first, under a GE LightSpeed Scanner. I lay on this narrow bed that moved back and forth through the central ring, which I think contains a rapidly rotating magnet. The IV was hooked up to a drip that rapidly dilated my blood vessels; the effect was a brief but very intense hot flash that began in my neck and ended lietarlly in my toes.
The machine talks to you during its cycle, telling you to breathe and hold your breath. It has a little smiley face at the top of the arch that indicates what you should do, too. They think of everything,
The bone scan was a much more sedate affair. Again, I lay still on a narrow bed, and a set of small imaging devices passed above and below me. It took about 25 minutes, as the machine hovered very close to me as they moved along their track.
Though I was in the same building for both of these procedures, they were not done by the same corporate entity. The bone scan was done by St. Joseph's Hospital. but the CT scan was actually done by the same medical group to which my primary care physician (PCP) belongs. I had requested that the reulsts be sent not only to my surgeon at johns Hopkins, but also to my local urologist and my PCP, and these two entities have different policies about that. It was a little disconcerting, as I don't like the feeling of depending on others to ccordinate the information flow.
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This week, I will have my pre-op physical, done by my PCP. I like my doctor; he listens to me. And, of course, he's the one who got me to do this test that probably saved my life. So, though the circumstances as not at all as I would have them, I am glad for the chance to talk things over with him before I go under the knife in November.
I do want to ask him about some practices for which he and the urologists differ. The digital rectal exam (DRE) is one of those things that guys put up with when they get to be a certain age. I think it's a lot less unpleasant than any gynecologial exam, a pap smear, or a breast x-ray, so I am not complaining; I just want to be clear on that. For the DRE, the doctor sticks a finger (the 'digit' in 'digital') up your butt, feeling the prostate gland through the colon wall. It's uncomfortable, but it only lasts a few moments. When my PCP has done this, he has me lie on my side on the table. But when the urologists have done this, they have me stand with my legs spread, gripping the end of the table -- and it's somewhat more uncomfortable.
I'm wondering if they're getting a better feel of the gland using that method -- my PCP was alerted by the PSA level; I don't think he ever felt anything. Yet the surgeon staged the tumor at cT2a/cT2b, meaning that he could feel it and it seemed to cover about half of one side of my prostate. Now, he does have a surgeon's hands, so it is possible that he knows what to search for in a way that an internalist wouldn't. But, I think I'll ask about it anyway.
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I am not alone among the men at my college who have prostate troubles. I am thinking of getting a few more copies of The Prostate Book, byt Peter Scardino, o share with some of my colleagues. I found it a sober account of th prostate gland, the things that can go wrong with it, and the treatments and their prognoses. If you are reading this because you have PCa or BPH, this book is a good one to read.
The two procedures were a pelvic/abdominal CT scan, and a whole body bone scan. As medical procedures go -- and I've had a couple now -- they're not so bad. I had to drink a barium 'smoothie' before I went to the hospital, so that my guts would be visible for the CT scan. When I arrived at the hospital, I began my procedures at the nuclear medicine dept., where they put an IV into my arm and gave me an injection of radioactive dye, so that my bones would be nicely visible, too. The nurse putting the IV in labeled it as 'hot'; this meant that it would be considered hazardous radioactive waste afterward.
We waited for a couple of hours until I was glowing. The CT scan came first, under a GE LightSpeed Scanner. I lay on this narrow bed that moved back and forth through the central ring, which I think contains a rapidly rotating magnet. The IV was hooked up to a drip that rapidly dilated my blood vessels; the effect was a brief but very intense hot flash that began in my neck and ended lietarlly in my toes.
The machine talks to you during its cycle, telling you to breathe and hold your breath. It has a little smiley face at the top of the arch that indicates what you should do, too. They think of everything,
The bone scan was a much more sedate affair. Again, I lay still on a narrow bed, and a set of small imaging devices passed above and below me. It took about 25 minutes, as the machine hovered very close to me as they moved along their track.
Though I was in the same building for both of these procedures, they were not done by the same corporate entity. The bone scan was done by St. Joseph's Hospital. but the CT scan was actually done by the same medical group to which my primary care physician (PCP) belongs. I had requested that the reulsts be sent not only to my surgeon at johns Hopkins, but also to my local urologist and my PCP, and these two entities have different policies about that. It was a little disconcerting, as I don't like the feeling of depending on others to ccordinate the information flow.
------------------------------------------------------------------------------------------------
This week, I will have my pre-op physical, done by my PCP. I like my doctor; he listens to me. And, of course, he's the one who got me to do this test that probably saved my life. So, though the circumstances as not at all as I would have them, I am glad for the chance to talk things over with him before I go under the knife in November.
I do want to ask him about some practices for which he and the urologists differ. The digital rectal exam (DRE) is one of those things that guys put up with when they get to be a certain age. I think it's a lot less unpleasant than any gynecologial exam, a pap smear, or a breast x-ray, so I am not complaining; I just want to be clear on that. For the DRE, the doctor sticks a finger (the 'digit' in 'digital') up your butt, feeling the prostate gland through the colon wall. It's uncomfortable, but it only lasts a few moments. When my PCP has done this, he has me lie on my side on the table. But when the urologists have done this, they have me stand with my legs spread, gripping the end of the table -- and it's somewhat more uncomfortable.
I'm wondering if they're getting a better feel of the gland using that method -- my PCP was alerted by the PSA level; I don't think he ever felt anything. Yet the surgeon staged the tumor at cT2a/cT2b, meaning that he could feel it and it seemed to cover about half of one side of my prostate. Now, he does have a surgeon's hands, so it is possible that he knows what to search for in a way that an internalist wouldn't. But, I think I'll ask about it anyway.
-----------------------------------------------------------------------------------
I am not alone among the men at my college who have prostate troubles. I am thinking of getting a few more copies of The Prostate Book, byt Peter Scardino, o share with some of my colleagues. I found it a sober account of th prostate gland, the things that can go wrong with it, and the treatments and their prognoses. If you are reading this because you have PCa or BPH, this book is a good one to read.
Thursday, October 05, 2006
I must apologize for letting so much time pass between posts -- I do wonder if I've lost my audience! I do think about a lot of things I'd like to write down, but the school year is never busier than it is in the first six weeks. Once we're past the midterms, my schedule should permit me to write a little more.
As far as news goes, I am scheduled for surgery on Monday, November 13, at Johns Hopkins Medical Center in Baltimore. My surgeon is Christian Pavlovich, an expert in laparoscopic surgery on the prostate. I went down to Baltimore to meet him and get a feel for what type of fellow he is -- I feel I am in good hands, come what may. I should be in the hospital for two nights, and then recuperating for about a week with a catheter.
I must confess that problems with my urinary tract have always been a bit of a phobia of mine. My father-in-law and sister-in-law are prone to bladder stones, and I have always gotten quite sqeamish whenever anyone in my wife's family discusses those problems -- I do hide my discomfort; one should always show concern and sympathy before anything else, especially when someone is recounting a very painul experience. But my phobia about this goes back much farther, I'm sure; I remember as a child feeling faint when one of my baby sitters was discussing having blood in her urine. If you've seen the movie "Reds," you might recall the scene when John Reed pees blood at the work camp; I cannot watch that scene. I shudder at a certain line in the Monty Python song "Brave Sir Robin." Of all the things I'll be dealing with over the next several years, the thought of the catheter is the one I hate the most. I am a wimp about these things.
I have a bone scan and a pelvic CT scan scheduled on October 10, pretty routine for prostate cancer. The CT scan is done to detect whether any cancer cells have gotten outside the prostate capsule and lodged in any nearby tissues, while the bone scan will look for distant sites. If they find enough bone sites, we will likely cancel the surgery and concentrate on therapies that arrest the cancer rather than remove it. The thinking is that if that's my situation, the primary tumor is probably no longer the major source of new cancer cells, so there'd be little point in removing it. But, that's getting a little ahead of ourselves. We'll jump off that bridge when we get to it.
One of the things that I've found over the last several weeks is that I really do not like telling people about my cancer, and I think I don't do a very good job of it. After I learned about it, I decided that I would tell people who I thought needed to know, and I'd tell people who asked, but that I wouldn't go much beyond that (although I really should send an e-mail out to my distant friends). The trouble with that strategy is that I often find the someone who needs to know when they ask me to do something I would normally do, and I have to tell them that I can't and why I can't. So, on top of them feeling sympathy for me, they also feel guilty for having asked. I'll probably write Dear Abby about this -- I don't have any insight into how to proceed.
As far as news goes, I am scheduled for surgery on Monday, November 13, at Johns Hopkins Medical Center in Baltimore. My surgeon is Christian Pavlovich, an expert in laparoscopic surgery on the prostate. I went down to Baltimore to meet him and get a feel for what type of fellow he is -- I feel I am in good hands, come what may. I should be in the hospital for two nights, and then recuperating for about a week with a catheter.
I must confess that problems with my urinary tract have always been a bit of a phobia of mine. My father-in-law and sister-in-law are prone to bladder stones, and I have always gotten quite sqeamish whenever anyone in my wife's family discusses those problems -- I do hide my discomfort; one should always show concern and sympathy before anything else, especially when someone is recounting a very painul experience. But my phobia about this goes back much farther, I'm sure; I remember as a child feeling faint when one of my baby sitters was discussing having blood in her urine. If you've seen the movie "Reds," you might recall the scene when John Reed pees blood at the work camp; I cannot watch that scene. I shudder at a certain line in the Monty Python song "Brave Sir Robin." Of all the things I'll be dealing with over the next several years, the thought of the catheter is the one I hate the most. I am a wimp about these things.
I have a bone scan and a pelvic CT scan scheduled on October 10, pretty routine for prostate cancer. The CT scan is done to detect whether any cancer cells have gotten outside the prostate capsule and lodged in any nearby tissues, while the bone scan will look for distant sites. If they find enough bone sites, we will likely cancel the surgery and concentrate on therapies that arrest the cancer rather than remove it. The thinking is that if that's my situation, the primary tumor is probably no longer the major source of new cancer cells, so there'd be little point in removing it. But, that's getting a little ahead of ourselves. We'll jump off that bridge when we get to it.
One of the things that I've found over the last several weeks is that I really do not like telling people about my cancer, and I think I don't do a very good job of it. After I learned about it, I decided that I would tell people who I thought needed to know, and I'd tell people who asked, but that I wouldn't go much beyond that (although I really should send an e-mail out to my distant friends). The trouble with that strategy is that I often find the someone who needs to know when they ask me to do something I would normally do, and I have to tell them that I can't and why I can't. So, on top of them feeling sympathy for me, they also feel guilty for having asked. I'll probably write Dear Abby about this -- I don't have any insight into how to proceed.
