Thursday, January 28, 2016

Leap Year

Leap year comes once but every 4 years and every 4 years I do a double take when I look at a calendar and see February 29th.  I've did a double take after I found out that my next step in prostate cancer treatment, seeding the prostate gland with little bits of a radioactive substance, was scheduled for the morning of February 29th.  

So imagine my surprise when I received an email from the builder of our new house in Arizona saying that they'd like us to come on down for the closing on our house to trade a large sum of cash for title and keys on February 29th. What are the odds?  
By the time you read this I'll be move in ready!
The builder broke ground the day I received my cancer diagnosis.  So in the race to see whether I'd beat cancer first or have to cough up money for a house I can't move into until I beat cancer is over, the house won. Needless to say I can't hand over money in Arizona while I'm sedated and having an invasive medical procedure performed on me in Seattle so my wife called the builder and sweet talked them into a no cost extension, because moving into a new house is a really big deal but becoming cancer free is job #1 prime directive now.  Only after recovery can I seriously think about job #2: paying for the new house, moving to the new house and selling the old house.  New house closing date is now March 15, the oncologist says I should be roadworthy by then.

I'm in the home stretch of daily radiation treatments and can't wait to hit the 5 week finish line.  The most annoying radiation side effect so far has been on my bladder.  Driven crazy by radiation it's in perpetual freakout mode, always alerting me that it's full and ready to burst. "I gotta go!!!!!", Right NOW!  There are no half measures, no stalling, no putting it off for the next rest area on the freeway.  It's always seems like a matter of desperation.  I sometimes awake every hour during the night to stumble to the bathroom and pee and man, is that annoying.  My oncologist says that this should diminish when the daily radiation stops, only to pick up again in March when radiation will be permanently installed in the prostate gland itself.  It should permanently diminish as the radiation half life decays the radiation away, kills the cancer and the seeds become inert.  Those inert seeds will go to the grave with me.

So how is this seed installation done?  What happens after the radioactive seeds are implanted?  If you're curious click here and read,
I received that in the US mail and it was most likely written by my oncologist as his name is first on the masthead. 

I had been under the impression that they would place these radioactive seeds in my prostate gland through my back door just as the urologist previously biopsied it but this isn't so. 

Following anesthesia, thin needles containing radioactive seeds are precisely placed under ultrasound guidance through the skin between the scrotum and rectum and into the prostate.

Yow!  That sounds like a frightening thing to let strangers do in a very tender place.  Anesthesia isn't what I thought it would be either:

The first choice is a spinal anesthetic where a thin needle is inserted in the lower back and a Novocaine-like medication is injected. With spinal anesthesia, patients are temporarily numb from the waist down and will not feel any of the needles being placed. In addition to the spinal anesthetic, patients commonly receive a sedative intravenously so that they are more relaxed and often sleep through the procedure. The spinal anesthesia is the most frequent choice of patients and the one that we usually recommend whenever possible. 

The second choice is a light general anesthetic so the patient is completely “out.” This works well but patients are often groggy for some time after the procedure. The anesthesiologist will review the details including both pros and cons of these two approaches. Sometimes the type of anesthetic is determined by the patient’s overall medical condition; other times it is a choice for the patient to make.

Make mine choice #2, light general anesthetic. I don't want to experience the lower half of my body turn numb while I watch people insert things into me.  I know that this work needs to be done, wake me when it's over.

Friday, January 08, 2016

Radiation Treatment for Prostate Cancer

I'm into my second week of 5 weeks of daily radiation treatments for prostate cancer.  Each morning I take the bus to the Polyclinic on Pill Hill, change into pajama bottoms, lay down and position myself into a plastic cast of my calves and feet and present myself to huge round device above me that looks like something out of a planetarium.

Technicians come in to verify my identity by asking for my birthday.  Then they pull my pajama bottoms down around my hips so they can find my little freckle tattoos in order to align me properly and hopefully avoid irradiating of any innocent bystander organs.

Once alignment is complete the technicians leave the room, close the door and the process begins.  I feel nothing and hear little.  Other than an occasional click there's no sensation of any kind.  When there's music it's been jazz or country.  After 10 or 15 minutes a technician comes in and we exchange pleasantries and it's over until the next time.  See you tomorrow!  I change back into my street clothes, leave the hospital and get back on the bus. 

That's it?  Beating cancer can't be that easy.  And it's not.  I've been warned that side effects are coming, specifically weakness.  And there might be some skin burning.  And other more invasive and unpleasant procedures will come after my 5 week course of radiation is complete and my diseased parts have been properly prepped.

One side effect that I am experiencing is an unusual flatulence.  It doesn't seem to matter what I eat.  It starts in the afternoon and continues for most of the night while I sleep, a sort of bubbly and near constant, sometimes painful production of gas.  Radiation is administered 5 days a week so when the flatulence faded over the long holiday weekend I suspected the radiation.

During my 5 weeks of radiation I get 5 minutes a week to talk to my oncologist so I asked him if the flatulence and radiation were related.  He smiled weakly,  nodded affirmatively and added, "there's going to be some mucus too".  Oh goody, gas and liquids.  "Will I get any warning or will it just happen?".  He smiled again.  "You'll get a warning".

It's not much of a warning though.  I'm starting to find the whole radiation experience to be just a bit creepy.  It's a treatment that I can't hear, see or feel yet I'm starting to experience the side effects.  The radiation has inflamed my bladder so I urinate frequently.  When I go anywhere my first task is to seek out and note all bathrooms.  I can't sleep more than 2 or 3 hours without having to get up to pee.  I'm looking forward to a period when I can recover from my treatment and prepare myself for the next much more invasive phase.