Winter’s got a hold on me

5K Prostate Cancer, Advanced Prostate Cancer, David Emerson, PSA, Steve Jobs - January 19, 2012

As I mentioned in my last post, I had this big plan to blog a lot this year. I’ll eventually catch fire and start to post more, but for now, winter’s got a hold on me and I just don’t feel very creative or motivated. I can’t complain about the weather that we have had so far this season, but it is still winter.

There are no real changes in my health. The fatigue is a little better. I have been in the office full time for seven straight days. The lack of appetite and diarrhea continue. The former is constant, the latter day to day.

I will share that I am reading the Steve Jobs biography. While I was always a fan and thought highly of him, this book has totally changed my opinion. To me, his management style and the way he treated people completely take away from his creative brilliance. I’m just half way through with the book, but cannot image there is some hidden gem in the latter half of the book that will change my perception of the man. Once again, his work and the products Apple created upon his return in the late 1990’s are unheralded, but at what cost to his family, friends and those that worked for him. This is just my opinion, you can decide on your own. The book is a thousand pages, and for the most part, a page turner.

Since we didn’t go to St. Louis over the holidays, we have been pleased to have family visit here in KC. Last weekend my brother Doug and his wife Michelle came in. We didn’t do much except watch some movies and football, but it was good to have the house full and spend time with them. The weekend coming up my other brother Dan, sister Barb and nephew Zach are coming. I look forward to that as well.

For now I will continue to trudge through winter. It has been extremely mild here in Kansas City and it looks like it might continue for the next several weeks. The next thing you know it will be spring, my favorite season of the year.

1961

Advanced Prostate Cancer, David Emerson, PCa, PSA, XL 184 - January 8, 2012

First of all, although things are slightly better, my intention to start the year off with a bang and my goal to post multiple blogs has fizzled. I’ll try to get better the year goes on, I promise.

I’d like to start with two prayer requests. There are multiple men I could list but tonight my mind is on Terrance from Seattle and a former neighbor of ours Jennifer. Terence had his 4th chemo infusion this week as well as a blood transfusion. He’s having a rough time, so please find a minute for T. Jennifer is battling stage IV colo-rectal cancer. She is planning to head to MD Anderson in a few weeks and I hope and pray that she will find a clinical trial that proves to be an effective treatment for her cancer. Again, please include them both in your prayers.

This week I had my monthly Oncologist appointment here in Kansas City. A few of my blood markers are borderline low, potassium was one. Initially, we are going to try to increase the level with diet.Mary already came back from the store with lots of bananas, avocado and coconut water. As bad as my appetite has been, I was happy that more things weren’t out of whack!

Before I break the big news I have to remind you all of a few things: first the clinical trial medicine that I am taking addresses bone tumors. Though they measure my PSA in Boston, the doctor and I don’t discuss it. It is the bone scan that is the key marker.

We knew my PSA would rise because as part of the trial I had to stop taking androgen blockers. It was a risk we were willing take at the time. This week we asked my local Oncologist for my PSA and though Tuesday’s measurement was not ready, my December 5th reading was 1,961. That is up from 1,043 in November and around 400+/- when we started the trial on August 30th.

On one hand, it’s just a number, the scans are what’s important (I tell myself in a semi-convincing manner). On the other hand I think, “Holy Roger Maris! 1,961”! From there the questions begin to mount, questions that I will be discussing with Dr. S when I return to Boston later in the month. Short term, I’m not to worried, what this might mean and how it will impact my treatment long term is what I am concerned with mostly.

Pretty close to normal

Advanced Prostate Cancer, Cabozantinib, David Emerson, FLHW, XL 184 - December 19, 2011

For all the issues I’ve been having lately, today, for more than a few hours, normalcy returned to our lives.

It started early this morning when I decided I would hit the disc golf course. No, not to play, just to walk along and visit with some of the guys. It only got better when Mary, for the first time ever, decided to join me. The crowd was light but it was already over forty degrees when we got to the park. I was only able to last until the 11th hole for two reasons; first I didn’t want to overdue it and two, the easiest way out of the woods is after the 11th hole.

We went home, I had a quick 30 minute nap and then it was time to get ready for the matinee show for Trans Siberian Orchestra. Brad, Mary and I had a great time,but it was not at all what we expected. I was expecting something more along the lines of Mannhiem Steamroller, this was more of a rock opera performance, with some seasonal music added in occasionally. The lights and special effects component was very, very impressive.

After the performance, it was off to the Country Club Plaza and our favorite restaurant, Houston’s. When we walked in at 6:30pm there was already a ninety minute wait.! Being seasoned veterans at Houston’s, within five minutes we had seats at the bar and were placing our orders for dinner! The service we received was as good as having our own booth in the dining room.

What a perfect, busy, entertaining, and nearly normal day!

November Review

Advanced Prostate Cancer, Cabozantinib, David Emerson, XL 184 - November 30, 2011

After 12 weeks on Cabozantinib (XL 184) things are going OK. I wish I could say GREAT, but I am also not complaining!

I started the trial on August 30th with a 25 mg dose. During the first 6 weeks I didn’t notice any side effects, however I did notice an increase in bone pain in several locations. On October 11 I had the first required follow up bone and CT scans. The results of those scans showed a 20% improvement in the overall state of the bone mets. While good, the trial was looking for 30% or greater.

On November 1st my dose was increased to 125mg. This dose was determined per the trial requirements. We were concerned about that high of a dose. [At this time I was on both 2 10mg Oxycontin and 6-8 325mg Oxycodone daily]. The increase in the trial drug coupled with the constant struggle with constipation from the pain meds, made for a rough beginning on the month.

After trying multiple over the counter laxatives, I finally got a prescription variety that started working right away. On the flip side, after six days on the higher dose of the trial medication, I was experiencing nausea that was unbearable at times. The doctor suggested I stop taking the medication for three days until the constipation and nauseas was fully relieved and then a smaller dosage would be suggested.

With both the nausea and the constipation under control, I started the trial meds again on November 10th at a new dosage level of 75mg. The following twelve days were spent readjusting the pain meds, laxatives, etc., and I was able to go back to Boston for my November 21st scans and doctor appointment on the 22nd. At the appointment on the 22nd the doctor showed me a side by side comparison of the October 11th and the November 21st bone scans. Even with my untrained eyes I could see a difference, and it was encouraging! There were a few smaller tumors that had cleared up completely and most others had noticeable reductions in size.

75mg may still be too high, I still have occasional nausea issues. I’ll stay on top of this over the next few days and talk to the doctor if it continues. We are trying to work around a limited appetite and I am suffering from fatigue. I have lost about 12 pounds. The best news is that I have not had Oxycodone in almost 48 hours. Sleep is getting better but there are still some nights that are rough.

Happy Holidays everyone, peace be with you all!

When a Buck is worth millions

Advanced Prostate Cancer, black labs, David Emerson, XL 184 - November 20, 2011

I’m alone in the house tonight, Mary and Brad are out running errands. I’m not real fond of being alone, in fact, I have grown to detest it. I don’t need a lot of conversation, just the simple presence of others, their nearness makes all the difference in the world.

I should clarify that I am never alone, he is always near to me. In this case, I am not making reference to God but to Buck. Buck is our 95 pound black lab. When we got him in 2002 I was ‘in between” jobs, so back then I was with him 24×7. He was house broken with in a week. Labs are something else, the finest dog one can own.

This pictures is just a typical moment in my day with Buck. Nose on the bed for a few seconds as he checks to make sure I’m doing OK or if I need anything. He’s so lovable.

Thanks Buck, I’m good right now, I’ll let you know if I need anything.

Too short

Advanced Prostate Cancer, David Emerson, PCa, XL 184 - November 18, 2011

It’s been a heck of a month, and yet a week remains!

One of our prostate cancer brethren, Terence in Seattle, started chemo. His second treatment is in a few days and so far things are going well. Please understand that much like myself, Terence is dealing with bone tumors and pain, raising psa and other PCa related issues. His pain was excruciating and the good news is, he has seen some relief there is just a few weeks. I hope the future brings Terence more relief and many, many years of peace and happiness with Sheri and the grand kids.

In early October I added a post regarding our golf tournament (Lucky number 7). The gentleman to my right in the first photo is Bruce. Bruce and I have known each other since high school, well over thirty years. After a while, life took us separate ways, so it was great when Bruce drove in from St Louis to play in the tournament and have dinner with Mary and I. Two weeks ago Bruce went to his doctor to have a few things checked out. That appointment led to a triple by pass two days later. Bruce has children under ten years old, so that adds to the complexity of the recovery process. I wish Bruce and Lisa peace and joy as they follow their journey down the road to recovery.

I have another good friend Bill ,whom I’ve know since I used to kick his butt in first grade math flash card wars! He’s to my left in the photo from this post (Golf 2010). It turns out last week Bill had his own heart scare. The incident happened while he was traveling to St Louis on business and required an overnight stay in the hospital and a battery of testing. Fortunately, the results were negative and his heart appears to be functioning very well. But it certainly created a stressful 36 hours of concern! Bill has three beautiful daughters. Bill, his wife Enid and all three girls are always in my prayers.

These are just three things going on in my life that have nothing to do with my own battle. There are others I could add, and many, many of you, the readers are expericing similar events yourselves. I share these as a reminder of the how fragile life is and as a way to ask you slow down around the holidays next week and next month. Enjoy time with your family and friends…life is too short.

Where are you going?

Advanced Prostate Cancer, Boston, David Emerson, XL 184 - November 3, 2011

On my way to Boston, I obviously had a lot on my mind. This is what I wrote on the plane yesterday morning:

When traveling and someone asks, “Where are you going?”, I simply want to reply, “Nowhere, I’m here for quite some time, if I have anything to say about it.”. These last seven years have included so many ups and downs, twists and turns, I have become somewhat immune to emotions, the negativity, and times immune to the seriousness of the ramifications.

I just carry on until the next set back. Bad news? I just regroup, lay out a new plan or adjust the current one. The point is, I move forward at a slow steady pace. I’m not 100 percent sure what actually will happen three hours from now. My instincts tell me that today my medication will be increased, but who actually knows.

A day later, today I have a bit more to be optimistic about. Yes the dosage of Cabozantinib (XL-184) was increased (from 25 mg to 125 mg). I took my first dose of the increased quantity yesterday afternoon and my second this morning. Last night I slept better than I had in weeks. It might have been exhaustion, it might have been psychological based on a feeling of relief, having hope that the new dosage will be effective and I will be able to resume to a better quality of life with less pain and less fatigue. Whatever it was, it was great. I woke up this morning and realized I hadn’t had in pain medication in twelve hours. That too was a first in several several weeks.

The doctor appointment fell right in the middle of my schedule for pain medications and I needed to have an empty stomach so I could take the first dose of the XL-184 while at the doctors office. Additionally, I had to wait nearly two hours for the new trial drugs to be delivered from the pharmacy. Consequently, I was four hours late taking the pain pills. I swear I could feel them working within 10 minutes as I rode the subway back to the airport. My flight back to Kansas City was direct but better than that, Mary and Brad were waiting to drive me home! That was the perfect way to finish a very long day.

The side effects that are most concerning are excessive exhaustion and complete loss of appetite. These are supposed to surface within 24 to 72 hours, if at all. I remain optimistic, as patients in previous phases of the trial have found it to be generally very well tolerated.

My next trip to Boston is not for three weeks, in the mean time….. I’m not going anywhere!

Condition and recognition

435 South, Advanced Prostate Cancer, Boston, Cabozantinib, David Emerson, XL 184 - October 30, 2011

I have spent most evenings over the past week trying to get the timing of Advil and Percocet down to a science. I haven’t earned a masters degree yet. Some days and nights have been fine, with very little to no daytime pain and decent enough sleep. There have been days of heavy fatigue and nights of tossing and turning and what amounts to maybe 3-4 hours of good sleep. Sleep on these nights comes in fits and starts which in turn leads to fatigue the following day.

My return trip to Boston can not come soon enough! I will be back for my next appointment in Boston on Tuesday. We anticipate the doctor will request my dosage be increased and we are hopeful that the new dose will offer me relief from the pain and attack those tumors in my bones that are causing me discomfort.

On another note, you may remember this story from earlier this summer.
http://www.435southmag.com/recentposts/2011/10/14/the-buddy-system/

I received word earlier this week that the writer, Kimberly Winter Stern, has been recognized for the article. The High Plains Division of the American Cancer Society recognized her for excellence in journalism.

Here is the link, scroll down to the ‘Magazine’ catagory:
http://www.cancer.org/MyACS/HighPlainsHawaiiPacific/AreaHighlights/high-plains-media-awards-winners

Kimberly, I think I can speak for John when I say thank you for capturing the story in such a perfect way and for sharing in our passion for finding a cure for prostate cancer.

When being a little sad is cleansing

Advanced Prostate Cancer, David Emerson, Finger Eleven, Foo Fighters, James Morrison, Lifehouse, Oasis, Train - October 15, 2011

On a recent trip, a few songs came on my iPod that made me sad. However, because I love to listen to each of them for a unique reason, I let them play. I guess maybe sad isn’t the right word…perhaps melancholy is a more appropriate description.

As with most music I listen to, I just listen, I don’t memorize lyrics or go read what they mean. It is usually the music and feelings they evoke that gets to me. So here is a list for you to review, or comment on if you desire and maybe go buy the song yourself if you choose.
– James Morrison: The Pieces Don’t Fit Anymore
– Oasis: Sunday Morning Call
– Lifehouse: Breathing
– Foo Fighters: Times Like These
– Finger Eleven: One Thing
– Train: Drops of Jupiter

These six are just a few that rotated through this particular flight, there are many more. Each of these, for it’s own particular reason, conjures up emotions. There are times when these emotions manifest into sadness and perhaps tears. To me this is perfectly acceptable because amongst other things, having cancer has taught me to accept and embrace my emotions. God tests us on a daily basis and in a number of ways and these songs help me become more energized to fight on.

Lucky number 7

Advanced Prostate Cancer, charity, David Emerson, Faith-Love-Hope-WIn - October 12, 2011

On Friday, September the 30th, we held the seventh annual FLHW Charity Golf Tournament. As with the six previous years the weather was perfect for the event!

The day included reunions with old friends.