On Monday I had my monthly Oncology appointment which included two shots, blood work and a brief meeting with the doctor. Due to my increased pain, which was becoming paralyzing, we wanted to talk further with the doctor to discuss treatment options and to develop a new plan of attack for these persistent PC cells that seem to be taking over my body. We went back today and talked with him about the treatments out there and a longer term plan.

Dr. V increased my pain meds and changed the steroid I am taking. I noticed changes for the better from both. I slept much better last night and overall, the pain decreased.

A bone scan was ordered and is scheduled for tomorrow afternoon. The primary objective of the scan is to identify tumors that would be considered ‘hot spots’. They may be the main source of my pain and could be targeted with radiation. Consequently, once my oncologist receives the scan results, he will talk with my Radiation Oncologist. We will meet with the RO on Tuesday morning to find out if he thinks there is a radiation therapy that may alleviate my pain. We also discussed chemotherapy and the two early access trials I mentioned here last week. In order to receive the treatments in early access, I would have to be approved and of course, both would involve travel as well. In order to consider treatments with travel, I will have to first get my pain under control. Having spent seven consecutive days in bed, it was all I could do this week just to get to the KU cancer center.

For now we won’t look too far ahead. We are praying the new doses of pain medicine will continue to counter my pain. On Monday we will head back to the cancer center to discuss the bone scan results with the oncologist and will also have a follow up consult with the surgeon who  performed my surgery in May.

That is all for now. We are taking things one day at a time.Thank you for your past and continued prayers. It really helps to know we have all the support that we do!!

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.

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.

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 (http://en.wikipedia.org/wiki/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.

It was last Friday, very early in the morning (1:15am) and it was my fourth day in the hospital. I obviously could not sleep. Though the staff on the Oncology/Hematology floor was great, the constant blood drawls and vital sign checks were driving me crazy and making sleep nearly impossible. I needed to be home.

Earlier in the week I had a stent placed in each kidney in order to deal with blockage and allow urine to drain from my body. I had experienced acute kidney injury. It was dangerous and a very scary experience for me, as well as the family. After the kidneys were drained, the surgeon attached tubes to my kidneys and put 2 holes in my back to allow the tubes to come through and attach to bags to capture urine. The good news is that it appears my kidneys are recovering and the marker for kidney function is back in the normal range. We met with Dr. Van yesterday and he was pleased with my progress. We scheduled an appointment for an outpatient surgical procedure on Thursday to have the tubes internalized so that they will allow the urine to flow from my kidneys directly to my bladder, which will allow me to urinate normally. We are relieved that the bags are just temporary. The blockage due to cancerous tumors will not allow normal drainage. The tubes will have to be replaced every 3 to 4 months, which will also be done on an outpatient basis.

After being released and returning home on Friday, the worst part has been getting the pain under control. By Sunday at noon the dosages of both Oxycontin and Oxycodone were not keeping up. My pain and discomfort was increasing. Mary made a phone call to the doctor’s after hours number. The doses of my pain meds were immediately doubled and Prednisone was added. After a few painful hours, I felt much better. I even ate a rather larger dinner (for my standards)  Sunday evening. I told Mary I enjoyed the meal more than I have in the last three months. Another positive note to report is that I have gained a little weight over the last week.

What lies ahead for the cancer treatment is another unknown. We have our monthly appointment with Dr. V on Monday (April 23rd) and will discuss treatment options and start to make a game plan.

Thank you to everyone who has been praying for us and sending us so much positive energy.

After stopping the XL 184 back on the 1st of April, we were expecting some positive changes. By last weekend, I did start seeing changes, but not so positive.

Friday night into Saturday morning, I began to experience mild pain in both femurs and in several areas of my back. Sunday morning I experienced several episodes of vomiting for the first time. It happened later that day again and both Monday and yesterday morning as well.

A call to Boston didn’t lead to much insight into my potential situation, as Mary was told that most people start feeling back to their normal selves after a few days of stopping the trial drug.

By Monday afternoon Mary called my local oncologist in Kansas City to alert him of her concerns with my deteriorating condition. The big concerns were pain, limited and liquid only diet for several days, my increased weakness and the onset of dehydration.

Yesterday (Tuesday) I was at the KU Cancer Center by 8:15 AM and then admitted the the hospital itself by 1:00 PM. With a catheter in place and many,many liters of saline solution the concern is no urine is being passed. Additionally, the marker for my kidney function is 4 times higher than it should be and increasing.

This morning we will find out the outcome of all the tests and scans that have been taken.

Looks like I’m here for a few days, but my spirits are high and we will get through this, as we have before.