A Bit of Good News

It has been awhile, and for that I apologize. What with Christmas and appointments and side effects I have basically ignored everything. But, there is good news.

First, let's review the Bone Scan results...nothing new there, except that what I thought was a fracture in my right foot way back when truly was. Yep, dropping a motorcycle on your foot will break the foot. The scan confirmed all of the existing mets and found nothing new. Damn good news.

In the intervening time I also had an MRI of the Brain and Spine--to check the results of the CyberKnife treatment--and all of the lesions have gone from small and dense to diffuse and larger. Before anyone freaks out, this is GOOD. As the lesions are treated and die they will result in some inflammation of the surrounding areas, and the tumor core will be "attenuated" on the scans. This has all happened; so things are good. The plan is to wait for another three months and see what happens.

As for the left thigh pain, that has been confirmed as a mets. I am currently undergoing full radiation therapy to the thigh for this, and should be done in about eight days. Seems to be working, as the stress related pain in my thigh is gone. Course, there is a downside, as my left leg feel decidedly weaker. Ah well.

That brings up an odd experience. The rad techs swore that I would noitice nothing, but yesterday when they blasted my leg every hair stood up like they were all charged...so much for them saying that "non-ionized" radiation has no ionizing effects. Of course, the techs think that I am nuts, but I know what I saw and felt.

Monday I have the Neck to Nuts CT; so we will see what the rest of my body is doing. Assuming that the scan shows a positive progression in the tumors, I will then have the Primary Tumor in my left kidney removed. Here's hoping.

As for the side effects; food sucks, but I am still keeping my weight stable.

If it were not for Robin and the kids I would probably have given up by now, but I cannot let myself do that. They are my life.

Happy New Year to all, and to all a good night.

Be well. Read more!

A Preliminary Reading

Well, today was the Nuclear Bone Scan. For those not used to the terminology, that basically means that I was injected with a material that binds to the active cells in the bones and emits particles that a fancy geiger counter can "see".

Granted, that is a horribly simplified explanation, but it works. The "camera" simply sees radioactive decay particles and plots them. Over time, you end up with an outline of the bones and some other areas. The brighter the area, the more decay particles. The brighter the area, the higher the probability of cells that are running at a fast metabolic rate. Again, a simplification, but it works.

So, on to my reading of the scan. First off, the only reason that I can guess at this is having a bit of the theory, and a bit of experience in seeing these scans--the fruits of many years working in the Emergency Department.

From what I saw, the left Femur (thigh) lesion is confirmed; whether cancer or a bunch of cells fixing a fracture I cannot say. The Kidneys are definitely a hot spot with some funky dark spots on the left. A good friend tells me that the dark areas probably mean that there are dead areas in the left kidney. The other interestingly bright area is in the region of the bladder; not surprising as the nucleotide is cleared by the kidneys and at the end of the test I was desperate to pee ;)

So, all in all, not too bad a scan--as far as I can tell. I'll get back when I see the real reading. Moving forward I am looking at going to the Orthopaedic Oncologist for the femur lesion; and then off to the Urologist for the left kidney removal. With luck this will all happen by the end of January, but I am not looking forward to having a titanium rod shoved into my thigh. Ah well, what is, will be.

On the chemo front the side effects are not too bad this time. The GI stuff is a bit of a bother, but seems better today.

Not too much on the home front; we are looking forward to tramping thru the forest this weekend and picking out a Christmas tree. With a bit of luck we will even manage to get it decorated this weekend. Speaking of that, what in the world do they tell kids now a days? My daughter is deathly afraid that a "real" tree will catch on fire, and that says that we have to get a "fake" tree. Ah, don't get me started. They can't sing Silent Night at their Winter Festival, but they can sing O Hannukah. Yet another symptom that the Judeo-Christian origins of the US are being sundered, and the States are dead. All hail the Politically Correct interpretation of (dis) reality!

Anyway, enough depressing stuff. Today was a good day. I am alive, the family is alive, and we are all healthy.

Two quick notes. For those who have been reading this blog, I have good news and bad news about some of the people that I have mentioned.

Last week my Aunt Noelle passed from this earth. She fought a long and valiant fight against some disease that they still cannot diagnose. She was a wonderful person and has enriched the lives of all of us that knew her. Noelle, I will miss you. Say hello to momma for me.

As for my office mate, he is doing well, and evidently living without a kidney is not too bad. According to all of the work-ups he has no metastases and should be fine. Let this be so.

Please pray for them both during this holiday season.

Be well, and remember that it is the little things that count. Read more!

Just a Tiny Little Pin-Prick

I saw the Neurosurgeon today for my follow-up.  Nothing earth shattering there, the wound is basically healed, and the remaining visual changes should resolve over the next month.  He did mention in passing a new mets that was seen on the post-op MRI of the brain on 9/25.  Evidently it is in the Temporal Lobe and about 0.5cm across.  This one will be left for the CyberKnife folks to deal with on Monday at Stanford.  Nothing like letting me know in a timely manner...  I wonder if that mets might be the cause of the Right Temporal Headache I had the other day?  The surgeon was pretty unimpressed...

He also mentioned that he has no idea where the hand cramps are coming from.  Why do all the docs say that?  Since I can so easily reproduce it by using chopsticks I'll chalk it up as a repetitive stress injury thing.

After the Neuro visit we raced over to Hayward to go see the general surgeon and have the barometer lesion removed.  All told they took out a chunk of my scalp about the size of the last joint in my thumb.  Call it 2.5cm x 1.5cm x 1cm.  If this is anything like the first excision it will end up hurting more than the craniotomy did, once the local anaesthetic wears off.  Now, where did I put those Percocet tabs?

Still waiting for the reading of the full spine MRI that was done on Tuesday--I guess I'll rattle the cages of a couple of people and see what shakes out.

Dad came down yesterday to bop around with us and keep me company during the appointments today.  He just jetted off because he has to be home by morning.  Sure is nice to have family around.

Time now to go get the kids from school.  Take care.

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Treatment Plan Update

Well, went in today for a few things. The day actually started yesterday afternoon with a call from the MRI folks--they were trying to get me in ASAP for the special Closed MRI that Stanford needs before the CyberKnife therapy next week. There was bit of confusion, because my records now read "claustrophobic" so they try to do everything with me under the "Open MRI", rather than in the older "Closed MRI". You know, the coffin tube. So around and around and around with the schedulers until I got frustrated and just called the Neuro Science team and asked them to kick some butt. Boy did they. Seems the NP and the MA from the NS team got frustrated as well, so they pulled in their Chief to raise a little cain. Next thing I know I got a call at 1045 this am from the MRI trailer asking when today would be good for me! Showed up at 1130, right into the coffin tube, and the special MRI scans were done. Oof, 3 mm cuts instead of the usual 5 mm cuts. Took a Long time. Gotta love that Xanax. I actually fell asleep for the last 20 minutes or so of the scan!

For those across the pond: think of an MRI (or a CT of that matter) as taking planar views (cuts) through a structure. For many of these types of scans the cuts are spaced every 5 mm. They can be done top to bottom, side to side, etc. Taking 3 mm cuts effectively doubles the number of "pictures" so it takes longer and has the advantage of offering better views for some tasks. Also, the Closed MRI truly looks like a tube, you slide into it instead of under it. The main advantage is that the spatial resolution and detail are much greater. The Open MRI is like lying between two huge metal pancakes with open sides, but the spatial resolution and detail is decreased. Much more comfortable though.

After the MR we ate a great Vietnamese lunch (Pork Bo Hue and Shrimp paste sticks: spicy pork soup and shrimp paste rolls on a stick), then raced back to the Hospital to have the staples out and a surgical consult on removing the "barometer" lesion at the back of my scalp.

The staples are now out and replaced with SteriStrips (why bother? The strips are stuck to the hair and not the wound. Not like they are doing anything). The wound looks great and is healing well.

The general surgeon will have me back on 10/9 to remove the barometer lesion. It is currently at 1.5cm x 1.5cm x 0,5cm, as I measured it on the MRI. Gotta love electronic records, I have a disk of today's MRI so I used it to examine the scalp lesion dimensions and extension. Much easier than trying to use my fingers at the back of the head.

Recup from the craniotomy continues to go pretty well. I managed to walk up to the kid's school after dinner tonight, and only needed a brief rest on the way back. Maybe by next Monday I can start bringing Sheba along again for the evening constitutional. Still foggy at times, but that is to be expected. Boy was the drive down to Hayward a rush! First time driving myself since the surgery, so a bit different (Robin was golfing in the hills, no cell phone coverage!)

Got the pathology results from the crani, they look a bit odd and are being sent out for a second. But, they did show persistent necrosis (death) in the tumor, so the chemo did have a good effect.

The current plan is to restart the chemo about 28 days post operatively, no calendar in front of me, but that would be around October 17 or so. Looks like we get to take the family vacation at Fort Bragg with me still able to eat. Woo Hoo!

Steroid taper starts today at 0600 hours! Yes, 4 more days and I can drop this crap!

The next posts are going to deal with technology issues, I have had some questions from family and friends, and I have some questions for all of you, so I am going to do a roll-up review and cover all of them at once.

Be Well.

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Damnation!

I was going to talk about some other stuff today, but somehow I have lost the motivation for that. Just got a call from the Onc. The MRI showed a 1cm lesion in the left parietal and some associated swelling. They also found a 2 or 3mm area that "might" be a recent bleed or a calcification. Oh joy. I am to start Decadron tomorrow morning. The doc is also putting in consults with a Radiation Onc and a Neurosurgeon.

Needless to say Robin and I are not in a great space right now.

Thanks to the team from work today for lunch. It was great seeing all of you!
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Friends Helping Friends

A friend of ours at the hospital heard about the MRI need and managed to get us on the schedule for today, so the MRI is already done. Yeah! Now all we need is a reading so that the Onc can pick a treatment plan. Also had the LDH and other labs drawn while at the hospital.

I've had many MRI's of my spine over the years, but today's was the hardest. For some reason I basically lost it in the scanner. It just got into my head that the inside of the tube looked like a coffin, and that I was going to be buried alive and no one would notice it. Suddenly, I just had to leave, and I mean right now. My chest got tight, I couldn't breathe; it was awful This all hit about halfway through the test, and when the tech mentioned that we would soon be ready to inject and redo the scans I almost hauled my butt out of the tube then and there. I managed to hold it somewhat together for the next 10 minutes of the scan, and then the tech came on the intercom and said that the radiologist had decided not to do a contrast study. My god, I almost cried when they pulled me out of the tube.

I will never, ever, get into a MRI again without sedation. I can still close my eyes and feel the walls of the tube squeezing me out of existence...
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The Next Nuking

OK, I had the CT of the Chest today. Again done with and without contrast. Boy, I am getting tired of needles, and here I've only been stuck three times in 10 days. What a weenie...

Again got a noncommittal response to my question about the CT. This time from a tech that my wife and I have known for years. That is definitely not good.

Yet more waiting begins. At least most of the diagnostic stuff (I think) is over.

Robin came to this appointment as well. God, I do love this woman.
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CT Scans and Evasions

Just got back from the CT. Full exam of the Abdomen and Pelvis, with and without contrast. Test went OK, but when I asked the tech if the "pretty pictures came out" all she would say was that the films didn't need to be repeated and would be read soon. All that without managing to look me in the eye. That can't be good.

Working while we go through all of this is really starting to get hard. I can't wait until my boss is back from vacation. Then I can drop the job and concentrate on this stuff.

Time to go pick-up the family at the airport. Read more!