Wednesday, June 30, 2010

Update 6/30/10, Chemo Consult

Met with Dr Fishman today at 1:30 for a consultation about chemo as the follow up treatment to my TC.  I didn't think chemo was going to really be in the running for treatment options, it sounds so miserable (and no doubt it).  But this is a very tempting follow up procedure.  Details below.

1. Cancer stage. I'm in the second best stage possible, what is called stage 1B (1A, obviously, is the very best). The b is b/c of the vascular invasion I noted from the pathology report

2. Clarifying "vascular invasion" -- Turns out this isn't as bad as it sounds. What it means is that there is still no evidence that the cancer left the testicle, but there is evidence that it left the tumor. So the chances are still the same, tiny, that the cancer has spread outside the testicle, but it had begun to move outside the tumor. Again this is the best possible scenario with the same treatment options.

3. I never thought I would say this, but chemo looks like a great option; of course there are caveats. The chemo recommended for my condition is a single dose (approx 3 hour IV drip) with minimal side effects. The downside to this treatment is that it has only been studied for a very short time (less than 10 years) so there is no confirmation that the treatment is as effect long term. But short term (4-8 years) it has the same success rate as radiation, which is around 97%

So we meet the radiation dr on Friday, and he'll try to sell us on his treatment. But right now the idea of a single dose vs weeks of radiation is very tempting. Both options have the same follow up schedule. First year is heavy on CT scans and blood work, years 2-5 much less observation.

I'll update again on Friday after the radiation consult.

Sunday, June 27, 2010

Update 6/27/10, More Doctors Appointments

Had a great weekend with my mom & sister up from Florida for a visit.  We went out to eat Friday night and then spent most of Saturday cooking, eating, and drinking.  Opened a bottle of vintage port Julie had bought for me years ago after I got a big raise at work.  The port was excellent, but the company was what really made it special.

This looks to be an interesting week for updates as I've got appointments on both Wednesday (chemo) and Friday (radiation) for consultations.  Details are:

  • Wednesday, 6/30/10, Chemo consultation at 1:30 pm (21st & K ST NW)
  • Friday, 7/2/10, Radiation consultation at 9:30 am (Sibley Hospital)
As I've mentioned before radiation is likely to be the treatment and it will likely take place at Sibley, which is a bit of a hike.  Although my family insists I should not do this (they all live in Florida and drive everywhere) there is a bus that picks up right outside my downtown condo that goes to Sibley.  It is a long ride but an easy one, and I suspect it will be my primary method of getting to/from treatments. 

But all of this is guess work right now.  First we have to see what the various doctors say about the CT scan & pathology report.  I'll update probably after both appointments.

Tuesday, June 22, 2010

Update 6/22/2010 The Good, The Bad, And The Ugly

I'll start with the ugly:  The spots on my body that were shaved for surgery which were never meant to be shaved.  I think it will be months before the hair is back and I start to feel normal again.

Before I get to the good & bad though, a quick update about the last few days:
  • Healing continues very well, worst part now is the itching from the stitches (and the fore mentioned newly shaved spots).
  • On Monday I got up early and went to the gym in our building and peddled away on the stationary bike for 35 minutes (at a pretty slow speed) and it went fine.  Went to work that day and felt like I was starting to get back to normal finally.  Or at least my new normal.
  • This morning I went out with Julie & Bica for a jog.  Just 1 week after my surgery the jogging went very well.  We did a scenic 4, maybe 4.5 mile run on the national mall including the Washington Monument, Lincoln Memorial, and the White House.  Very pleasant to jog again, and although I ran very slowly (Julie was faster than me!) I had no pain at all, no shortness of breath, just a hell of a lot of itching.  Felt even better at work today and was very busy, so the day flew by.
So the good & the bad from my Drs appointment today which was to discuss the pathology report on the tumor:

The good -- The case was what is called pure seminoma, which as I understand it basically means it was just one type of cancer.  If it were mixed that would be bad (worse, I guess) news.  But if I had to have cancer, this was the kind we wanted it to be.  This cancer responds very well to radiation.

The bad --  There was evidence of vascular/lymphatic invasion, which (again as I understand it) means there is a higher chance the cancer could have spread.  If you've read below you know that as far as they can tell the cancer has not spread, but this bad news makes it more likely (slightly, perhaps, but still more likely than before) that the cancer could show up later.

So it seems now extremely likely, almost a sure thing, that I will have to have radiation therapy in the coming months.  The good folks at TCRC have a lot of info up about this entire process, including radiation therapy.  But the therapy will most likely mean 2-3 weeks of daily radiation blasts (each weekday) which will have all the nasty side effects you'd expect (fatigue, nausea, etc.).  But at the end of that treatment period things should slowly being to return to normal.  I mean my new normal.  Not a fun outlook for the next few months, but by all accounts I'll be as cancer free as is possible for medical science at this point.

I still have to meet with the various drs about both radiation and chemo (chemo is still an option so one I have to explore).  I'll update after those discussions take place.  For the next few weeks I expect to have a normal life again, running in the mornings, working all day, walking the dog at lunch, etc.

Saturday, June 19, 2010

Update 6/19/10 Returning to Normal

Not much to update now, I expect this will be the last update until I get more news from the doctor.  Physical pain in now greatly reduced.  I can't run or do pull-ups, but otherwise walking, sleeping, showering, and everyday activities are pretty close to normal.  Still a little pain sitting down & getting up, a little light headed sometimes, a little fatigued.  But overall significantly better. 

I can't imagine I'll be able to run any earlier than Tuesday, and probably not until later in the week.  And those first runs will be slow, short, and comprised of a lot of walking Bica in-between.  But it won't be long, I'd wager, until I'm back to running many miles and yelling at Julie that she's too slow.

Baseball game tomorrow afternoon.  It's about a 1.5 mile walk to the stadium which I think is how we'll get there & return.  So that 3 mile walk will be my most exercise since Monday 6/14.  Looking forward to that more than the game, in some ways.

Friday, June 18, 2010

Update 6/18/10 Physical vs Emotional Recovery

I managed to stay off Rx pain pills yesterday and today.  I took Tylenol three times yesterday but that was it, no other pain pills. That's not to say the pain is gone, but now it feels more like I ran a really hard race and my body is sore, no longer piercing pain like Tuesday night and all day Wednesday. 

But as the physical pain became more tolerable yesterday, I was having a harder time emotionally.  Not overwhelmingly bad, but definitely feeling the emotional effects of the surgery.  I'm hoping the second day of being clear-headed and less pain will help.  I was able to shower finally yesterday afternoon and I shaved today.  I think getting back into a normal routine will be a big help.

Jogging seems unlikely before Tuesday, maybe even later.  But perhaps I'll feel much better by Sunday and that will change.  I'm looking forward to walking Bica around a few times today, I think that will help too.

Thursday, June 17, 2010

6/17/10 Recovery

Yesterday was spent mostly on the couch under a slight fog of pain killers, playing video games & watching movies (with a nap or two for good measure).  But I was able to move around reasonably well and my appetite hasn't been bothered at all.  I'm just as hungry as ever, only now I can't exercise to burn some of those calories off.  Not only that but I'm eating a lot worse (Julie kindly bought me several containers of butterscotch pudding) that usual.

But today, two days after the surgery, I'm feeling a lot better.  Still a decent amount of pain, but I only took Tylenol this morning and not the pain killers.  And I've been walking around the condo with my cane all morning.  It's a pretty day outside so I plan to stroll the city with Julie and Bica soon.

I'll find out the next steps in a week or so.  In the meantime I'm looking forward to healing & starting back to jogging (even if slowly) early next week.

Wednesday, June 16, 2010

Update 6/16/2010--Lefty's Gone

Tuesday 6/15/2010 wasn't the best day of my life.  But after spending close to 9 hours at the hospital I'm now recovering at home and reasonably comfortable.  I didn't get a lot of sleep last night, between the pain, emotional confusion, and restlessness; well it was a tough night.  But not the end of the world, and I expect the pain to become more & more manageable. 

All of our friends have been great through this.  One friend hung out with Julie at the hospital during and after the surgery, that really meant a lot to me.  And we almost no notice our neighbor picked us up from the hospital last night.  That made it much easier to get home as they rent a parking space (from us) in the building so I was able to just get out of their car and get in the elevator to our floor.

Next Drs appointment is 6/25 when we'll get more details and learn the next steps.

Tuesday, June 15, 2010

06/15/10 Update-- It's Showtime

Today is the big day.  I had the last food I was allowed to eat around 10 pm last night, and I was allowed 24 ounces of clear liquids (luckily that included black coffee) this morning before 8 am.  Headed to the hospital around 12:30 this afternoon and surgery is scheduled for 3.  Hopefully my next update will be all about what a piece of cake the recovery has been.

Saturday, June 12, 2010

6/12/10 Update

Follow up appt with Dr Shin went well, all good news.  No sign that it has spread.  Surgery on Tuesday at 3 pm (possibly moved up to 1 pm) which has a chance of being 70% curative.  We'll discuss future treatments in a couple of weeks, those treatments probably would not start until August.  Observation, rather than additional treatments, is also an option.

I ran the lawyers have heart 10K today in Georgetown.  It's a miserable out & back run, and always too hot.  But I persevered and finished with my best time ever on this particular course (only the second time I've run the race), and 8:10 per mile pace, for a final time of 50 Mins, 41 Seconds.

Thursday, June 10, 2010

Tony's TC 6/8/10 through 6/15/10

Well we reserved this website in case we ever wanted to rent-by-owner our Ocean City condo.  We won't be using it for that purpose anytime soon so we're doing this instead.
  • 6/8/10:  TC Day
    • Initial doctors appointment & diagnosis. 
    • Blood taken
    • Ultrasound performed
    • First consultation with surgeon (Dr. Shin)
    • Nationals Park for the first game of the Strasburg era.
  • 6/9/10:  Skirmishes 
    • First fight with insurance company
    • Appointments scheduled, then canceled
    • Truce with insurance company
    • Appointments rescheduled for 6/10/10
  • 6/10/10:  Battery of tests
    • CT Scan
    • More blood work
    • Liverwurst on rye with mayo, mustard, and onions washed down with two Miller High Life's.
  • 6/11/10:  The fun begins
    • @8 am I drop off a deposit at the sperm bank
    • Final consultation with Dr Shin
  • 6/15/10:  Lefty's last day
    • Surgery at 3 pm
    • Pain pills