I got out of the habit of writing blog posts because there was nothing to report. During the first three weeks or so after the end of treatments the irritation on my back side completely cleared as did the other minor side effects. The fatigue held on and decreased noticeably only in the last couple of weeks. It’s now nearly six weeks after the end of treatment and I feel very good. There is still a bit of fatigue in the evening, but during the day I feel great. During my lunch hour on weekdays I walk just over a mile, including four flights of stairs in one location and two in another, in twenty-five minutes. I didn’t realize how much the low hemoglobin count had affected me.
On January 30 I had my second visit with Dr. Geiger, my surgeon. He took a look at the rectal tumor with a sigmoidoscope and said it appeared to have decreased by at least 50%. He was happy with that. We discussed the two surgery options again and I told him I had decided to leave the healthy portion of the colon in. With twenty more years of full-time work likely, I believe the convenience of having fewer bowel movements with a portion of the colon compared to the number I would have with no colon outweighs the risk of recurrence. In addition, I know I will be getting annual colonoscopies for a while, so if cancer returns to my colon it should be detected early. This wasn’t an easy decision and even though I felt it was the best route to take early on, I thought it through numerous times the past few months.
I asked for the tentative March 4 surgery date to be moved up. Dr. Geiger said the radiation reaches its peak effectiveness about six weeks after the last treatment. At about ten weeks, it begins to lose ground. He likes to perform surgery right in the middle, which is the basis for the March 4 date. I’m disappointed, but understand his reasoning. When asked about the post-surgery schedule, he maintained the four to six day stay in the hospital, which is standard for all patients undergoing this surgery. However, rather than the three weeks of at-home recuperation he previously stated, he said I should only need two. That was great news. I’m sure I will be climbing the walls after the first week.
If chemotherapy is needed after the surgery, Dr. Geiger said I would probably start it within a few weeks and the ileostomy would stay in place throughout. I had hoped the ileostomy would be reversed two to three months after the surgery and then chemo would be given. I can understand the need to start it as soon as possible; I just don’t want the restrictions the ileostomy imposes any longer than necessary. With stage II cancer there is a chance that post-op chemo will not be necessary. It will depend on what is discovered during surgery. At this point I expect it will be recommended. I would welcome it to some extent as it would give me some reassurance that if any stray cancer cells remain, they have been taken care of.
After seeing Dr. Geiger, I met with an ostomy nurse. She covered the basics of the ileostomy and provided two types of ostomy bags for me to take home to check out for myself. Most importantly, she marked the location of my stoma – the opening for the ileostomy. I had to sit, stand, lie down, and move around so she could find the best location that won’t interfere with daily activities yet still do its job. Mine is about two inches to the right of my belly button. She gave me a surgical marking pen and some clear bandages and told me to keep the spot marked until surgery.
I finished my appointment with a visit to the hospital’s pre-op testing office. A nurse practitioner went over a questionnaire covering my medical history and someone drew blood for the usual tests. It was a busy few hours with some good and some so-so news, but it was one more step toward surgery. Now I just have to wait.
Tuesday, February 18, 2014
Monday, January 13, 2014
Treatments 27 - 28 (The last two!)
Indianapolis received 11.4 inches of snow on Sunday, January 5th, and below-zero temperatures were forecasted for the following two days. I received a call Sunday afternoon informing me that the radiation oncology department would be closed on Monday. Work was also called off for Monday – a rarity for the State – so I was happy to not have to get out. However, that did mean a delay of my last treatment from Tuesday to Wednesday.
Even though the treatments have gone well and the people at the cancer center have been great, I was happy that Wednesday was my last treatment. I was congratulated by a number of people at the center, beginning with Sheila, one of the receptionists. After changing into a gown, I had to wait a few minutes for a radiation therapist to arrive. Brandon, one of the guys I see about twice a week, came in and said “There’s the graduate”. Afterwards I had my weekly appointment with Dr. Langer, my radiation oncologist. The nurse who checked my vital signs congratulated me as did Dr. Langer when he came into the room. I’m sure all those folks are genuinely happy to see a patient get through a treatment regime. It’s probably even better when they have a patient like me who has minimal complaints.
I was warned that the side effects I have already experienced will continue and could get worse over the next two or three weeks. In addition, new side effects could arise. That doesn’t worry me. The fatigue continued through the weekend much like it has been the past few weeks. The irritation on my backside was only marginally better at the middle of the week after using the prescription gel three or four times a day. Once the radiation was completed I could use anything on the area, so I switched to petroleum jelly. That began to provide a noticeable improvement after two days. It will probably take another week for the irritation to disappear.
Reaching this milestone provides a great sense of accomplishment, although I can’t take much credit for it. I was just along for the ride. The fact that it went so well gives me greater confidence moving forward.
Even though the treatments have gone well and the people at the cancer center have been great, I was happy that Wednesday was my last treatment. I was congratulated by a number of people at the center, beginning with Sheila, one of the receptionists. After changing into a gown, I had to wait a few minutes for a radiation therapist to arrive. Brandon, one of the guys I see about twice a week, came in and said “There’s the graduate”. Afterwards I had my weekly appointment with Dr. Langer, my radiation oncologist. The nurse who checked my vital signs congratulated me as did Dr. Langer when he came into the room. I’m sure all those folks are genuinely happy to see a patient get through a treatment regime. It’s probably even better when they have a patient like me who has minimal complaints.
I was warned that the side effects I have already experienced will continue and could get worse over the next two or three weeks. In addition, new side effects could arise. That doesn’t worry me. The fatigue continued through the weekend much like it has been the past few weeks. The irritation on my backside was only marginally better at the middle of the week after using the prescription gel three or four times a day. Once the radiation was completed I could use anything on the area, so I switched to petroleum jelly. That began to provide a noticeable improvement after two days. It will probably take another week for the irritation to disappear.
Reaching this milestone provides a great sense of accomplishment, although I can’t take much credit for it. I was just along for the ride. The fact that it went so well gives me greater confidence moving forward.
Tuesday, January 7, 2014
Treatments 23 - 26
The treatments and side effects were much the same as the previous weeks. I had New Year’s Day off. Friday was the first of three booster treatments that will finish off the regime. Booster is a bit misleading as the last three actually have a reduced dose of radiation. However, the radiation is more narrowly aimed at the tumor. Normally a treatment session begins with the therapist taking one image to ensure I am properly positioned. If necessary, the table is moved remotely from the control room and then the treatments begin. On Friday some extra images were taken. While I laid there waiting impatiently (and very still) my radiation oncologist examined them and then determined the details of the booster treatments. It added about five minutes to the normal routine but having to lay there with nothing happening made it seem longer.
I met my new medical oncologist, Dr. Safi Shahda, after Monday’s treatment. He seems like a good guy and will likely do a fine job, but no one can replace Dr. Clark. I didn’t get a good vibe from his nurse. I’ll assume it was only because our meeting was brief. Maybe next time will be better. I don’t expect to see either of them until after I return from surgery.
On Monday I also saw Dr. Langer, my radiation oncologist. I told him about the irritation at the radiation site which had gotten worse since I saw Dr. McMullen the previous week. He provided a tube of gel made for that purpose (RadiaPlexRx). It is helping, but is not working as quickly as I would like. Everything else was fine. I had blood drawn that day, so he didn’t have results to discuss with me. I did see them later in the week. My hemoglobin count increased again and was at 13.2 Monday. The low end of the recommended range is 13.4, so I am almost “normal”. It still could decrease as a result of the cumulative effects of the radiation. A couple of other measures were slightly out of their recommended ranges, like lymphocytes, but those are the result of the treatments. My white blood count, one measure that garners a lot of attention, is well within its preferred range.
I called Dr. Geiger’s office Tuesday. When I saw him in October, he said to call about a week before my last treatment to discuss scheduling surgery. I have an appointment to see him on January 30. At that time he will look at the rectal tumor with a sigmoidoscope (what fun!) to see what effect the radiation has had. He will also evaluate my general health. During the same visit I will go to another office in the building for some pre-op tests. I was given a tentative surgery date of March 4. The woman I talked with said their standard is to schedule surgery eight weeks after the last treatment. I didn’t bother asking for an earlier date, figuring Dr. Geiger will have to determine that. I will ask when I am there on the 30th.
I met my new medical oncologist, Dr. Safi Shahda, after Monday’s treatment. He seems like a good guy and will likely do a fine job, but no one can replace Dr. Clark. I didn’t get a good vibe from his nurse. I’ll assume it was only because our meeting was brief. Maybe next time will be better. I don’t expect to see either of them until after I return from surgery.
On Monday I also saw Dr. Langer, my radiation oncologist. I told him about the irritation at the radiation site which had gotten worse since I saw Dr. McMullen the previous week. He provided a tube of gel made for that purpose (RadiaPlexRx). It is helping, but is not working as quickly as I would like. Everything else was fine. I had blood drawn that day, so he didn’t have results to discuss with me. I did see them later in the week. My hemoglobin count increased again and was at 13.2 Monday. The low end of the recommended range is 13.4, so I am almost “normal”. It still could decrease as a result of the cumulative effects of the radiation. A couple of other measures were slightly out of their recommended ranges, like lymphocytes, but those are the result of the treatments. My white blood count, one measure that garners a lot of attention, is well within its preferred range.
I called Dr. Geiger’s office Tuesday. When I saw him in October, he said to call about a week before my last treatment to discuss scheduling surgery. I have an appointment to see him on January 30. At that time he will look at the rectal tumor with a sigmoidoscope (what fun!) to see what effect the radiation has had. He will also evaluate my general health. During the same visit I will go to another office in the building for some pre-op tests. I was given a tentative surgery date of March 4. The woman I talked with said their standard is to schedule surgery eight weeks after the last treatment. I didn’t bother asking for an earlier date, figuring Dr. Geiger will have to determine that. I will ask when I am there on the 30th.
Monday, December 30, 2013
Treatments 19 - 22
Last week was very similar to the one before, with the exception of having Wednesday off for Christmas. I did have a treatment on Christmas Eve. My radiation oncologist, Dr. Langer, was off last week, so I saw Dr. McMullen on Tuesday. I told him about the irritation at the radiation site. He checked me and wasn’t concerned with what he saw. I also told him about the bladder irritation and he prescribed a medication for that. The bladder irritation wasn’t as bad at that time as it had been the previous weekend. I delayed taking the medication until yesterday. The rash got worse during the week and I have alternated between hand lotion and petroleum jelly on the site, but neither seems to help. I will tell Dr. Langer when I see him this week.
Since I only had one day off from the radiation treatments, Mom came here for Christmas. It was good to visit with her – our first time together since Thanksgiving. She got to see that I really was doing as well as I had told her.
I expect this week to be more of the same with respect to the treatments. I will meet my new medical oncologist today and will probably see Dr. Langer on Tuesday. New Year’s Day provides another mid-week break from treatment, although at this point I would like to have that treatment and be one day closer to the end.
Since I only had one day off from the radiation treatments, Mom came here for Christmas. It was good to visit with her – our first time together since Thanksgiving. She got to see that I really was doing as well as I had told her.
I expect this week to be more of the same with respect to the treatments. I will meet my new medical oncologist today and will probably see Dr. Langer on Tuesday. New Year’s Day provides another mid-week break from treatment, although at this point I would like to have that treatment and be one day closer to the end.
Tuesday, December 24, 2013
Treatments 14 - 18
This is starting to get boring – the blog, that is. The third full week of treatment was like the second. I feel about the same. Over this past weekend I noticed a little irritation at the site where the radiation is given. That’s normal. I alternated between lotion and petroleum jelly on the area. There is a medicated gel that can be prescribed. It also seems my bladder is irritated. This is common for organs near the radiation site. The sensation is similar to a bladder infection. I check my temperature daily, as directed by one of my doctors, and it has stayed between 98.0 and 99.0. I don’t think there is an infection since my temperature is normal and irritation of the bladder in particular is common during radiation for rectal tumors. I’ll let my radiation oncologist know about both issues during my next visit.
There was a bit a bad news during the week when I was told my medical oncologist, Dr. Clark, had broken her arm and would require surgery. Then I was told she had previously informed everyone she would be leaving. Work had already begun to assign her patients to other doctors, but her broken arm has accelerated the transition. Dr. Clark is my favorite doctor among those I have encountered this year. An appointment with her is much like a visit with a friend. She is genuinely interested in all aspects of my health and asks lots of questions. I will certainly miss her. A lot of the people I met with during the week knew her and had similar feelings.
There was a bit a bad news during the week when I was told my medical oncologist, Dr. Clark, had broken her arm and would require surgery. Then I was told she had previously informed everyone she would be leaving. Work had already begun to assign her patients to other doctors, but her broken arm has accelerated the transition. Dr. Clark is my favorite doctor among those I have encountered this year. An appointment with her is much like a visit with a friend. She is genuinely interested in all aspects of my health and asks lots of questions. I will certainly miss her. A lot of the people I met with during the week knew her and had similar feelings.
Monday, December 16, 2013
Treatments 9 - 13
The second full week was much like the first with respect to side effects. Over the weekend I felt as well as I did last weekend, if not a little better. I’m starting to get self-conscious because of the lack of problems.
I saw my medical oncologist, who I see once every two weeks, on Monday. She is happy with my current condition. One especially encouraging note is that she said patients who experience serious side effects during their treatment show initial signs by the point at which I was then. I realize that doesn’t mean I won’t have any problems, just that the probability of serious problems is small. I assume that as I progress further without problems, that probability decreases more. At least I have convinced myself of that.
On Wednesday I had my weekly appointment with my radiation oncologist. He also is happy with my condition. He has the results of my blood tests each week and informed me that my hemoglobin count rose again. It’s still short of the normal range, but is well above its level in July when my anemia was diagnosed. The radiation will cause it to decrease at some point. I hope it is no time soon.
It’s great to have nearly reached the halfway point of my treatment and feel this good. I don’t expect the second half to go this well, but I have hope that it will not be too difficult.
I saw my medical oncologist, who I see once every two weeks, on Monday. She is happy with my current condition. One especially encouraging note is that she said patients who experience serious side effects during their treatment show initial signs by the point at which I was then. I realize that doesn’t mean I won’t have any problems, just that the probability of serious problems is small. I assume that as I progress further without problems, that probability decreases more. At least I have convinced myself of that.
On Wednesday I had my weekly appointment with my radiation oncologist. He also is happy with my condition. He has the results of my blood tests each week and informed me that my hemoglobin count rose again. It’s still short of the normal range, but is well above its level in July when my anemia was diagnosed. The radiation will cause it to decrease at some point. I hope it is no time soon.
It’s great to have nearly reached the halfway point of my treatment and feel this good. I don’t expect the second half to go this well, but I have hope that it will not be too difficult.
Wednesday, December 11, 2013
Treatments 4 - 8
The first full week of treatment was incident-free. Wednesday night I felt sleepy earlier than usual and went to bed about thirty minutes early. I did the same on Thursday night. Late in the week I also experienced an increase in stomach gas, which probably is unrelated to either of the treatments. However, with the possibility of nausea, it made me feel a bit uneasy. I have since read that the mere anticipation of nausea and vomiting is a common problem during chemotherapy and can cause it.
The radiation treatments were a mixed bag. Monday I was greeted by a different team than usual. It shouldn’t be a big deal, but even after only two days with the other two technicians I had started to learn their routine. On Tuesday I was a few minutes early and had to wait about ten minutes after changing into a gown. I was finally greeted by yet a different pair of technicians. Unlike my previous visits, they had not set up the table in advance so I had to wait a couple more minutes after getting into the treatment room. That’s when I really missed my usual team.
On Wednesday the regular crew was back and I was happy to see them. Unfortunately, there were problems getting me positioned correctly on the table. About half the time after getting me positioned with the laser lines and then taking an image, someone will come back in the room and make a slight adjustment. Wednesday, someone came in twice to make adjustments. Then both techs came back in and said they couldn’t get it right and had me get up while they checked and repositioned the molds. We started over and it worked after that. They said sometimes something is off and the only way to remedy it is to start over. The sessions on Thursday and Friday went much better.
I am relieved to get through a full week with no significant problems. Having finished eight out of twenty-eight treatments means I am past the one-quarter mark. I know the last quarter will be harder than the first, but it’s that much in the rear-view mirror.
The radiation treatments were a mixed bag. Monday I was greeted by a different team than usual. It shouldn’t be a big deal, but even after only two days with the other two technicians I had started to learn their routine. On Tuesday I was a few minutes early and had to wait about ten minutes after changing into a gown. I was finally greeted by yet a different pair of technicians. Unlike my previous visits, they had not set up the table in advance so I had to wait a couple more minutes after getting into the treatment room. That’s when I really missed my usual team.
On Wednesday the regular crew was back and I was happy to see them. Unfortunately, there were problems getting me positioned correctly on the table. About half the time after getting me positioned with the laser lines and then taking an image, someone will come back in the room and make a slight adjustment. Wednesday, someone came in twice to make adjustments. Then both techs came back in and said they couldn’t get it right and had me get up while they checked and repositioned the molds. We started over and it worked after that. They said sometimes something is off and the only way to remedy it is to start over. The sessions on Thursday and Friday went much better.
I am relieved to get through a full week with no significant problems. Having finished eight out of twenty-eight treatments means I am past the one-quarter mark. I know the last quarter will be harder than the first, but it’s that much in the rear-view mirror.
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