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.
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