Hip-Hip-Hooray!

Well, today wasn't a shot in the arm for me (my sore hip attests to that), but it was worth celebrating. By getting the ADT shot in Jacksonville today, I now (finally!) have started treatment for my prostate cancer. I haven't experienced any fatigue or hot flashes yet; that may start in the next few days. Or maybe in a week or so; they say the side effects vary quite a bit. In any case, I'm glad the first phase of my treatment has begun.

A Shot in the Arm

At least I hope it’s in my arm. I’m going to Jacksonville tomorrow to get the ADT (androgen deprivation therapy) injection. I was going to get it from my urologist in Tallahassee, but then I thought about all the scheduling difficulties and delays I’ve had with his office. The UF Health people are much more efficient and organized, and I’m sure to get the right shot, sooner.

As for scheduling, all I know now is that my next trip to Jacksonville (for the “Simulation” visit) will be in about two and a half months, with the proton treatment starting a couple of weeks after that. They don’t do exact scheduling this far in advance, but I should know in a couple of months what the exact dates will be. Stay tuned.

Good Test Results, and Progress

The unofficial report today from my PTI case manager is that the CT scan and MRI results from last week are just as problematic as the ultrasound was: that is, not at all. As soon as the PTI doctor makes that conclusion official, he will issue a referral for the next step: the ADT (androgen deprivation therapy) injection. I’ll be able to get it in Tallahassee, saving me a trip to Jacksonville for a 5-minute procedure.

After that, while the drop in my testosterone is busy starving and weakening the prostate cancer cells, all I have to do is wait two and a half months before my next visit to Jacksonville in mid-May. That will be a two-day session of preparation for the actual treatment—which will begin at about the end of May.

When I get more exact dates, I’ll post them.

Last of the Scans?

Well, that was a busy two weeks. While in Houston for Winston’s mother’s Celebration of Life, I got a call from PTI. I was scheduled for the last (hopefully) three scans on Thursday the 16^th, the day after I got back from Houston at 8 pm. So, at 7:30 the next morning I drove to UF Health’s Emerson facility, in South Jacksonville, where I could get all three scans in the same day.

First, the thyroid issue. The endocrinologist did a thorough ultrasound and found two nodules. Both were tiny and “not suspicious.” He said they were too small to even do a needle biopsy, and advised me to get a repeat ultrasound in a year or so.

Next, drink about a quart of barium solution to prepare for the CT scan. It wasn’t as bad as I expected, much like a mocha milk shake made with skim milk.

The barium takes about an hour and a half to spread out inside me, so I went for the MRI of my chest to check on a possible issue with my upper spine and a rib. I put on the hospital gown, and after the tech mentioned I’d get a shot of contrast dye part way through the scan she put me on the MRI bed and moved me into the machine. The usual strange MRI noises started, and then stopped. She moved me back out of the machine, and told me I wouldn’t be able to get the MRI because I was going to have a contrast shot for the upcoming CT scan, and I couldn’t get both contrast shots in the same 24 hours without overloading my kidneys.

So, I waited until the barium was ready and then got the CT scan. This will let us know if I have a problem with my liver. No results yet; perhaps there will be by early next week.

What about the MRI? The MRI machine at the Emerson facility wasn’t available again until next week, but the good people there arranged an appointment for me at the main UF Health campus near downtown. It was scheduled for 24 hours later, of course, so I drove back to Tallahassee. The next morning I drove to Jacksonville again, got the MRI with no problems, and drove back home again. The MRI results also won’t be available until next week. Again, I’ll be patiently waiting.

More Waiting, and Still More Scans

I won’t be going back to Jacksonville this week, but maybe Monday. Or maybe in a couple of weeks.

First, the good news. Apparently they've ruled out any problem with the "hot spot" between my eyes, as they've not scheduled a follow-up to the head x-rays to investigate it.

But now I need three more scans to investigate other possible issues found in the results of earlier tests: an ultrasound of my thyroid, a CT scan of my liver, and a PET scan for my spine. The first two scans are cleared (that is, Medicare will cover them). They’re still working on the PET scan insurance coverage, and that may take a while. 

So, I may go back to Jacksonville for the first two scans on Monday--if they can be scheduled in time.  I’ll be out of town from the 7^th through the 15^th, so the next possible date for the next Jacksonville visit will be the 16^th or the 17^th, or some time the following week. If it’s one of the later dates, I may get the PET scan on the same visit. After all three tests are completed it will take a few days for the results to be reviewed, and if everything is okay I’ll get the ADT injection on still another, later, visit. Then I'll wait two and a half months after that before going back again to begin preparing for the actual proton beam therapy.

Still Waiting

Thought I'd have been to Jacksonville again by now, but that's not the case. I called my case manager this afternoon and found that not all of the results of the tests I had last week have been fully reviewed. She did give me a heads-up that I'll probably need another scan when I do go back, but that it hasn't yet been scheduled. I'm hoping I'll get everything wrapped up by the end of the week.

Good News and More Scans

Good news from Monday’s MRI: It shows no cancer outside the prostate. This means they can proceed as planned, including the use of the Space OAR (see Nov. 24 post). EXCEPT, they need some more tests. Today I had the bone density scan I expected, and that they weren’t able to fit into Monday’s schedule. I also got some head x-rays, because they wanted a closer look at the hot spot between my eyes that showed up in Monday’s bone scan.

They also wanted a CT scan of my chest, because the MRI showed an area of concern on my spine. I expect this is related to a condition called DISH (Diffuse Idiopathic Skeletal Hyperostosis), AKA Forestier’s disease. This is a calcification of ligaments in areas where they attach to your spine. There are few, if any, symptoms—but I was diagnosed with it years ago when I had a little upper back pain. The CT scan took some time to schedule, but my case manager pushed it through so I could get it today.

I didn’t get the ADT injection, because they want to review all test results first…and the CT scan results probably won’t be available before Friday. So…back to Tallahassee. Now I’ll wait until they contact me to set up still another visit to Jacksonville, probably Friday or Monday.