Wednesday 30 April 2008

Radiation Therapy - Week SIX

DAY THREE


Day 21 - 17 still to go!

It's such a great feeling this side of halfway!

Now as I count down the treatments left I also say good-bye to more and more fellow patients. It is a little sad to say goodbye to someone you feel as though you know so well.

Even though in reality it's been somewhere between a few weeks and a couple of months!

You seem to bond very closely when you are in circumstances such as this. Sometimes words are almost superfluous; when just an understaning look, or a wink, or even just ... "I understand" can convey quickly and deeply the sentiment needing to be expressed and received!

There are also so many new faces on the scene now! And with the influx of new people, comes the opportunity to get to know some more wonderful people. Of course, not everyone is outgoing, or even wants to talk; but they usually melt after awhile.

Wow! I'm starting to feel like a veteran!


Treatment

My treatment today went well, as expected. I continue to be grateful that there are no side effects from the Radiation Treatment!!

Tuesday 29 April 2008

Radiation Therapy - Week SIX

DAY TWO


My treatments seem to be going so much faster now that I have passed the 'halfway' mark.

Today's treatment was number 20, which means that I have 18 treatments to go! It sure feels good to have this much of my treatment, 'under my belt' - no pun intended!

Today, my treatment went well and was on time - which is a bonus. After treatment, I had a leisurely lunch (30 minutes) as I was 'on time' and could enjoy more than the usual 15 minutes and off to work!

Every day holds out something new to experience if you just look for it! Today, I marvelled at the efficiency of the new NUM (Nurse Unit Manager).

She, and my favourite nurse; Nurse Judy, were busily engaged in tidying up files on the computer and ordering stock as well as a myriad of other tasks.

And even though they were so very busy, they both still found time to interact with the patients - for a quick chat. Such dedication and compassion deserves to be noticed and applauded!

I am so very fortunate to have chosen this particular hospital!

Monday 28 April 2008

Radiation Therapy - Week SIX

DAY ONE


Today, being Monday, I was scheduled for my regular weekly reiview of my treatment with the Radiation Oncologist. After filling in the weekly survey (4 pages of quite intimate questions) I was ushered in to discuss my treatment.

To all intents and purposes, my treatment is going very well. The doctor was particularly pleased, that after 19 treatments that I have NO significant side effects resulting from the radiation! I'm particularly pleased about that too!

On the other hand, the side effects associated with the Hormone Therapy, are beginning to 'get a little weird'!

First, I discovered that the hair under my arms (read armpits) has simply disappeared!

Second, I noticed, belatedly, that the hair on my stomach and chest had 'all but' disappeared.

Third, I noticed that my armpits were really sensitive to touch!

Fourth, my 'pectoral muscles (hmmm ... man-boobs) are getting larger and the nipples are not only senitive but also sore.

Upon mentioning the above to the Oncologist it turns out that there's nothing much that can be done - except for the 'man-boobs'!

It seems that an amount of radiation aimed precisely at the 'problem area' can somehow resolve this issue and I won't have to be fitted for a 'trainer bra'! That of course came as enormous relief!


My treatment once again went without a hitch; which I must admit, I tend to take for granted at times.

When it's all said and done however, I am extermely grateful for the technology that is giving me a chance at a cure.

Not only is my hosptial one of the few in the country to possess such technology but it was also the very first to have it available in the country!


Thursday 24 April 2008

Radiation Therapy - Week FIVE

DAY FOUR


Well my last treatment for the week went well as usual. I marvel, that even at the half way mark, I still have no 'significant' side effects from the Radiation treatment!

Today, my good friend Mary, had her last treatment. While we celebrated that fact and her good results, we were both a little sad that we would most likely not see each other again!

As Mary exited the treatment room via the extended 'tunnel' - and knowing I was 'up next' - I took the initiative to approach Mary mid-tunnel and offer her a 'hive 5' ... to which she responded with equal gusto!

The staff simply laughed as Mary and I then exchanged well-wishes and gave each other a big hug!

After my treatment, I headed off to have some lunch before heading back to work.

By the way, my lunch consists of - among other things - a large 'high protein drink' and a well balanced meal; aimed to boost my energy levels after the treatment and to give me to have the strength for the journey back to work.

All, continues to go well!

Wednesday 23 April 2008

Radiation Therapy - Week FIVE

DAY THREE


Today, my treatment was about 30 minutes late! This gave me time to chat with a number of the patients, most of whom I don't ordinarily see because they have later appointments.

Several of us just sat their swapping stories about our condition and the great treatment we are receiving at the Radiation Oncology Department.

I'm sure, that many of the staff overheard our conversations, as they made a point of 'smiling' and 'saying hi' each time they passed. It actually felt good, to watch the staff's faces light up!

Nothing outstanding to speak about, regarding my treatment today; all went well and according to plan. The only 'hitch', was in regard to my appointment with the dietician - set down for 12noon.

I was a couple of minutes late (remember my treatment was late) in attending the appointment. Well ... after a few questions asked in the right places ... the Dietician gave up on me (or maybe gave in to her cravings) and headed off to the canteen for lunch.

My response?

I headed off for lunch too! And since I was late and not wanting to 'stretch the friendship' with too long a time away from work; I held a 'board meeting' ... where: Me, Myself and I, all voted unanimously to postpone the appointment until next week!

Tuesday 22 April 2008

Radiation Therapy - Week FIVE

DAY TWO


It's amazing how easy life can become 'routine'.

I mean, if you enter a phase in your life where most days are very similar in terms of expectations, people that you encounter, and routine that is observed; then you either become accustomed to the routine in which case it often fades into the background; or at times you can simply become an observer watching life go by; but there is another option ... let me give you an example.

To date, I have been attending the Oncology Department for 5 weeks. In this time I have spent a lot of time 'waiting' and enduring the often monotonous routine of hospital outpatient life.

For example: staff racing around attending to any number of important, and sometimes urgent, tasks. Patients coming and going; most with 'glum faces' and the rest with stoic looks that almost demanded: 'Please don't talk to me'!

While I have been waiting, I have resisted the urge to become like those described above, and have passed the time by 'deliberately' getting to know the other patients. I have also 'gone out of my way' to memorise their names as well as the names of ALL the staff.

This has helped me to pass the time constructively engaging with the 'world around me'! I want to focus on 'living'; whatever time I have left, rather than anticipating and fixating on how soon I will die! This has been sorely tested at times when at first others misunderstand your genuine attempts to simply 'be friendly'. However, I have persisted.

The outcome?

Recently many of the other patients have begun to comment on: 'how nice it is' that we have all become friends! The staff have commented on: 'what a great group we are'! Little did I expect however, where all this might lead!

Today, my determination to live and engage with life and those around me took on almost 'comical' proportions! Let me paint you a picture...

'Mary' (a fellow patient) arrives. Mary is a little confused. She is running late! Mary sits down and mutters: 'what am I supposed to do'? Well ... being a 'friend' and a keen observer of the almost changeless routine ... I speak up.

'Mary, don't forget to ask Helen of Judy (nurses) for your meds. You have to have them 15 minutes before your treatment'! Mary of course thanked me for the reminder and toddled off, wondering: 'how on earth did he know that'?

Upon reaching the nurses station, Mary has forgotten about her meds but has remembered that she has not yet seen the doctor this week and begins 'insisting' on seeing him! The nurse checks Mary's chart and finds no mention of a doctor's appointment; puzzled [and very busy] she passes on the responsibility to the new NUM!

The NUM (only her first day on the job) is sporting a worried look as she passes me, when I blurt out: 'excuse me, I might be able to help'. To which the new NUM responds: 'Please do'.

'Well first of all Mary was scheduled to see her doctor yesterday as part of her regular weekly review; but he was away - so there is no urgency. But since Mary has only two more days until her treatment finishes she's a little fixated on the thought that she might not see her doctor at all'!

'But more importantly, for the moment; Mary hasn't had her 'pain-killer' which she has to take 15 minutes prior to her treatment! Oh, and you might ask Helen and Judy to keep an eye on her she's a little confused today'!

The NUM's response was: 'Oh ... thanks John, it would have taken me quite a while to unravel all that; you've saved me a lot of time'!

Now this is not the end of the story ... several other occurences saw me offer support to either the patients or the staff, too many to mention here though.


Now I know that I took a real risk at 'interacting' in this fashion; but, I firmly believe, that if there are no risks in life ... there is ... NO life!

Oh, and by the way my own treatment went very well today as did the trip back to work and the remainder of my shift.


'Excuse me ... ahh .. if I can butt in for a moment; I noticed that you've been paging Margy (the AIN) for some time. You'll find her in the canteen in the main building ... she's taking an early lunch...'!

'Oh thanks again John, you've been so very helpful today'!


Monday 21 April 2008

Radiation Therapy - Week FIVE

DAY ONE

Today marked a new phase in my treatment; today, I started back at work! This meant, carrying out my normal duties until 10:am and then driving for 30 minutes to the Hospital for my scheduled treatment.

This was followed by a light lunch and then a 30 minute drive back to work to complete my shift!

I wasn't sure if I would have the strength and the stamina to undergo such a routine; but to my delight, I was able to fulfill all that was required of me on both fronts!

Arriving at the Oncology Department, I made my way straight to the 'dining' area for a cup of tea. There before me was: Nurse Judy, head in hands, lost in her private thoughts and sporting a rather solemn look!

It soon became obvious why she was so glum!
As I sat down beside her I overheard ...

"Oh, I miss my daaarrling soooo much..."
These were the first words that greeted me, until she became aware that I was seated beside her! Ohh its you! Tell me ALL about it ... how did their trip go? Are they OK?

The two of us sat there reminiscing, about the time we spent with Lauren and her children; both a little teary as we sipped our tea - covering up the odd sniff of emotion!


The treatment went well today, albeit that it was about 45 minutes late! Lunch was a little rushed as I wanted to see just how long I would [normally] be absent from work. I didn't want to 'stretch the friendship' as the Chairman of the Board had been so understanding and generous with time allocation and offer of support etc.

At the close of the day, I sat and reflected on what was an eventful and satisfying day! I was now convinced that I would be able to complete the remaining 23 treatments, while at the same time being gainfully employed.

It is important for me that this be so! I know, if I were to sit alone at home before and after attending treatment each day that I would become too 'cancer-focused' and this would prove highly detrimental to the treatment outcome!

Working also provides me with a sense of having some control over my life's events; not to mention some sense of normality! With so much 'taken from you' this is of vital importance!!

Thursday 17 April 2008

Radiation Therapy - Week FOUR

DAY FOUR

I received a phone call fron the Oncology Department early this morning, notifying me that the Linear Accelerators were down! It was agreed that I would wait to hear from the Radiation team re a later appointment.

Unfortunately when the expected call eventuated, it was not what I expected. My appointment was cancelled and my next treatment would be on Monday morning as previously scheduled.

This means, that I will receive an updated printout of my schedule on Monday detailing where I will 'pick up' the lost treatment day - most likely it will be tacked onto the end.

Speaking of schedules, I thought I would include the following 'algorithm' which details the choices available at various stages, regarding Treatment.


Wednesday 16 April 2008

Radiation Therapy - Week FOUR

DAY THREE

Today, was our last day with our daughter and grandchildren, before they start out on their return trip to Chile. Consequently there was an informal 'farewell' at the Hospital - with more than a few tears!

Both Matti and Banjo (not to mention their mother - Lauren) have won a great many hearts in the Oncology Department over the past 4 weeks. It was a great time of 'well-wishing', mixed with genuine sorrow, as new friends parted. It was quite touching as parents/grandparents to witness this.


Banjo's last day at the Oncology Department


Today, we attended the Oncology Department for:

(1) My regular treatment, and

(2) An appointment with a Dietician.

The Radiation treatment went well as usual without any delays - the Linear Accelerators have been causing some problems this week.


My appointment with the Dietician was interesting. It turns out that my diet has been somewhat inadequate. Although, impressed with my diet and goals overall, the Dietician pointed out one major floor - no Protein! That is, I had eliminated all red meat from my diet.

The result, was that without protein from red meat, I was undoubtedly anaemic (low in iron) and this no doubt was contributing to my fatigue level.


I quickly moved past the 'what a fool' stage and moved straight onto the 'you beaut' stage ... I LOVE red meat!!

And so what did we do you ask? We went out that night to a nice restaurant and enjoyed a wonderful meal containing ... you guessed it 'red meat'!

Tuesday 15 April 2008

Radiation Therapy - Week FOUR

DAY TWO

Today things were 'back to normal' at the Oncology Department. With the Linear Accelerators in full swing; it was 'action stations' and 'full steam ahead'.

On a personal note, I find it amazing, the bond that grows between fellow patients while awaiting treatment day after day!

I guess I would describe it as a bond of 'camaraderie'. You feel as though you are fellow combatants who both understand the enemy and appreciate its resourcefulness and at the same time grow to appreciate and respect the courage in your 'fellow soldiers'!


Laughter is a GOOD Medicine

There’s not much laughter in the Oncology Department, at the best of times. However, having our daughter and her children visit every day for the last few weeks has certainly changed all that!

It has been wonderful to see the smiles on so many faces that previously have simply sat there rather stoically and avoided eye contact with each other!

Many of those receiving treatment in the Oncology Department, are there trying to ‘buy time’.

That is, they have been told that there is NO cure for their condition and are hoping against hope that Radiation treatment will allow them to secure some precious extra weeks … months … years!


Not exactly the setting; for striking up in depth conversations and forging new friendships!


My Treatment

Once again my treatment went off without a hitch! Once again, I am grateful for the incredibly dedicated team who look after us! Well done guys!


My medicine!

Monday 14 April 2008

Radiation Therapy - Week FOUR

DAY ONE

Well today I received a call very early, from the Oncology staff. The call was twofold in purpose:

(1) To notify me that they were experiencing technical difficulties with the Linear Accellerators; and,

(2) To reschedule my appointment for 5:00pm instead of 11:00am this morning.

Now this of course was unexpected and caused a little concern. I mean these machines are valued at millions of dollars and work within incredibly fine physical tolerances.

The computer models that are programmed to drive the Linear Accellators (LA's) demand a very high level of precision.

Then I remembered that the two LA's were due to be 'down' for routine maintenance this Friday and this was therefore to be seen as 'routine'.

This may sound a little 'over the top'; but when you consider that you have to trust in the precision of both the machine and the operators, and that you are completely 'out of control' and feeling very vulnerable when lying prostrate on the bed; a little anxiousness from time to time is not unreasonable!

Anyway, this news allowed us to enjoy the day with our grandchildren and our daughter; particularly considering that they fly out to Chile in two days!

Later that evening I attended an interview with my Radiation Oncologist and my daughter (a doctor) was able to meet and discuss my condition with him in some detail. I left the room towards the end of the interview, so that the two could talk 'doctor to doctor'!

I figured that since we will be living with our daughter in Chile in a couple of months then it would be useful for her to know the details of my treatment; the anticipated prognosis; possible side efffects; and, any other pertinent information.

Well once again all went well with my treatment and we headed off to a favourite restaurant before returning home.


The entrance to Linear Accellarator 1

Saturday 12 April 2008

Radiation Therapy - Week THREE

DAY FIVE

Today I received the results of my liver function test - courtesy of Nurse Judy! I had no sooner asked if she could contact the doctor for me and request them on my behalf; when PRESTO! There was Nurse Judy approaching me with a 'printout' of the results in her hot little hand!

Never one to disappoint, Nurse Judy had simply 'taken over the NUM's office'; used his computer to look up the results and sent them off to the nearby printer. That easy! I had been waiting 4 days for the doctor to contact me! There's nothing like knowing the 'go to person' for getting things done!!

Now after all that ... there was nothing outstanding about the results; so that's another one for the good guys!

The Radiation Treatment went well again today - no hiccups. The staff and I are becoming more like friends than a strictly professional, patient to health professional relationship.



I must admit I really enjoy their company and it certainly makes the daily treatment much more tolerable. In fact, all of the 'hands on' staff have been amazing; from the front desk (reception) to the Linear Accelerator team.

Thursday 10 April 2008

Radiation Therapy - Week THREE

DAY FOUR

Well ... today represented a milestone as far as my treatment is concerned. Today I arrived the '25% completed mark' i.e. Ten treatments now complete and ONLY thirty to go!


Makes You Wonder!

A strange thing happened today! Just prior to my treatment, I was looking around for something to casually read; you know, to take my mind off things. Suddenly I spied an interesting looking clipboard with certain information sheets on it - 'dumped' beside one of the visitors chairs and a pile of what looked like discarded papers ready for the shredder.


Hmm ... I wonder what that is?


Now with my curiousity piqued, I figured that a 'quick' look wouldn't be out of the question. And so, with the documents [on the clipboard] now clasped firmly in my hand, I noticed that the content was actually a summary of all patients who had died over the past several years!

Now, for some inane reason, I blurted out to my daughter who was my accomplice before the fact:

"I'll bet you that my name is on this list"!

Guess what? It was!

Now just in case you're interested; I 'John Purcell' died [of cancer] while still a patient of the hospital [in question] on 8th August 2005!

I of course, was simply hoping that this was not a 'predictive' list i.e. an estimate based on the current prognosis with a mistake made concerning the year! I'm not sure I'm in a hurry to see the 8th August this year - just in case!


Do the Right Thing!

Well ... yes I did do the responsible thing! I took the list to my friend 'Nurse Judy' and [hamming it up] stated:

"You've got the wrong date on this"!

Nurse Judy's response; once she read the document I handed over; was one of shock, disbelief and outrage!

As I left her office, having explained just how those documents came into my possession; I could hear her mumbling:

"Admin ... they got a lot to answer for! Just wait 'til I see ..."


Treatment

Yes, my treatment went well again today, thanks for asking!

Wednesday 9 April 2008

Radiation Therapy - Week THREE

DAY THREE

I must admit, that the treatment I am receiving, is rather boring once you get over the initial concern, anxiety, wonder etc. And since there's not much else to do, I spend my time meditating.

I usually start with:

"Well ... that's 9 down and 31 to go"!
From there I move into a deep state of meditation.


Here I am already 'out to it' so to speak!


The procedure normally takes from 15-25 minutes; but to me it seems like 2 minutes - as time flies! To date, I am still essentially sympton free in regard to the radiation. The only possible signs of what I may have to look forward to are:
  • Burning when urinating

  • Skin irritation

  • Irritable bowel - leading to diarrhoea
I have begun to experience these but not consistently .. so I'll have to wait and see. I really cannot complain as the 'hands on' staff have been remarkable!

Tuesday 8 April 2008

Radiation Therapy - Week THREE

DAY TWO

Today we were 'racing against the clock' a bit! Even though we allowed 90 minutes to make a 30 minute journey; BUT ... it rained ... and rained ... and rained! And the traffic slowed to a dead stop, so many times; that we thought for a while, we were not going to make it on time!

Well, we arrived at the hospital at 10:50am, for my 11:15am appointment; very much relieved ... at least I know that I was; only to find that the Radiation Department was well behind schedule anyway.

Treatment number 8, went off without a hitch; and we were back in the car and on the way home before we knew it!


Celebrities


The grandchildren have become quite the celebrities at the hospital. Partly because they represent hope for the future; in an environment which otherwise could represent death or at least many valiant efforts to defeat 'premature' death! And partly because they are just so darn cute!

Little Matti has become something of a star, as 'Nurse Judy' has taken a real shine to her! We no sooner arrive, and Nurse Judy has wisked Matti away from her mother and is off on her 'rounds' to show her off!!

Well today, Banjo decided that he wanted to (once again) accompany grandad to the change room after treatment. I always get a kick out of this! But today, unbeknown to Banjo or me, several of the staff were watching on! I heard the commotion and the: "Now that's really cute / adorable / so nice" etc, and thought that it was Matti once again stealing the show!!





It was only when Banjo and I emerged from the change room that I realised what had happened ... it felt pretty good I must say!

While on the subject of feeling good, I cannot stress (pardon the pun) the absolute importance of remaining as 'upbeat' as possible; even through all the setbacks and challenges! Having my daughter and her two children accompany me each day is like medicine to my soul!

Thanks Lauren!!!

Monday 7 April 2008

Prostate Cancer Staging

As stated in my most recent post, I was told today that my Prostate Cancer Staging was: 'T3N0M0'. In order to put this in some perspective, for our readers; I decided to post the following:

The following article is excerpted from PSA Rising - Prostate Cancer Survivor (News, Info & Support) I would encourage all our readers to visit the author's website.


What is Staging?

If prostate cancer has been found by any method, the next step is to see how much of the prostate it takes up and whether it has spread outside the prostate to nearby tissue, lymph nodes, organs and/or bones.

This is called staging the cancer. Your prostate cancer stage is key to your treatment options. Primarily, staging is based on your digital rectal exam (DRE).


Two different systems of staging have been used for prostate cancer.

Today the older ABCD system has largely been replaced by the TNM (Tumor, Nodes, Metastases) system. In addition, two levels of staging are used, clinical and pathologic.

Clinical staging is based on digital exam and any further non-invasive tests necessary to find the extent of the cancer. It affects primary treatment decisions.

Pathologic stage refers to examination of the prostate and any other tissue removed during surgery. Only patients who undergo surgery receive the second level of staging.


The TNM system of staging

Primary tumor (T)

TX: Tumor cannot be assessed.

T1: Doctor is unable to feel the tumor or see it with imaging such as transrectal ultrasound.

T1a: Cancer is found incidentally during a transurethral resection (TURP) for benign prostatic enlargement. Cancer is present in less than 5% of the tissue removed.

T1b: Cancer is found after TURP and is present in more than 5% of the tissue removed.

T1c: Cancer is found by needle biopsy done because of an elevated PSA.

T2: Doctor can feel the tumor when a digital rectal exam (DRE) is performed but the tumor still appears to be confined to the prostate.

T2a: Cancer is found in one half or less of only one side (left or right) of the prostate.

T2b: Cancer is found in more than half of only one side (left or right) of the prostate.

T2c: Cancer is found in both sides of the prostate.

T3: Cancer has begun to spread outside the prostate and may involve the seminal vesicles.

T3a: Cancer extends outside the prostate but not to the seminal vesicles.

T3b: Cancer has spread to the seminal vesicles.

T4: Cancer has spread to tissues next to the prostate (other than the seminal vesicles), such as the sphincter, rectum and/or wall of the pelvis.

T4a: Invades bladder neck, external sphincter, or rectum.

T4b: Invades muscles and/or pelvic wall.


Regional Lymph Nodes (N)

To see if the cancer has spread to the lymph nodes or bones, the doctor may order a CT scan or an MRI of the pelvis and a bone scan.







Sentinel lymph nodes in the pelvis that look suspicious on CT scan or MRI can be examined by fine needle aspiration biopsy method. This is done commonly in breast cancer staging.

NX: Nodes cannot be assessed

N0: No regional node metastasis

N1: Single node metastasis, 2 centimeters (cm) or less at largest point

N2: Single node metastasis, 2 cm to 5 cm at largest point, or multiple nodes, no larger than 5 cm at largest point

N3: Metastasis larger than 5 cm in any node


Distant Metastasis (M)

MX: Metastasis cannot be assessed

M0: No distant metastasis

M1: Distant metastasis

M1a: Distant lymph node(s) involved

M1b: Bone(s) involved

M1c: Other site(s) involved (e.g. liver, lung)


Note on stages that "cannot be assessed."

Patients in whom abnormal digital rectal examinations (DREs) do not match up with their prostate biopsy findings are "clinically unstageable."

To find out what unstageable prostate cancer involves, Wisconsin researchers looked at post-op pathology reports of some 100 patients who were unstageable.

"For these patients pathological staging revealed pT2a cancers in 26%, pT2b in 53%, pT3a in 19%, pT3b and pT0 in 1% of patients." The authors conclude: "Thus, the prevalence of unstageable prostate cancer is low but significant and it can be accurately classified into clinical stage T1c. "Clinical and pathological characteristics of unstageable prostate cancer: analysis of the CaPSURE database. Langenstroer P et al. Medical College of Wisconsin. J Urol. 2005 Jul;174(1):118-20.

Radiation Therapy - Week Three

DAY ONE

Today I arrived at the hospital to find that treatment would be late. This allowed me to have extra time with the Radiation Oncologist's Registrar - the former was on leave. The regular weekly review is very important for many reasons, chief among them (for me) is that such such sessions allow me to ask as many questions as i like!

Unlike last week, I was prepared this week with a list of question that I had written down - taken essentially from the (hand written) diary that I keep. This diary is also the source of much of what appears on this blog. I find keeping the diary invaluable, as these days I can't rely on my memory - one of the side effects of the treatment I'm on!

In case you're interested, here is this week's list of questions:
  1. A reminder (to the doctor) that I should have had a 'liver function test' weeks ago! This I knew ONLY because of my own research! Oh ... ah ... YES let's do that today. (The pathology request was marked URGENT). When you have no 'Case Manager' looking at your treatment from a 'holistic perspective', your treatment can suffer; as the various specialists tend to focus (mostly) upon their own field of expertise - therefore 'things' can be missed!

  2. What can I do about the increased fatigue and subsequent breathlessness? I'm afraid there's not much we can do about that. But you should begin to tolerate that portion that can be attributed to the Radiation in about another week or so.

  3. What about the 'confusion and memory loss'? You have so much 'on your plate' right now; it's no wonder you suffer a bit in this area!

  4. My weight gain (9kg) concerns me is there anything you can suggest? I'm afraid not ... it goes along with the treatment ... particularly the Hormone Treatment.

  5. In that case would you think that seeing a Nutritionist is advisable? Yes ... I think this is an excellent idea. I'll ring through now to obtain an appointment.

  6. Night time urinations have actually increased despite being prescribed 'Flomaxtra'? We might have to double your dosage. My research tells me that Flomaxtra doesn't really kick in for about 7 days; and since this is day 7, would you suggest we wait another week? Yes that would be very sensible.

  7. I am currently on holidays do you think I'll be up to a return to work on the 16 April - in the middle of my Radiation Treatment? We'll really have to wait and see ... but if we feel you're not ready (for work) I would be happy to write you a certificate to that affect.

  8. Would one month after my treatment finishes be too soon to fly overseas - to live? Again we really need to wait and see, but I would imagine that that would be fine.

  9. I'll be on the LHRH Analogues for 2-3 years ... will I need to be on the Anti-agonist that long as well? (My research said YES). I'm afraid so ... but I'm sure that you'll be fine.

  10. I have had a bout of the 'flu for a week now, is it OK to take some cold and 'flu tablets to relieve the symptoms until the virus is defeated? Yes, that'll be OK.

With pathology request in hand, I then went in search of my favourite nurse - Nurse Judy. Not only was she able to point me in the right direction, she was also able to 'take the blood'. Mission accomplished! I then felt that we were getting somewhere.

Now off to my Radiation Treatment ... I'll ask if they're ready for me yet!
Oh, I almost forgot ... I was finally given my actual 'staging result' today - after repeated requesting.

The result ... T3N0M0. In order to understand this result better, my next post will seek to explain what 'staging' means in relation to Prostate Cancer.

Saturday 5 April 2008

WHAT IS FLOMAXTRA®?

FLOMAXTRA® is a medicine for use by MEN only. FLOMAXTRA® is often used in men who have a medical condition called benign prostatic hyperplasia (also known as BPH). In BPH the prostate gland is bigger than normal. BPH is NOT prostate cancer.


WHAT IS FLOMAXTRA® USED FOR?

FLOMAXTRA® belongs to a group of medicines called alpha-blockers. Your doctor has prescribed FLOMAXTRA® for you because you have symptoms caused by an enlarged prostate gland.

The prostate gland is at the outlet of your urinary bladder. Because your prostate has become bigger than it should be, it is affecting how well you are able to pass your urine. This causes some, or all of the following symptoms; they usually start gradually and increase in severity:


  • Urine flow is slow.

  • The urine stream may become a trickle, or it may stop and start.

  • You find a delay when you try to pass urine, and you have to strain to do so.

  • You feel that you cannot empty your bladder completely.

  • You may dribble at the end of passing urine.

  • You need to pass urine often during the day.

  • You need to get up often during the night to pass urine.

  • You feel an urgency to pass urine as soon as you first feel the need to do so.

HOW DOES FLOMAXTRA® WORK?

When you pass urine, the urine travels from the bladder through a channel in the prostate. When the prostate gland becomes large, this channel becomes narrow. The channel may even become blocked. If this happens, no urine can be passed. This is a medical emergency.

FLOMAXTRA® is a medicine which relaxes smooth muscle, especially in the prostate. In BPH FLOMAXTRA® works by widening the channel through the prostate gland. This allows the urine to flow.


WHEN SHOULD I NOT TAKE FLOMAXTRA®?

FLOMAXTRA® is for use by MEN only. If you are a woman or a child, do not take FLOMAXTRA®.

If you are not sure whether you should start taking FLOMAXTRA® you should contact your doctor. You should not take FLOMAXTRA® if:


  • You are allergic to any of the ingredients in the tablet.

  • You become dizzy or light-headed or have low blood pressure when you stand up, after sitting or lying down. This is called orthostatic hypotension.

  • You have serious liver problems.

  • You have serious kidney function problems.

  • You are taking other medication which relaxes the smooth muscle of blood vessels (some of the tradenames are Minipress®, Prasig®, Hytrin®).

BEFORE YOU TAKE FLOMAXTRA®

Use FLOMAXTRA® only if your doctor has prescribed it for you. All medicines have benefits and risks. In deciding to prescribe FLOMAXTRA® for you, your doctor has weighed the risk of taking FLOMAXTRA® against the benefit it is expected to have for you.

Your doctor has prescribed FLOMAXTRA® for BPH. FLOMAXTRA® does not treat prostate cancer. BPH and prostate cancer may have similar symptoms. A man can have prostate cancer and BPH at the same time. You should be checked for prostate cancer before you start FLOMAXTRA®. It is recommended that men be checked for prostate cancer once a year, from 50 years of age onwards. These checks should continue while you are on FLOMAXTRA®.

Before you start taking FLOMAXTRA® tablets you should tell your doctor if you:


  • Are allergic to FLOMAXTRA® or any of its ingredients.

  • Are taking any other medicines, and what they are. This includes medicines that you buy without a prescription from your pharmacy, supermarket or health food shop. In particular, tell your doctor if you are taking cimetidine, a medicine generally used to treat stomach ulcers or reflux.

  • Have angina (severe pain in the chest, usually on exertion) or have had a heart attack during the last six months.

  • Have high, or low blood pressure, or your blood pressure is controlled by medication.

  • Have had ejaculation problems.

  • Are suffering from any other illness.

  • If you are going to have eye surgery, please advise your surgeon that you are taking or have taken FLOMAXTRA®.


WHAT UNWANTED EFFECTS MAY OCCUR WITH FLOMAXTRA®?

Most men prescribed FLOMAXTRA® benefit. As with any medicines, some side effects may occur. FLOMAXTRA® does not usually cause any problems. If you develop a skin rash, itchiness or swelling of the face, lips or tongue, tell your doctor immediately, as you may be having an allergic reaction to FLOMAXTRA®. Swelling of the face, lips or tongue may cause difficulty in swallowing or breathing.

One side effect of FLOMAXTRA® is known as “retrograde ejaculation”. When this happens the ejaculation fluid is not squirted out, most of it runs back into the bladder. Retrograde ejaculation is painless.

Other side effects reported by people taking FLOMAXTRA® include dizziness, headache, itching, weakness, dizziness on standing, nausea, vomiting, diarrhoea, constipation, rash, fast heart beats and blocked nose.

FLOMAXTRA® can occasionally cause people to feel faint and dizzy. You should get up slowly from the sitting or lying position to reduce the risk of dizziness or light-headedness. If you do feel faint on standing up, you should lie down for a short while. If the dizziness persists you should contact your doctor. You must not drive a car or operate machinery if you feel dizzy.

Extremely rarely, medications similar to FLOMAXTRA® have caused prolonged painful erection of the penis, which is unrelated to sexual activity. If you have a prolonged erection, call your doctor or go to the Emergency Room as soon as possible.

This is not a complete listing. Other unwanted effects may occur in some men. Tell your doctor if you

notice any other effects or if the unwanted effects are particularly bothersome.
You should always tell your doctor about any problems you have whilst taking FLOMAXTRA®.


HOW MUCH FLOMAXTRA® SHOULD I TAKE?

The dose is one tablet a day. Swallow the tablet whole, preferably with a glass of water. Do not crunch, bite or chew the tablet, as this changes how FLOMAXTRA® works.

Do not take FLOMAXTRA® if the packaging is torn or shows signs of tampering, or if the tablets show visible signs of deterioration.


If you forget to take it:


  • If it is almost time for your next dose, skip the dose you missed and take your next dose when you are meant to. Otherwise, take it as soon as you remember, and then go back to taking FLOMAXTRA® as you would normally.

  • If you are not sure whether to skip the dose, talk to your doctor or pharmacist.

  • If you miss a whole day, just continue to take your normal daily dose the next day .

  • Do not take a double dose to make up for the dose that you missed.

    • Friday 4 April 2008

      Radiation Therapy - Week Two

      DAY FOUR

      Today we once again arrived early - it's often difficult to predict the traffic - and were rewarded, once again, with an early appointment as someone had just cancelled.

      The procedure had to await the 'end of week' CT Scan which is used as an indication of how the treatment is proceeding. The Radiation Treatment once again went without a hitch. While lying on the 'bed' I mentally checked off ...

      'Six down ... only thirty four to go'!

      As can be seen below, there's not much in the way of 'reading material'!




      Meanwhile outside there was quite a commotion. Nurse Judy, had commandeered our grand daughter and was busy showing her off to all the other staff! Not to be outdone, our grandson with a fan club of his own in tow, was introducing himself around the ward!

      Mother and grandmother were left wondering what had just happened!

      Thursday 3 April 2008

      Radiation Therapy - Week Two

      DAY THREE

      Today we arrived early - it's often difficult to predict the traffic - and were rewarded with an early appointment as someone had just cancelled.

      The procedure was over in what seemed like 'no time at all'. Perhaps I'm getting used to the routine and tend to simply 'space out' ... who knows.

      While lying on the 'bed' I can remember telling myself:

      'Well this will be 5 down ... only 35 to go'!


      Contrary to the suggestion in the following image, the machine did not 'go haywire' and destroy the ceiling ... requiring one of the staff to steady it.

      Pictures can be worth a thousand words, but ... they can also LIE!




      I continue to have NO noticeable side effects related to the treatment; at least none that I could clearly associate with it immediately afterwards!

      Tuesday 1 April 2008

      Radiation Therapy - Week Two

      DAY TWO

      Well day two is here already and it's time to head off to the hospital for my 4th Radiation Treatment.

      In the back of my mind I begin to wonder whether I'll suffer another extreme fatigue / dizziness bout? We leave the kids at home ... just in case!


      Well I shouldn't have worried about that, as fate; had something else in store for me - you can read about it here.


      I settled down onto the 'bed' in the treatment room and began to imagine: 'the treatment all over and me 'cured' feeling well and strong'!

      Next ... the technicians are 'measuring me up' for the treatment.

      In the photo below you get some idea of what this looks like from YOUR side. Imagine what it feels like from MY side.




      Oh and by the way, you've gotta like the tatoo!! I have three exactly alike!