Becoming Routine

We've had some wild and woolly weather since my last post.  True to New England fashion, nothing transpired as predicted.  Luckily the larger storms produced more rain than snow, but there were a few storms we got hit with about 8 inches of heavy wet snow.  Hey this is January, and it's almost over.  The clocks will be changing again in early March.  I've already noticed sunsets getting a tad later.

Since my last post, I've been calling/messaging/emailing various providers to ensure all the stars are aligned for various upcoming procedures.  My next being in early February.  I'm going in for a removal of  my capsule in my left eye.  Since I had my cataract surgery, vision has become cloudy in that eye.  It was discussed after the surgery that condensation might cause that, so it's not a surprise and should be quick.  I've already received some eye drop meds for post-op.  

I received a call scheduling my colonoscopy.  Still waiting for more information (prep instructions) for the March 23rd procedure.  This will be close to home (Haverhill Holy Family Hospital).  

I'm scheduled for my annual AAA repair check-up in Worcester on March 20th.  Because an earlier CT-Scan showed an enlarged aorta above the heart, the doctor wants to have a new scan done.  I received a call and they want me to have blood work done to clear me for the contrast.  Working on getting that scheduled so it's a few weeks before the procedure.  In addition, Dr Mossanen wants me to have a urogram prior to my next appointment with him.  Still trying to get that paperwork finalized.  [Still find it hard to fathom in this day and age that a fax machine is the preferred method of communicating medical information.]

Dose 3- Round 2

Not sure exactly, but this week's BCG appointment was moved to today (Thursday).  I'm thinking the bad weather had something to do with supply chain issues, but being retired (and not having a different doctor's appointment) the change was pretty easy to make. 

I arrived, checked in, provided my sample, waited my turn and visited yet another examination room.  The Physician's Assistant, Michael administered the BCG today.  Of all those that administered, he's the best.  And I told him so.

Just finished my two hour marination and waiting for any side effects to kick in.  Feeling chilly (but not the chills), mostly tired.  We'll see how the day progresses.  The sun is out, but it's breezy.  Another change in the weather.  Yup, New England.

Just received email notification/confirmation of my last two BCG appointments, bringing me up to February 22.  Let's hope the weather cooperates. 

Post Script:  I did have some bleeding but it wasn't too much and cleared up quickly.

More to come!

I Know The Drill

Today I had my second BCG treatment for this round (two).  After having the appointment time change a few times, I arrived 10 minutes prior to my appointment and checked in.  The front desk was really understaffed today, but I was patient.

After my Covid screening, I was given a specimen jar and asked to provide a sample.  Although I haven't visually seen any blood, I was concerned that I might be disqualified if they did find some.  So I completed my task and returned to the waiting room.

About 10 minutes later, my name was called.  I was grilled on my identification information while following the medical professional to yet another examination room. After being asked if I was allergic to latex, iodine and any medication and answering negative.  I was told, "You've been here before so you probably know the drill." Yes, I know the drill.

Torri, the Nurse Practitioner arrived.  She was quite personable and bubbly.  We chatted about the weather while she arranged 'things'.  She did the procedure relatively painless and said, "You are done.  We'll see you next week."

I got home and managed to marinate for the full two hours then emptied my bladder.  I knew that my energy level would decrease as the day went on so I went to the recycling center, dropped off some outgoing mail and picked up a few thing at the store.

I made something to eat and started feeling kind of blah.  As predicted, my energy levels dropped and I was having frequent visits to produce a few drops, but feeling like I had much more.  Normal.

So I'm keeping a low profile tonight and just taking it easy.  I hope that things return to 'normal' tomorrow, although I have an early chiropractor appointment.  It is what it is.

More to come!

So Far...and Far Away

Since My Last Post 

I had a call from Anna, the scheduler for Northeast Urological.  Since I missed my first treatment of BCG, she said she would provide a new schedule for my upcoming treatments so I get my round of six.  Basically she said she would tack them on to the end of my current schedule.  She did say she would follow-up with confirmation via email and snail mail.  I also mentioned that I had a conflict on the 11th and was not able to make the treatment.  Once again she said she'd tack it on the end.  Cool.

Later that day I received two email confirmations; one appointment tacked on the end, but another for Monday the 9th.  I had recalled that they only do BCG treatments on Wednesdays so I was semi-skeptical on the Monday appointment.  So I was prepared to have this week's treatment on the Monday versus the Wednesday.

Monday came and I arrived at the office a bit before my appointment time.  Upon check in, I had mentioned that I was there for my BCG treatment.  The attendant looked puzzled as she looked at my 'chart'.  Then she said, "They just want a urine sample today."  I wasn't going to have an argument, but did mention that I generally provide samples the day of (with a few exceptions).  So I took my collection cup and completed my task.  On the way home, I realized that I left the specimen at the sink instead of placing it the depository cabinet.  I hope someone sees it and puts it where it's supposed to be.  (Someone did.  I received notice from the lab that the sample was 'routine', meaning no blood or infection).

Later that day, I received the snail mail confirmation.  I had to laugh.  In the envelope was two appointment cards.  Of course the one for this day was clearly marked 'urine drop off  from 8AM to 3PM.  The email had no mention of that.  Now I have to chase down another replacement appointment. [By the way, Mercury is in retrograde currently]. 

Consultation with Dr Mossanen

After a consultation with Dr Mehta, his office scheduled an appointment with Dr Matthew Mossanen.  He is affiliated with Mass General/Brigham and Women's.  He has a number of offices, but according to Dr Mehta, procedures are administered in Boston (for joy).  

My first consultation appointment was for 10AM in Foxborough.  Given the time of day and the work commute, I gave myself two hours to get there.  In preparation I looked up the address and reviewed the directions so I have it in my head what to expect.  Of course traffic was typical and there were the slowdowns at various intersections of major routes, but generally moved along.  

My GPS took me 495S to 3S to 128/95S to Route 1 (to Gillette).  As the crow flies, pretty direct, but that part of the world has spotty internet/phone signal.  The closer I got, the less I knew where I was heading.  It was almost 10 and I wasn't there yet and GPS had me turn onto a street that was very residential looking.  Par for the course, GPS decided to change the destination from 20 Patriot Place to 20 Patriot Circle (cul de sac with expensive homes, but no offices - or stadium).  I knew I was lost so I called the office, got in the automated phone maze and finally got someone who transferred me to an automated system for directions...in Spanish.  

I retraced my path to get back to route 1 hoping to see a human where I could ask for directions to Gillette.  All pavement and roads, but not one human could be found or seen.  So I drove on Route 1 looking for any signs to Gillette.  In the distance I could see the stadium, but no clear path to get there.  It was now 10:20AM.  I was seriously contemplating turning around and going home, but by chance I found a turn that bought me into the massive parking lot.  I meandered around and caught a glimpse of a sign that said "Health Center".  Of course there were signs everywhere indicating that you can't park here.  Finally I found a lot where it said parking for guests of Patriot Place.  I pulled in.

I noticed a slight incline and many restaurants, bars, stores, etc.  Then, hallelujah, Brigham and Women's sign.  I found the entrance, made the path to pick up a mask and sanitize my hands.  Found the information desk and was directed to the Urology Department.

Arrived to a small waiting room (not a soul waiting).  I walked up to the attendant and said, "Sorry I'm late, but I got lost.  I have an appointment at 10, but I know it's 10:30."

She asked my name, looked at the computer and said that she would check to see if they will still see me.  YES!  She told me to have a seat.  I didn't wait long before a nurse called my name and had me follow her to the vital sign station.  I had my weight recorded, blood pressure, pulse, temperature and answered some questions.  I was then asked to follow her to an examination room where Dr Mossanen would be seeing me.

I was happy to have finally arrived but a bit anxious. It wasn't long until Dr Mossanen arrived.  A young guy, very personable and engaging.

I had provided information from the questionnaires I completed online and we discussed my medical odyssey beginning from my breast cancer, multiple surgeries, AAA repair and finally my relationship with bladder cancer.  Not having my daily allotment of coffee and having had a commute from hell, it was tough bringing up the dates/time frame/and various doctors involved in this medical chapter.  But we were able to build a good time-line to help him understand my journey.

After having 4 TURBT's and one failed round of BCG, I had mentioned that I just started another round of BCG treatments.  He agreed and supported my current plan, but he did discuss some options, if BCG doesn't work.

He provided a web site: BCAN.ORG (Bladder Cancer Advocacy Network).  Quite informative.  I will be checking out the contents and I also sign up for their newsletter.  Dr Mossanen also talked about possible treatments which are chemotherapy, but unlike the chemo I had intravenously, this is administered like BCG.  He gave me two drugs to read about: Gemcitabine and Docetaxile.  Both are used to treat various cancers.  Of course I gravitate to the side effects.  So far I've been reading potential side effects when administered through the veins.  A few things I've read about being inducted into the bladder had some side effects listed, but not as scary as those caused by intravenous. 

Basically, if it came to this, I would be getting this in the Jamaica Plain location.  I'd marinate, void and be on my way.  Not happy about the location, but I'll worry about that later.  There are always unwanted side effects, I might lose my hair again...but this time for good.  And, other potential side effects that really are unpleasant.  More reading/research is in order.

So Dr. Mossanen was in agreement with my current plan.  He will obtain pathology reports, requested that I have a CT Urogram and have a tele-health visit in the Spring (after my BCG and next cystoscopy/TURBT is done.  [At this point, I was thinking that today's visit could have been done via telehealth...grrr]

So I have more reading to do.  More calls/correspondence regarding when and where I'd need the CT Urogram.  Once again, the more you know, the more you don't know.

More to come!

Some Semblance Of Order...Possibly?

Housekeeping

Since my last post I managed to catch some 'crap' going around.  I tested negative for Covid (twice), but this really threw me for a loop.  I began to feel poorly on New Year's Eve (day) and it went down hill from there.  The headache, the chills, the aches, the runny nose, the loss of appetite and general feeling of sh*t came on strong and lasted for a few days.  So I had yet another crappy holiday (minus Christmas with good friends).  

While being benched, I was fortunate that so many were willing to provide anything I needed to return to good health.  Other than myriad remedies and home grown brews, a friend dropped off some homemade chicken soup (very hearty) and fresh baked goodies.  There is something to said about the chicken soup cure. Each day now is better than the previous, but I do have a lingering post nasal drip and sporadic coughing spells.  Yes, this too will pass. 

I was able to reschedule my January 11th appointment to Monday, January 9th.  In addition, I have a new appointment tacked onto my BCG schedule that will bring me out to February 8th.  I logged on to my patient portal and completed all the questionnaires required for my appointment/consult with Dr Mossanen in Foxborough, next Wednesday.

Another Journey

After last week's false start, it was recommended that I provide a urine sample on Tuesday (which I did). Once again it was to be tested for the presence of blood in the urine.  Since the BCG vaccine cannot be introduced to the blood stream, it's imperative that I am not bleeding.  I heard nothing from the office so I felt pretty confident going in today.

I arrived and after check in and a re-scan of my medical coverage cards, I was told I had a credit so no co-pay.  (I'll take that.)  I was asked to provide yet another sample, which I gladly provided.  After which, I waited to be called.

My name was called and the nurse walked up to me and asked if I was feeling OK.  I know I had my temp taken and aced my covid SAT, but did say that I had a cold last week.  She said, we found some blood in my sample.  [CRAP! again].  She said he was going to talk to the doctor for guidance. Not long after a different person called my name.  I expected them to say it's not happening today, but she said,"Follow me."

Walking to the examination room I was tested on my DOB, name and address [Aced it again].  Prior to entering the examination room, the Nurse Practitioner, Kristine said, "I'll be right with you."

I was instructed to drop trow and sit on the table covering the uglies with picnic table sized napkin. Kristine came in and I inquired why I was getting the BCG when there was blood present in the urine.  She said, "It was microscopic.  You have bladder cancer. That would be the normal result, so the BCG induction was cleared to proceed."  I was ambivalent, but was eager to get this show on the road.

As usual, the procedure is quick, but very unpleasant.  Some administer it so much better than others.  But I was on my way.  At this time I didn't have my rescheduled date so I indicated that I might not be back for 2 weeks. [But I'll be back Monday].

I went home to marinate and I made the two hour mark. I'm attributing this to my having only one cup of coffee.  I'll have to remember that next time.

More to come!