Preparing For The Next Round

It's November already?  Wow, tempus fugit (time flies)!

Getting ready for (hopefully) my last round of BCG.  I ended October with some required tests to ensure that I'm able to get my next round.  On Wednesday, I had a visit with the urologist's office to provide a urine sample.  That afternoon, I received a call informing me that I had an appointment scheduled for a CT (Cat Scan) on Halloween at Holy Family in Haverhill.  I never received any communication prior, but I'm glad the office decided to call and verify. I was also informed that I needed a blood test.  Luckily I could do this at the same location prior to my CT appointment.

Halloween was quite warm (summer-like).  I arrived at the hospital early and checked in.  It wasn't too long before I was called in for my lab work.  The phlebotomist is wonderful.  One jab and instant results.  Unlike other visits elsewhere when I felt like a pin cushion. I then meandered to the Radiation department and checked in.

After completing a standard questionnaire, I was directed to the CT room and told to have a seat.  I waited about 10 minutes before being called in by the tech.  I was given a quick overview of what was going to happen (although this was not my first rodeo, I listened and concurred).  I was told to lie on the slab and lower my pants to my knees.  I was also asked which arm to use for the IV/contrast.  Given my recent puncture, I selected my other arm with a proviso that I haven't been lucky in the past and the IV was given on my hand.  Of course, this information was dismissed and the nurse proceeded to jab me (repeatedly) before resorting to my hand. (No one listens.)

The rest of the procedure was pretty routine.  The contrast experience was a bit concerning; the warm feeling and metallic taste, but this too passed. So I was finally free to leave.  Hope the test results are favorable and I'm allowed to have my first round of BCG next Wednesday.

More to come!

No News Is Good News

I had a follow-up appointment today with my oncologist, Dr Mehta.  I was scheduled to have a Blood Draw prior to meeting with Dr Mehta, so I arrived as instructed and after a quick check in I was called.

After being grilled for my credentials,  I had my weight and height checked.  Apparently gravity is still winning and I'm a half inch shorter than my last visit.  My weight was about the same as my last visit.  Upon completion, I was brought over to the lab portion.  I was once again grilled for my identification.

After providing the correct information, I was asked which arm I wanted to use.  Generally the phlebotomist has difficulty getting blood from both my arms and ends up drawing the blood from my hand.  I guess that information fell on deaf ears because neither arm produced blood.  The medical professional called for another to try.  Same result.  Once again I felt like I was a pin cushion.  Finally, they got some blood from my hand.  Deja vu!

After my needling, I was brought to the exam room and was told Dr Mehta would be right in.  He did come within a few minutes.

After pleasantries, he asked me about the the progress of my bladder cancer treatments and current results of the BCG.  He appeared to be happy that my treatments are working.  He did say that if that changes, there are other options.  Let's hope I don't need to consider those.

Dr Mehta then asked me to lift my shirt and he began to feel for lumps, anomalies and swollen lymph nodes. I heard him say, "Good".

He then asked about my next mammogram, to which I said I already had one scheduled for December.  (I found out when I got home that the appointment is in March).  So he said he wanted to see me following my next mammogram. So he said, "See you in January".

Upon check out, I was booked for January 15, 2025.

Once I got home, I checked my calendar and noticed the mammogram was scheduled for March 17, 2025.  So I went to my patient portal and left a message indicating that information and requested another follow-up visit after the mammogram. While in the portal, I noticed the results of my blood test. All results fell within normal limits.  However there were two test that fell just over/under the normal limits.  One showed my red blood cell count was slightly lower that the normal range and my glycerine level was slightly elevated, neither had red flags.

So I await my new appointment.  Happy that I have no new news to report, which is good news.

More to come!

Post Script: I received a call from Dr Mehta's office and I have my appointment rescheduled to March 25, 2025.

September Morn

Love New England, especially in early September.  Generally the days are sunny and warm and the evenings, although a bit darker, are cool and great for sleeping. Last night I got some much needed sleep.  I had four booster shots on Sunday (Covid; RSV; Pneumonia: and Flu).  I don't usually get multiples, but I decided it was wise to get it done.  The worst part was the sore arms (both).  Being a side sleeper, Sunday was basically sleepless in Haverhill.  Although the arm pains have dissipated (pretty much), last night was good, sleep-wise.

Today I had my in-office cystoscopy with Dr Previte in North Andover.  I had completed my three rounds of BCG in July and today was 'look-see', to see if the treatments are keeping the bladder cancer away.

I arrived for my appointment on this gorgeous day.  Parking lot was packed so I ended up finding a place on the far end of the building.  Beautiful day for a walk.  Of course there was basically no one in the lobby.  I waited to check in and was charged a co-pay and 'paid up' my outstanding debt.  I still can't figure it out, but I'm paid.  Now I'll have to see if I get a check from Medicare again.

I gave my sample and waited to be called.  After a bit, my name was called and while walking to yet another examination room, I was quizzed on my personal information.  At least this room was not like the meat locker.  If anything, it could have used more air exchange, but it is what it is. I prepared myself and awaited the arrival of Dr Previte. 

The doctor arrived and reviewed my chart and verified a few things then got to work.  I was not able to see the monitor screen this time, but I was attuned to his utterances. He didn't seem to make any 'bad' sounds.  He did say that I had two diverticulars.  (First I heard of it).  He exclaimed that all the tissue was clean.  He spent extra time looking in the diverticulums and said they look good.  He removed his instruments.

Upon updating my file, he said that I had one more round of BCG and another cystoscopy to go.  He did say that he wants another cat-scan.  He mentioned that sometimes cancer is in the kidney, but wanted to rule that out.  This was troubling, but his due diligence is appreciated.  He said I would receive a call for the BCG dates and scheduling of the cat-scan.

When I got home, I had a voice message indicating that the next round will begin in November and a cystoscopy for December 19th.  I still have the cat-scan to be scheduled before 12/19.

More to come!

Third Round Completed

Today I had my third dose of BCG.  

Another early appointment.  The drive was uneventful and there was no problem finding parking since my appointment would be one of the first today.  I figured I'd be in and out, but they were short staffed. It was just Carmen working the counter.  Although she was the whole show today, she remained in good spirits and announced that she was all alone and she will do the best she could.  Well that's all we can ask for.

I stood in line and waited for a spell when she called me to the counter.  I gave her my name and the reason for my visit.  She looked in her computer and  turned to find my folder.  Like other times she verified my vitals and checked to see if there were any changes. Luckily everything was the same.  She gave me a specimen jar and asked that I provide a sample and have a seat.  Easy enough.  Done.

I returned to the waiting room and had a long wait.  I brought the daily paper with me and I read the whole thing and I still hadn't been called.  I arrived at 7:45 and it was now 8:30.  I almost approached her and asked if I had been forgotten, but my plans were halted when my name was called.

The medical professional requested that I follow her.  On the way to the examination room, I was grilled for my identification vitals.  We finally reached my destination.  So many examination rooms; I had not been to this one before.  I was told to prepare myself and wait for Morgan (Physician's Assistant).  I dropped my pants and covered up with the large napkin I was provided and waited.

Morgan arrived and indicated that the examination seat/table was wonky and might not work.  Apparently a replacement is in back order.  Luckily, she was able to position it so she could give me my treatment.  Although the device had seen better days it was actually pretty comfortable (like a padded couch).

Morgan is very good at this.  She inserted the catheter and instilled the BCG with very little discomfort.  She was very quick and efficient.  She said, "We're done".

She had confirmed that this was my third dose and asked if I had my cystoscopy scheduled already.  I said, "It hasn't been".  She instructed me to schedule the appointment before leaving.

I returned to the waiting room and there were quite a few people waiting to be checked in.  I took my place in line and waited my turn.  Mind you, I'm usually on my way home to begin the 2 hour marination, but I had to wait in line.  Upon reaching her, she told me to go to the scheduling window.  There was another line.  The attendant needed to call another office to find out the availability.  She asked if I could go to the Salem, NH office, but corrected herself by saying I needed to return to this office.  Looking at the calendar she said the doctor is booking September.  I said fine.  So she gave me September 19th at 3:30PM.  On the way out Carmen got my attention and indicated that I owed a co-pay.  Whatever.  I whipped out my card and she collected $15.00.  [I still don't understand how that works.  I had been charged $50.00 in the past then received a refund form Medicare.]

So I wasted about a half hour that I could have been marinating.  Once home I started.

The first hour and a half was pretty much normal, but the last half hour was excruciating.  I was uncertain if I was having a similar issue as last week, but I tried my best to hold out.  I had 15 minutes to go, but I was in agony.  I gingerly got up and slowly walked to the bathroom hoping not to have an "accident".  I emptied my bladder, but once I was done, I had the urge to go (like last week).  Actually I had two deposits.  (I know - TMI).  Well that explains my discomfort.  I hope that my not doing the last 15 minutes won't change anything.  Although I had an extra half hour of standing marination in the office.  (I'm sure it's not the same).

For most of the day, I was running back and forth to the toilet.  My bladder felt full, but the output was low.  The burning was really bad. I took the pills, but they hadn't gone through my system yet.  So I surrendered to the fact that I would be tethered to the toilet.

I made coffee.  I hoped that would help flush my system out.  I had some bleeding (expected).  By 6PM I was making fewer visits.  But I did not take my walk today because I didn't think it was wise, considering.

So I'm glad this round of 3 is completed.  I trust that things will begin to return to normal over the next few days.  I do have concerns about not making the whole two hours.  Recalling my very first treatment, I had a few times when I couldn't make the whole two hours.  Not sure if that was the reason why it wasn't successful the first time. So I'll worry about that until September 19th.

More to come!

I Remember This Now

The brutal heat wave continues.  Had just a brief thunderstorm last night.  Didn't really rain much and only made the air more humid.  They always talk about the dog days of Summer being in August.  Doesn't provide much comfort from my view in mid July.  Well at least there's no shoveling LOL!

I went for round two of the BCG this morning.  The early morning 'seemed' cooler, but by the time I arrived in North Andover, the sun was in full force and started cooking.

Being one of the first patients to be seen today, I figured I'd be in and out.  But I had to wait longer than usual.  Of course, there was another Richard in the waiting room.  So when they called the name I immediately approached the medical professional, but could hear the other party asking if they wanted [Last name not heard].  The response was affirmative.  So it wasn't my turn.

Finally I was called.  I was grilled for my identification verification and must have passed the pop quiz because I was directed to follow the medical professional to an all familiar examination room I call the 'meat locker'.  With the weather being what it has been, one would find the 'freezing' room a pleasant respite, But wearing "Summer-attire", and only having an extra large napkin for coverage, I had memories of the Seinfeld episode where George Costanza had 'shrinkage' issues.  Well enough of that.

The Physician's Assistant, Morgan, was the BCG administrator again today.  Like last time she was very quick, efficient and performed her duties with very little discomfort.  Once completing her task, she reminded me about my marination responsibilities and what to do if I had an adverse reaction.  She looked at her notes and said, "Until next week".

Upon arriving home, I commenced the marination.  Past instances, I experienced discomfort during the last 15 minutes of the two hours.  But today was a tough one.  About half way through I was so uncomfortable.  Being a 'regular' guy, I can set the clock on when it's time to "go".  But not having coffee today, the body decided that maybe now was a good time. Oh my god, between having a full bladder and a full colon, the last hour almost brought me to tears.  It was reminiscent of my extra long commutes to work and having to 'hold it in'.  I made it to almost 2 hours.  (Just shy of 5 minutes).  I gingerly waltzed to the bathroom and made a huge deposit.  (Sorry for the visual). This is the first time I've had this.  I hope it doesn't repeat.

My treatment last week was pretty easy to tolerate.  But given the corrosive properties of the BCG and second barrage, my bladder wasn't happy.  Frequent urination with very little output, burning and feelings of pins and needles through my entire body.  As cautioned, I have had some blood.  I'm sure it will clear up by tomorrow.  I did take Phenazopyridine Hydrochloride (AZO tabs), but it takes a bit to go through the system.  That has helped in the past.

So a do nothing day today.  Staying near the toilet and drinking a lot of water to flush things out. I do remember that these side effects are sort of accumulative.  So I'm not looking forward to next week in that regard.

More to come!

A Necessary Evil

Since my last in office cystoscopy on D Day (June 6th),  Dr Previte scheduled my next round of maintenance BCG. Seems like a hot minute when July 3rd came around for my pre-treatment check in. Being the day before the 4th, it was quite busy, but it ended up being a quick check-in and specimen drop off.  This was to ensure I was still a candidate for this next round.  Yes, I passed!

We happen to be in the grips of an extended heatwave.  Temps have been in the 90's and humidity hovering around 76%.  Pretty hellish.  Luckily for me my portable AC is working overtime and is pulling lots of moisture out of the air.  It's by no means cool, but it's far better than the weather outside.  In the afternoon (as the house bakes in the sun) the inside temps get into the mid 80's.  But with copious fans strategically placed, the 'semi-cooled' air gets moved around making it tolerable.  After the sun goes down, the temp in the house gets to 72 degrees, so sleeping isn't too bad.

I had an early appointment today for my first round of 3 doses.  I arrived at 7:45 and after the standard check in and specimen, I was called in.  The nurse was really liking my mustache.  (Go figure).  After verifying my vitals stats, I was brought to a familiar room where I was told the PA, Morgan would be with me briefly. I've had Morgan before.  She is very efficient and knows what she's doing.  The instillation was relatively painless (mostly uncomfortable) but quick.  I got out at 8:30.  Not bad at all.

Just in the short period of time the temperature was already 88 at 8:30AM.  Car ACs are nice, but when you leave the confines of the car, the oven awaits and even though the house AC had been on, it didn't feel very cool.  Oh well.

I did my 2 hour marination.  I actually dozed for a bit and probably had an extended period on one side, but I did make it through without having much discomfort.  (I didn't have any coffee or tea so there was little water in me).

Just taking it easy today.  More to come!

And So It Begins.....again

On the anniversary of D Day, I had an appointment with Dr Previte for my in-office cystoscopy to ensure that the cancer hasn't returned and ultimately 'clear me' for my next round of BCG. 

It was cloudy and a bit humid today.  Most cars are looking green because of all the pollen.  We are supposed to get some rain later, so cars will return to their normal color for a day or two.  Spring!

I arrived to a full parking lot today, but manged to find a slot not far from the door.  The lobby was busy, but patients were being processed rather quickly.  I checked in and gave my obligatory specimen and waited to be called.

It wasn't too long before hearing my name announced.  I followed the nurse who was grilling me for my personal information, but I knew which room we were going to.  Once there she did some prepping for the doctor then asked me to drop trousers and assume the position.  I waited for Dr Previte to arrive.

Not too long after, the nurse arrived with Dr Previte.  After some pleasantries and reaffirming my medical situation and last round of treatments, he asked if I was experiencing any blood or difficulties urinating.  Answering to the negative, he then prepared the device to begin it's descent into my bladder.

I had a clear view of the screen and he was a bit more descriptive as to what we were seeing.  I was concerned when I saw some spots, but as he zoomed in, they were just 'puckering' of the tissue that once had cancer cells removed.  The camera moved all around as the doctor examined the walls.  To my eyes the skin looked like baby's new skin.  He interjected,  "We are now at the opening to the diverticulum".  He stated that this is the area I previously had much of the cancer.  It looked squeaky clean.  He said, "I'm about to say you are cancer free, but I want to check out the urators (vessels that carry urine from the kidneys to the bladder)." He navigated to what my eyes looked like, an exposed vein, then he zoomed in to a tiny opening.  He said, "The watched pot never boils, but I want to see it open and see if the urine is coming through alright". But while watching, I could see the tiny while open up like a whale's blow hole.  He said, " That's what I wanted to see".  The human body is amazing.

He removed the device/camera then said, "You are OK to begin your next round". He said, " You'll be done with 'all this' in 2025".

More to come!