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Thursday, December 19, 2024

No Coal In My Stocking This Year

Great News!

Had a scheduled cystoscopy today.  Uneventful commute and relatively easy check in.  The wait wasn't too long.  After the obligatory specimen sample, I was called, grilled and lead to a familiar examination room.  After housekeeping issues, I prepared myself for Dr Previte.

I didn't wait too long before he arrived and reviewed his notes (as a recap).  He said my Cat Scan showed no surprises (normal), my specimen was free of blood cells and all things were looking up.  As he prepared his instruments we chatted about the Reading Symphony Orchestra's New World Symphony performance I attended early in November.  Dr Previte, who is second chair violinist, indicated that he will be on musical sabbatical during the Winter, but will return in the Spring.

During this conversation, there was some discomfort as I sensed intrusion and movement of his scope.  He proclaimed, "Your bladder is clear'.  He reiterated that he needed to keep an eye on my diverticulum (original spot of cancer).  A few moments later he said, "That's clear.  The BCG worked".

He removed the apparatus and went back to his notes.  He did say that I had another round of BCG to bring me up to 3 years of treatment.  He said it will be in April and a follow up cystoscopy probably in June.

In my mind I thought that this was the last round, but it is what it is. Unfortunately it will put a damper on my plans to visit the U.K. in the Spring.

As Dr Previte finished up, he extended his hand and shook it while saying Merry Christmas. I returned the seasonal dialogue and readied myself.

Sunny day with relatively mild temps greeted me as I returned to my car.  No coal in my stocking.

More to come!

Wednesday, November 20, 2024

Another Graduation (of sorts)

There was frost on the windshield this morning.  I guess it's time to take the snow brush and ice scraper from the cellar and place in the car.  I guess snow shovels will be next, but left's not rush things.

I had an early appointment at the urologist today to get my final dose of BCG.  According to Dr Previte, this should be my last round.  I'll be having an in-office cystoscopy in about a month.  If my bladder is clear (and free of cancer), I'll be relegated to an annual check up.

I had an earlier appointment today.  Not knowing what the traffic situation would be like, I gave myself 40 minutes for a normal 10-15 minute drive.  The office opens at 8AM, so being one of the first patients has its advantages: plenty of parking. 

I arrived at 7:45 and was worried that I might have to wait until they officially opened, but thankfully the door was unlocked and my check in was immediate.  After providing the obligatory urine sample, it wasn't too long before I was called. Upon hearing my name, I responded, "Here", and approached the medical professional.  After exchanging pleasantries, she grilled me for my personal info as we walked to an all too familiar examination room, I dubbed the meat locker.  Luckily today, it wasn't cold.

Getting prepared for the instillation, I was all set waiting for Morgan to arrive.  It didn't seem too long when she did arrive.  Looking at my folder/notes, she said, "This is your last one".  Gleefully, I responded, "Yes".  Morgan asked if I already had my in office cystoscopy scheduled, to which I said, 'Yes".

Morgan struck up a conversation (as a distraction) and shared that she and her husband are looking to buy a house.  She has a two year old now and they no longer want to rent.  We chatted about paying down the principle to reduce the time-frame of the loan.  And before you knew it, she was done. She is getting to be quite the pro.  We wished each other Happy Holidays.  And I jokingly said, "I hope I don't have to see you again..at least not under these circumstances". 

I arrived home in about 10 minutes and began my marination.  Those last 10 minutes are the toughest.  I tried, but I couldn't stand the discomfort and was shy of my 2 hour marination.

Since the side effects of BCG are cumulative, today's recovery was rough.  It seemed that I needed to 'go' every 5 minutes with very little output.  I was hoping the pyridium would kick in (which it did by 5PM).   I felt blah, most of the day and needed to constantly visit the facilities.  I'm glad I had some depends to use, otherwise I'd be changing my clothes a number of times. I didn't plan on leaving the house so I decided to change my guitar strings.  With each string I replaced, I needed to rush to the toilet.  Even though I had an extra layer of protection, the urge was so strong and the burning so intense, the little I produced was not satisfying.  But I've been through this.  It's just a commitment. 

It's 6:30 now, and although I had many calls to nature, they seem to be less frequent and my output has increased.  I'm sure I will be having disrupted sleep tonight.

So, the healing begins and the next 'look see' will be December 19th.  Hoping for good results.

More to come!

Wednesday, November 13, 2024

Eye Doctor and Round Two

Mass Eye And Ear

Had an early morning appointment with Dr Song at Mass Eye And Ear.  Previously in Waltham, this is my second time at their new facility in Lexington.  Although it's closer (exit wise), the new building is really out in the sticks (end of Hartwell Rd).

Luckily, Monday was a holiday and traffic was manageable.  I made decent time. I arrived about a half hour early and checked in.  I didn't wait too long before being called to another waiting room. I guess moving around makes one forget about how long you actually wait.

I had my first test of the day, which took just a few minutes.  After completing those, I was asked to follow the medical professional to another examination room on the opposite side of the building.  Once seated I was given the Snelling Card test then asked to look through the machine so they could flip filters/lenses until I could see perfectly.  I'm assuming that this is used to determine if I need an eye glass prescription.  The result indicated that I might benefit from some corrective lenses or use 'cheaters' reading (the kind you get retail), but I have no problems reading.  I have mono vision (two implanted lenses: one for distance and one for reading).  The only time I notice that things are not clear is when I take a sip of coffee while reading and the cup covers my line of sight (on my reading eye). Barring that, I don't need glasses.

I was finally given the dilation drops and was asked to wait until the drops kicked in. I seemed to take about 20 minutes before the doctor arrived.

Upon arrival and after pleasantries, Dr Song stated that my test results were good.  He then took out his bag of tricks and began examining my eyes at all angles.  I'm generally keen to picking up utterances, but either there was nothing to grunt about ,or he's a good poker player. Luckily for me, he was pleased with everything and told me to return in a year.  YAY!

Round Two BCG

Today, I had an early appointment for my second dose of BCG.  Traffic was heavy, but it moved and I arrived right on time.  After checking in and providing my specimen sample, I didn't have to wait too long to be called.

I was quizzed on my vitals as we walked to a familiar examination room. I had just removed my coat when Morgan arrived.  Jokingly I said, "I'm not ready yet". She said, "I can come back".  I indicated that I'd be quick and I was.

Morgan set up her implements and quickly went to work.  Very little discomfort and before I knew it I was done.  She said, "See you next week".  I returned my paperwork to the front desk and went home to marinate. 

I was able to do the full two hours.  So I voided, then had some coffee and took my pyridium (Azo). I then waited.

I recall from my previous rodeos that each subsequent dose was cumulative for the side effects. Today was no different.  For the next six hours, I stayed near the bathroom and made visits with very little output.  The burning seemed to go through my whole body.  I could feel/hear my lymph nodes screaming.  Eventually, the Azo kicked in and it was less uncomfortable to go.  Like other times, I did see some blood and passed a few clots (normal and expected).  This cleared up as the day progressed.  I felt BLAH and just chilled out.  No chores or walk today.

I expect to be back at it tomorrow and healing up for my next (and hopefully last) round.

More to come!


Wednesday, November 6, 2024

The Fun Starts Again

Well I had my blood work and CT scan completed.  I got notification that my urine sample was routine (meaning normal- no blood).  I heard nothing about the CT Scan nor my blood test, so I'm hoping that is a good sign.

Today was extremely warm for November.  Traffic was bordering on horrific.  My appointment was 8:20, so I'm assuming it was regular commuting traffic.  However, there was some construction going on at my exit.  Of course getting off the highway at the exit I was greeted with signs that said the exit was closed.  Would have like to have know this prior to my taking the exit.  I meandered through and took some back roads and got back on track.  I made it there with one minute to spare.  I lucked out and got a parking spot near the entrance.

Upon entering the medical office, it was like a ghost town.  So it was a quick check in.  The ride was stressful thus I had a good supply for the urine sample.  I returned to the waiting room and was quickly called.

After answering my personal information questions, I was brought to a familiar examination room.  The medical professional took some vitals and asked me to prepare for the BCG instillation.  I dropped trow and covered with their extra large napkin.  Not long after, Morgan arrived and reviewed a few things.  She had me sign a document indicating what I was getting and the risks involved.  (Every new round requires this).

Morgan is a pro.  She made short work of the procedure with very little discomfort.  After completing, she said, "See you next week."

I got home and did my marination and was only 5 minutes shy of the two hours.

Today was a do nothing day.  Given current events, I listened to classical music and watched some you tube videos I subscribe to.  I had a pretty typical reaction to the BCG.  I had some Azo to help with the burning, discomfort and frequency. When I checked the mail today, my supply of Azo arrived from my eBay purchase.  Good timing.

More to come!

Friday, November 1, 2024

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!

Wednesday, October 2, 2024

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.

Tuesday, September 10, 2024

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!

Wednesday, July 24, 2024

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!

Wednesday, July 17, 2024

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 cumulative.  So I'm not looking forward to next week in that regard.

More to come!

Wednesday, July 10, 2024

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!

Thursday, June 6, 2024

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!

Tuesday, April 2, 2024

Short And Sweet

I had a check-up with my oncologist, Dr Mehta at Dana Farber today.

It was quite busy today, not sure why, but things moved right along.  I didn't need any blood work today since this appointment was scheduled to discuss the results of my mammogram and any other issues that have surfaced since my last visit.  I already knew my results because the hospital sent me a letter that nothing was found. 

After being called in after a very short wait, I had my vitals checked and recorded.  I was brought to an examination room and not too long after, Dr Mehta arrived.  After exchanging pleasantries and discussing the status of my bladder cancer treatment, he said he really had nothing for me.  So he said my 10 year mark will be next summer (2025), but until that time he wants to see me in 6 months.

My next appointment with him is October 2nd. So I was in and out in less than an hour.

More to come!

Monday, March 25, 2024

It's Always Something

I had my annual ultra-sound and follow up for my triple A (Abdominal Aortic Aneurysm) at Umass Medical in Worcester.

I got an early start and join the throngs headed off to their work.  I'm happy that traffic cooperated and I made it to my appointment with a few minutes to spare despite my spacing out and missing my exit.  The detour didn't take me too far off course.  I attribute this navigation error to my lack of caffeine since I had been fasting since 11PM last night.  So I had a serious case of brain fog.

My appointment is a two-parter: Ultra Sound then review/follow up with the doctor (or his associate).

I was called in for my ultra sound and I had someone in training observing and talking medical jargon.  Like most of my ultra-sounds, the attendant had a tough time due to bowel gas.  She had me take deep breaths and exhale a number of times in hopes that the gas would 'move along'.  I was hoping it didn't move further south and escape.  This could have been quite embarrassing if flatulence permeated the confines of the exam room.  I guess it was lucky for them that we had no disturbance, but the trapped gas made their job a bit harder.  I did notice there was some 'hubbub' as the were quickly riffing into medical-speak.  To me, this is generally alarming and makes the mind reel when no explanation is provided.  Eventually the hard pressing was done and I was dismissed.

I returned to the waiting room and was almost immediately called in. I was weighed and had my vitals checked and recorded.  I was told that the Nurse Practitioner will be with me shortly.  Since 2017, I've seen both a NP/AP and Dr. Schanzer. 

Nurse Practitioner, Shauneen arrived and initially said all my tests looked good.  I had no endo leak and my sac is continuing to shrink.  She said it was 3.4cm versus 3.8 last year.  She checked the pulse in my lower extremities and indicated that I had a strong pulse.  She added that I'll be returning in a year.

I got home and had a message indicating my visit notes were available in my portal. I think I found what the hubbub was about, but apparently it's not a concern.  But of course I had to look it up to see what it was.  Of course the results are varied and may or may not indicate a cancer. But since it doesn't seem to be a concern for the doctor and staff, I'm going with that.

Basically the findings were:

 
•  Duplex ultrasonography of the endovascular stent graft appeared patent.
•  No flow was seen in the residual aortic aneurysm sac by duplex ultrasonography.  The residual aneurysm measured 3.4 cm.
•  A linear hyperechoic structure was noted along the vessel wall at the level of the distal fixation. It was not possible to distinguish dissection versus plaque. This appeared to be consistent with CTA findings from 3/20/2023. The distal stent edge appeared to be poorly adhered to the vessel wall. This did not appear to be of hemodynamic significance.
 
ASSESSMENT: Satisfactory progress 7 years following endovascular repair of a an infra renal aneurysm
 
PLAN: We will plan to see him back in 1 year with a repeat EVAR duplex. He should continue on his aspirin and statin indefinitely.
 
Next appointment will be March 24, 2025.
 
More to come! 

Thursday, February 29, 2024

Leaping Joyously On Leap-Day

Happy Leap Day!

Apparently Mother Nature ignored the extra day in February and acted like March: Coming in like a lion.  We had some rainy weather and the new front coming in from the arctic had spawned very strong gales.  So, it certainly feels like March. 

Today was my in-office cystoscopy.  The doctor had a look/see into my bladder to see if my cancer is still in remission.

I had an early appointment.  I found a place near the door (for a change).  The waiting room was packed but hustling in activity.  I checked in; provided a urine specimen and hardly waited before being called.  I was grilled on my personal data and ended up in an examination room with the 'equipment' all set up and waiting for me.  While stripping from the waist down, I noticed that the monitor was working this time.  Last time it was out of service and I was unable to see what the doctor saw.

After assuming my position, the nurse arrived and readied the examination table.  She did mention that the lower flap (part that would support my extended legs) was not working.  So I straddled and positioned myself so it was less uncomfortable for my legs. The nurse prepared me for the doctor, then left while saying, "Doctor Previte and I will be right back".

Not long after, the doctor arrived. After exchanging pleasantries and verifying past results,  he did say that my prostate was enlarged, but my latest PSA test had good numbers (1.86) and I haven't been exhibiting any symptoms, but he had his suspicions that it might be cancer.  {Lovely}  After some paper shuffling, he was ready to go.

He was making audible signs of approval, then asked if I could see the monitor.  I mentioned that I could, but didn't know what I was looking at.  He pointed out some geographical markers and I watched the camera's eye gloss over unblemished skin that at times appeared translucent.  He said, "Here's that diverticulum that had all the cancer.  We are going in to see how it's doing." to me it all looked cavernous. He said, "This looks really good.  Nice and clean."  I said, Yay!

He finished up and said that the BCG treatments have been successful.  He looked at his notes and said you'll be having more treatments until June 2025.  My next treatment will be in July with a cystoscopy before and after. [I checked my email and the next in office cystoscopy has been scheduled for June 9th.]

So a good day.  In my head I was leaping with joy on this Leap-Day!

Post Script: Next round of BCG has been scheduled for July 10, 17 and 24th.

More to come!

Wednesday, January 24, 2024

Round 3 Of 3

Well I had a similar feeling of the last day of school after getting my 3rd dose of BCG. It took awhile but hind-sight; where did that time go?  But, I've completed this 'course' and the big exam will be on Leap Day.  I'm hoping for a clean bill of health.

Getting to this point hasn't been easy.  Dealing with the weather and health obstacles there were a few times where I thought I couldn't complete the regimen. During my previous maintenance (Sept/Oct), I had a few rough tolerance and recovery challenges.  I was prepared for that this time, but after my first round, I was able to soldier through and had a quick recovery.  However, subsequent treatments seemed to get tougher to cope with.  

After my second dose, thinking it was my body working to recover, I seemed to have had a bad reaction to the treatment, the flu, a cold or something.  I had no indication that it might be Covid.  I did test last Thursday just to rule it out.  And I tested negative.  As the days moved along, I felt much sicker.  It was suggested that I test again a few days later.  Lo and behold, I tested positive for Covid.

This was my second time with Covid.  Last time was January 2022.  That was mild compared to this.  But once I knew what the route cause of my illness was, I began to feel better incrementally.  Although I was aching, sneezing, runny-nosed, coughing, hoarse and phlegmy I began feeling a bit better each day.  I did have a few live streams, but decided it was in my best interest to cancel a showcase and jam session I had scheduled with friends in Maine.  

Sunday I seemed to come to life.  I was able to take my walk and do some errands (masked).  I felt almost back to normal on Monday.  Tuesday, I resumed my live stream and had no problems doing an hour set.  That brings me to today (Wednesday).

We had a bit of snow, but mostly nuisance snow not worthy of a shoveling.  The ride to the doctor's office, of course, was interrupted by a passing train.  I had to deal with a full parking lot.  At check in, they couldn't find me in their system.  So I had to produce my ID and insurance cards so they could be scanned.  Another employee took note of this and stepped in and 'found me'.  They did say they needed to update their records for the new year so providing my ID and insurance needed to be done.

I provided my obligatory specimen then was called in.  Once again I had the same examination room.  I had mentioned that it should be renamed since it's my personal exam room.  Not even a chuckle acknowledgement.  I guess no one wanted a laugh today.

I prepared for the instillation and waited swaddled in my napkin. Jenn the Physician's Attended arrived and we exchanged pleasantries.  She got right to work and was finished before I knew she started. After verifying my next cystoscopy date, she bid me adieu.

I arrived home and immediately began my marination.  I almost made the two hour basting, but had to cut it short by 5 minutes, because I just could hold it in anymore. [To be honest, I believe I went more than two hours because my kitchen timer didn't ring twice so, I may have been racking up more time than I thought.]

As recovery goes, compared to last week's difficulty...so far this has been easy.

More to come!

Sunday, January 21, 2024

Now Things Make Sense

Since my last BCG treatment, I've been experiencing many symptoms. Other than the 'regular' symptoms, I had flu-like symptoms since Thursday.  I did take a Covid test and it came back negative.  As the days went on, I continued with my 'sickliness' and soldiered on.  I never thought of taking another Covid test....until today.

I received notification from a fellow musician that she test positive for Covid.  She had told me she was feeling sick on Friday.  She had attended a wedding in New York the previous weekend so she thinks she got it there.  Because I'm still dealing with 'whatever I have', I took a Covid test.  Well, big surprise...I'm now testing positive.

I've been housebound since Thursday afternoon and have been nursing my symptoms, so I can only assume that it started Thursday.  It's now Sunday and although I still don't feel well, have intermittent coughing jags, runny nose and general blah feeling.  I do feel a bit better.  But it makes complete sense now.

I'm hoping I'll be 'better' and testing negative before Wednesday (my next BCG treatment).

I checked my records and this is my second round with Covid.  The last one being January 2022.  My recollection is that my last time was more of a nuisance.  This time it hit me harder.  But now I know.

More to come!

Wednesday, January 17, 2024

2nd Maintenance Dose Of BCG

Had been watching the weather forecasts and was hoping the snow would hold off, peter out or at least be timed so it wouldn't interfere with my 2nd dose of BCG.  After last week's snow (forecast of 5 to 8 inches) resulted in 18 inches of heavy wet snow I wasn't thrilled about the original timing for this storm.  Happily it came on Tuesday and only dropped about 5 inches of fluffy white stuff.  

We have been in an arctic blast  so one cannot ignore the accumulation since it could result in turning into concrete.  Last week's storm of 18 inches was washed away with a 'warmer' storm of 2 inches of rain. I do not see that happening this time.  So I was able to do clean-up Tuesday night.  

This morning, the sun was out, but with a breeze, arctic air and a wind chill, it felt like 8 degrees.  I had refrained from clearing my car off last night because we had some sleet/frozen rain which iced up everything.  But my decision was a good one.  It was very easy cleaning the car off since the 'crust' of ice didn't penetrate the snow.  Thank heavens for small favors.

Having nearly a half hour for travel to N Andover, I was prepared for any traffic or train crossing which would add to my commute.  Once again I was fortunate to have light traffic and no trains to worry about.  I did eat up some time looking for a place to park.  The parking lot stripes couldn't be seen so people parked where ever they liked.  I did snag a spot way at the end and carefully traipsed over iced cover sidewalks and took my place in queue at the doctor's office which was quite busy.  There were four windows for check in, but one said closed, two had patients at the window and another had no one present.  Eventually, the medical professional with the closed sign called me over.  I decided it was in my best interest to not mention that her window said closed. I was there, so I'd let someone else provide that unsolicited information.

My record was reviewed and certain statistics were verified while she grabbed a specimen jar for my obligatory sample.  She directed me to the rest room area and said, "You're all set".  Thank you!

I was doing my thing and was interrupted with knocks and heard, "Anyone in there?" "I'm in here."  "Ok, sorry."  I heard.   A few moments later another knock and similar exchange.  I assumed it was someone else, or they really had to go.  When I opened the door to leave, there was no one there.  We'll never know now.  I rejoined the throngs in the waiting room. 

It wasn't too long when I heard my name called.  I was grilled on my stats and was allowed to proceed.  We came to my now favorite examination room (or at least my most frequented). I was told to prepare my self and wait for the Physician's Assistant, Patrick.

Not long after, as I sat swaddled in my napkin, Patrick knock on the door and entered.  Mystery solved, I had him last week but didn't catch his name.  He went through his spiel, adjusted the table and arranged his implements.  He announced that he was going to get the medicine.

A few moments later he did his thing, quickly but with some discomfort, then said "I'll see you next week."

I got home and did my 2 hours of marination.  As the day progressed, I felt very blah and had some blood (which is normal).  So I'm taking it very slow today and will dispense from my daily walk  (extremely cold and low energy). I'm hopeful that the side effects will start to calm down by tomorrow.

Post Script: 

Day two: Still feeling achy, with stuffy nose slight sore throat and periodic coughing.  Still feeling cold and chilly. Voice is scratchy and tight feeling.  Refrained from participating on online sessions.  Did manage to play live stream, but I played all instrumentals. Took a Covid Test and it came back negative.  Still having difficulty passing urine.  Although the burning has subsided, the frequency is concerning.  I got up two times last night.

Day three: Still feeling flu-ey.  Muscles hurt from coughing.  Went through two boxes of kleenex.  Appetite is pretty non existent.  Been able to have Progresso soups I had on hand.  And insult to injury..I have a touch of vertigo.  I've canceled all my performances this weekend.  Frigid outside, good time to stay put and recover.

More to come!

Wednesday, January 10, 2024

Rinse And Repeat

January brings a new year and a new round of maintenance BCG.  I provided a urine sample 11/3 to determine if I would still be eligible to receive treatment.  Happy I got the 'good to go' sign.

Always a concern this time of year with Mother Nature's plans for the weather.  I had been watching the weather forecast with anticipation and hoped that the major storm predicted, would take place prior to my first round.  True to form, this part of the world got a good wallop of heavy wet snow.  Apparently the Merrimack Valley was the jackpot area and we received more than 18 inches of very heavy wet snow.  The storm came in a few phases and lasted the weekend.  

I had gone to sleep Saturday night and we had 2 inches, but the following day another 13 inches. The weatherman predicted that after the snow, temps would be falling so it was advised that snow be cleared ahead of the deep freeze.  I was out shoveling the driveway and clearing the roof at 6AM.  But the snow kept coming down.  Luckily the temps had dropped and new snow was on the fluffy side, but still needed shoveling.  I took many shoveling trips and stopped at 11PM. The next morning we had a few more inches.  Oh my muscles ached. 

Just like New England weather, we had a huge rain storm with temps in the 50's.  Best part was: most of the snow had melted.

Round One

Still on the warm side, the sun was out and my ride to Northeast Urological was uneventful.  The parking lot was almost full, but there were only a few patients in the waiting room.

After the obligatory specimen, I was called into a familiar examination room.  The (male) nurse [didn't catch his name] arrived and went through his spiel and had me sign some paperwork.  I had this guy as an observer one time, so I'm glad he got his promotion.  He was very methodical and efficient.  Really nothing eventful this time.

Went home and marinated.  So far just feeling cold and kind of blah.  Pretty much the same as other treatments.  So I'm taking it easy.  I did notice that another weather system is headed my way on Tuesday.  I hope it doesn't interfere with round two next week. One day at a time.

More to come!