Another Graduation?

Today was my sixth and final dose of BCG.  This being the end of round two, there was less celebration for my graduation.  It was even quite quiet in the office waiting room.  

Upon entering, I had to really think if I had my appointment day correct since there's usually a boat-load of people.  But, I was right, it was my day to be here.  Still, it was strange.  I began to think that maybe my 'tacked on' appointments (due to my being ineligible last December because of bleeding and my skipped appointment in January) brought me out of sync with everyone getting the BCG on the 6 week schedule.

I had received an itemized bill in the mail on Monday (first one from this place).  It showed that I owed $40.  I recall last time they said I had a balance of $40 and a new co-pay of $50, so I thought that it was possible the bill crossed in the mail.  I called the number listed and received a call back indicating that I did in fact, pay the balance due.  In addition, she said I had a $35 credit. So I was not asked to pay the co pay today. I was asked to provide a specimen, which did and then waited to be called in.

Not too long before I heard my name.  Seeing I was the only person there, no confusion this time with two Richards standing when the name was called. I followed the attendant to an examination room I had been previously, was grilled for my identification data and told to 'strip from the waist down'.  Done.

Michael arrived, and after indicating that this is my 6th dose, he said my next visit will be with Dr Previte.  I indicated that I was already provided with an appointment.  He acknowledge it and began his preparation.  He was quick, and there was very little discomfort and no leaking.  I mentioned that he did it the best, to which he chuckled and said, "That's good to know".

I got home and did my 2 hour marination.  Those last 10 minutes seem to last an eternity. So at this point, I feel kind of blah and meh, and feel chilly (not the chills).  I do have the urge to go, often but produce very little.  This is normal.  I'm hoping to NOT have any blood (like I did two times ago), but if there is, it is expected.  So, just taking it easy today.

More to come!

And It's So Nice Out

Wednesday again.  I had an early appointment for my 5th dose of BCG in this second round. We did have some ice last night and when I got up, I noticed that everything was coated.  I figured I'd have to let the car warm up so I could chisel away the ice.  The streets had been treated so it was just sidewalks, driveways and tertiary roads that could be treacherous.  The sun was shining bright and the weather man said today was going to be the 'pick of the week'. So I grabbed the local newspaper from the perch and had my one cup of coffee.

I gave myself extra time to clear the ice off the car, but to my enjoyment, the sun had melted away most of it.  The front windshield, being in the shade, still had ice, but by this time it had softened significantly rendering it to slush. I guess the weather man might be right, for a change.

At this earlier hour, many were clogging the highways as they rushed to work.  Although heavy, traffic was moving.  I arrived at Northeast Urological at the planned time.  Lots of cars and lots of people in the waiting room.  I checked in and was hit with a $50 co-pay and had to pay a balance due of $40.  Whatever!

While at the window I had inquired on the referral to get my CT Urogram (as requested by Dr Mossanen).  There was nothing in the paper file, but she did see some notes.  She excused herself and returned with Dr Torri Rogers (whom I spoke with last time).  From what I heard everything was all set and it just needed to be scheduled.  The attendant said, "You are generally free everyday."  I replied, yes generally, when I'm not at a doctor.  She then said, "The scheduler will be calling you today to schedule the CT scan at Holy Family in Haverhill.  Great!

I was given my specimen cup and directed to fill it and return to the waiting room.  Easy enough.  Task complete.

Not too long after my returning to the waiting area, I heard: Richard.  I stood up as another guy stood up.  Apparently he is a Richard too, but he didn't have my SAT answers so he did not pass go nor collect $200.  I was drilled for more info and visited yet another examination room.  It was set up this time.  I was asked if my meds were changed and if I had any surgery since last week.  Yes, I had eye surgery Monday (laser) and I was on predisolone acetate 1%.  She noted it in the file, but it had no affect on my getting the BCG.  So she instructed me to drop trow, sit on the diaper and gave me a very large napkin to 'cover up'.

Dr Torri Rogers arrived, asked a few questions then went right to work.  Torri is very personable and has a bubbly personality.  With all the chatter going on, the procedure was done in a flash.  (No wet bottom this time either.)  I did mention that this was my 5th dose, but I had two more appointments scheduled.  I wondered if the last was a follow up consult.  Torri indicated that the extra appointment must be a mistake and she'll report it to the front desk.  Her records showed this as being the 4th dose.  But I corrected her with the dates and who administered the previous treatments. [Wondered to myself if I should have just kept the extra appointment, but also though that someone might be waiting for the BCG.  So I think I did the right thing.]

I got home and marinaded for the 2 full hours.  Made blueberry muffins and banana nut bread and tried to get out of the brain fog.  As the day progressed, I began to feel blah and meh; cold but not the chills and pretty much low energy.  Still waiting for the call for the CT scan appointment and anxious to see if I bleed.  So I'm gonna take it easy and go with the flow.

Post Script: Received a call scheduling my CT Scan (Urogram) at Holy Family Hospital for 2/23/23 and a follow-up visit with Dr Previte, April 6th.

More to come!

Aye Aye, Doctor

A balmy 45 degrees today when my sister picked me up for my laser surgery in Waltham.  I was scheduled for a YAG Capsulectomy (in English: Had the layer of tissue separating my vitreous humour from my in-ocular lens removed with a laser).  This was a corrective procedure to eliminate the condensation on the underside of the lens which caused my vision to be less than perfect.

Traffic was free flowing and we arrived at the Surgiste location 45 mins early.  Upon check in the attendant said, "You are early.  Have a seat and I'll call you soon to check you in."  My sister had just returned from the rest room and I joking said that I was yelled at for being early.  The attendant interjected, "I didn't yell at you." I responded that I was joking, but thought that this might get weird.

We sat down and waited.  She called, "Mr Page", but it didn't register, but my sister heard it.  I walked to the counter and said, "That's my father's name."  She chuckled.  So I knew she did have a sense of humor.  I was asked for my insurance cards and my covid vaccination card.  She scanned them into her system, then had me electronically sign some paperwork.  She was interrupted as she was asking if I had a health proxy.  Since my sister is my proxy I pointed out the attendant's name on the screen so she could use it to answer her.  She did, but blamed me for having her do it.  We all laughed.  We finished up and was allowed to go to the 'other-side'.  I bid my sister adieu, and said, " I'll see you on the other side."

Well the other side, unlike biblical/religious lore was just another waiting room.  So I did my time in purgatory then was called for some procedural preparation.  I had my vitals recorded and many eye drops.  I was sent back to purgatory (they must have found another sin I needed to atone for).  Then I was called for some dilation drops.  Then returned to purgatory for twenty minutes of atonement.

Finally, the pearly gates called me in.  More drops, then waited for the doctor to arrive. Upon his arrival he prepared the 'machine' then I received some numbing drops.  I guess it's a good thing because he had a guide lens sit right on my eye.  I just felt pressure, no pain.  Drops were working.

Dr Song had me rest my chin and forehead on the rails of the machine, then had me look at a light.  He then proceeded to play space invaders and I could hear multiple clicks of the trigger and saw a very colorful battle with flashing lights and many explosions.  All scary looking but no pain.  It was over before I knew it.  I received more drops and was returned to purgatory to atone for a really old sin they discovered. About 20 minutes later, I was called.

I entered another examination room and a nurse (Ralph) checked my eye pressure.  It looked like he was training someone because he was describing his every move and what each instrument was for/and doing.  After a few minutes, they both exclaimed in unison: 12.  I know that's a good number from past visits.  I was dismissed and provided with some post op instructions.

I walked back to the main waiting room and found my sister and said we are good to go.  She recommended that I use the facilities prior to leaving (good plan).  We left and she had made me a sandwich and some cookies that I chowed down as we drove home.

Uneventful ride home, and was thankful that the weather and traffic cooperated.  Thank you Leslie for the ride, laughs and the lunch!

I have a post op follow up with Dr Song next week.

More to come!

It Depends

For my fourth dose in this round of BCG, things were pretty much routine.  Much like that TV series: Cheers, the place were everyone knows your name, familiarity is taking hold and I'm learning most of the medical professional's names and they know me.  Kind of weird when you think of it.  I'm such a regular, but the offerings go straight to the bladder. Just food for thought.

It was a bit chilly, but sunny today.  Check in was very routine.  I'm still waiting for a referral for my CT Urogram (requested by Dr Mossanen).  I'm most certain that it's in the pile of faxes...somewhere.  I provided my required specimen sample and didn't wait too long before being called in.  This is a good sign since they wouldn't call me in if there was blood found in the sample.

Was given the required identification questions that I apparently answered correctly then visited yet another examination room.  While entering, the attendant uttered, "There's no set up." Then she quickly set the 'table' with 'things' needed for the treatment.  It was interesting to see how the sausage was made nonetheless.  After completing the task she said, "Strip from the waist down.  Torri will be right with you."

I got ready.  Dropped trow, sat on the 'diaper' and covered the uglies with the very large napkin and waited.

Torri arrived and after asking a few questions (verifying who I am and any allergies) she asked, "Do you have any questions for me?"  I thought it might be a good time to talk about the CT Urogram referral/paperwork.  She was aware of the reasons why, but said she would look into the paperwork.  She even asked where I was going to have this done.  I took it as a good sign.

As procedures go, the bladder has to be emptied before BCG can be instilled.  So the uncomfortable catheter is inserted and any urine present is drained into a plastic urinal.  This is normal, but I felt a warm sensation 'down there'.  Torri said, "Looks like someone had some coffee today.  I thought I got it all, but there was more."  I did say that I had one cup of coffee (not that I shouldn't, but coffee is a diuretic and my normal intake makes my 2 hour marination difficult in the last 15 minutes.  So Michael suggested that I only have one cup.)

Torri blotted what she could and gave me the BCG.  I could feel that my 'bottom' was wet.  After she was done, I used my napkin to 'towel off' and noticed that the diaper I was sitting on, did its purpose.  So I'm sure that has happened before.  

Got home and marinated the full two hours and waited for the side effects.

Most of the day I felt meh and blah.  Brain was foggy and I didn't really feel like doing too much.  It was too cold (and I felt too chilly) to take my daily walk.  Late in the afternoon I went grocery shopping joining all those that needed bread and milk for the up coming polar vortex.  

I basically chillaxed until going to bed.  No blood was passed.  

More to come!

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!