Met with my oncologist for my normal 3 month visit. Today, which is not normal, his offices were packed out, almost no where to sit. He was running behind, as he had several new patients to evaluate, which takes a lot of time. Instead of his nurse coming out to get me, he came into the waiting room, aplogized to someone (one of the new ones) and told them that he needed to see me first. That was a nice courtesy, as there was no telling how long I would have to wait. Because of his situation, this was my shortest visit, instead of my normal hour, we spent 30 minutes. But it was long enough to go through 10 questions I had in my notebook, plus whatever he wanted to talk about
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Big news, with my consent, he decided that he didn't want to do a PSA test this time, the last one was 3 months ago. He said he didn't see the point, and wants to stick to doing them every six months. I had no problem with that, because its not like we were waiting for some specfic number or about to start any advanced treatments. And no, that doesn't worry or concern me, I have long stopped worrying about PSA numbers. I am sure its up from last time.
Other news, in the past 3 months, I have lost another 9 pounds, with no attempt at exercise or dieting. I had been averaging 6 lbs per visit, so the loss has increased. Have lost a total of 21 pounds since January.
He was very disapointed in the aborted exploratory surgery. He wants my uro/surgeon to go ahead and do a laposcopic surgery to access the bladder, so that he can get inside it safely. He agreed that there really isn't any decent scan out there with a collapsed bladder, he didnt like the idea of doing a pelvic MRI, waiting a year, and comparing again. He doesn't feel that it would be wise to wait a year for two scans that would probably be inconclusive without any way of injecting a contrast of some type. He plans to talk to my uro to see what risks would be involved in that type of surgery. His opinion, was that my bladder should have been removed 2 years ago approx. when the bladder by-pass surgery was done, but he's not a surgeon, so he had to respect my uro's opinion for not doing so. He feels it's always going to be a potential problem. He's concerned about the increase in both number and severity of bladder spasms I am having, as it could indicate that my bladder is bleeding from the inside, and there is no way to relieve any fluid or pressure. Some of the worse ones now can last a full minute or more and I would put them at a 8 or higher on the pain scale, perhaps 1 1/2 to 2 dozen a day. That's why its so important to get inside that bladder and find out what is going on, before it causes a major or emergency type problem.
I told him about all the pain I now get when I have a full stomach or full bowels, how it causes massive back aches, he thought it could either be an indication of an ulcer (which since I never have heartburn, etc, doesn't seem as likely) or, my pancreas could be acting up again. I had severe pancratitis when I was 28. He had me stand up and he probed with his fingers below my kidneys, and on the right side, found a sweet spot that made me cringe with pain. If it doesn't improve in a week, he wants me to see some kind of gastro specialist to get an opinion.
He talked to me about the severe danger of getting too hot with the Fentanyl patches on, as heat can make the entire patch release at once, which could be life threatening at the dose that I am on. He said the warning sign, is if I suddenly get shallow breathing or labored breathing, he said to pull off the patch and get to the nearest ER asap, that people have died from that happening. Fortunately, I live 2 or 3 blocks from a hospital ER.
We also talked about my BP getting lower and lower, and he wants me to talk to my GP about that. I stopped taking any kind of BP meds over a year ago, because it kept falling. I have had 2 incidents in the past month where I got dizzy and passed out, the most recent less than a week ago. I thought it was just the heat getting to me.
As far as the PC goes, he's content to continue to monitor things, and still feels that there's not point in me having any advanced treatments at this time.
Finally, we talked about my pain meds in general, and mutally agreed to leave well enough alone. My body has adjusted well to the combination of Fentanyl and Loratabs, and I told him that the meds kill 90% of the pain 90% of the time, and that I wasn't interested in upping any of the meds to get rid of the rest of it, as I don't want to feel medicated.
He is going to draft a letter about my condition so that I can give it to my county VA agents, to see if it would help get my disability case moved up.
Got my 30 minutes worth for sure.
David in SC