Not all sunshine, lollipops and rainbows. . .

I was thoroughly chuffed after my last update. Probably shouldn't have been to upbeat, as Murphy must have been reading the mail.

This one is a bit of a case of domino theory. I have had spinal stenosis (and lots of pain) for some years. One of the treatments for this condition is lumbar epidural steroid injections every 3 or 4 months. I have had several injections, with good results. Unfortunately, the last one wasn't so. A couple of days after that last injection, I went into atrial fibrillation (irregular heart rhythm). This was confirmed because my pacemaker "tattled" on me in its periodic remote data transmission to the device clinic.

The device clinic said that since I had been in afib for such a long period (25 hours), I would be at risk for a stroke, so I must start anti coagulation therapy. I have Xarelto on hand for such occasions, and am to take it for one month following such a lengthy afib episode.

So, I reluctantly started the anti coagulation therapy. Two days later I started passing blood in my urine. Nasty, dark red stuff. Not "slasher-movie" bright and goopy red, but scary red nonetheless.

I messaged the device clinic. They just prescribe the anti coagulation meds, no real troubleshooting ability.

So, I started the evaluation process with my uro. First stop, urinalysis. That was yesterday morning. No doubt about it -- definitely blood in my urine. Within a couple of hours I got a phone call from his nurse. Too dark to ignore it. Need to scope me to see what's happening. (I'm not a fan of the scope due to a very bad prior experience with the rigid cystoscope.) Doc had a cancellation, could I come in Tuesday AM for the (dreaded) scope? I'm a sissy, but not stupid, so I agreed.

Went in this morning for the test. Not fun. Not comfortable. But when performed by a very compassionate and highly skilled uro, not the horrible experience I feared. Took about 10 minutes. Initial findings were that I have a few small capillaries near the bladder neck to the prostate that are varicose and were seeping some blood into the bladder. I asked if this would be enough to produce the graphic results seen in my analysis cup and doc simply said "Yup."

No specific treatment for the varicose veins at this point, as he believes that they will self-resolve within a few days. He did send me out later in the week for a CT scan to rule out issues farther "north" in the urinary system (kidney stones or other issues) but he feels that this test is merely precautionary and that of a baseline documentary.

This time, after the scope, I did not go home with a Foley and leg bag, thankfully. I did, however, go home with a reminder of what it felt like to urinate for the first few weeks after radiation treatment. Just like peeing battery acid.

Also, with the other discussion here about secondary bladder cancers after RT for PCa, I was thoroughly relieved to hear him say that there is nothing that even remotely looks suspicious for bladder cancer, so I can go ahead and buy those green bananas.

I will keep you posted, as I imagine that there are lots of men who have had RT and deserve to know what happens even if all goes well. I just hope that only a few of us have to experience it all, and the rest can just read along.

Well that sucks, Pax, to say the least.
I just went on Effient (prausegel is the generic). It's a blood thinner with a black box warning. So we'll see. I have been on it before with no issues. I'm on it due to a stent being placed in my coronary artery a month ago. They put me on Brilinta, $300 copay for 3 month supply. So a couple weeks ago I asked them why I cant be on Effient, which is a $9.00 copay and the doc said, oh, yeah, good point. DOPEs

Thanks for the ideas regarding alternative meds, everyone. Hopefully this med will again be only short-term. At least, once this most recent steroid injection was absorbed (probably just a day from injection date), I was back in a normal sinus rhythm. If I remain in normal sinus rhythm for 30 days, I can discontinue Xarelto again -- until/unless I have another lengthy bout of afib. When this all works, it is pretty good. When anything goes out of kilter, lots of other things go wonky too.

I did have the CT scan of abdomen and pelvis. No urological issues noted, so it looks like the only issues causing the gross hematuria were the couple of radiation-induced varicose veins at the bladder neck, seeping a bit of blood, along with being anti-coagulated, making the bleeding worse.

As of Thursday AM, no further visible blood, so I am hoping that this episode is closed.

Now, the next dominoes --
My PCP reviews all of my test results carefully.

He read that the radiologist noted a couple of small nodules in the lower portion of my left lung. Now he has referred me out to a pulmonologist for further evaluation. From my reading on the web, though, it looks like my lesions are well below the size at which they would call for biopsy, so I expect that the doc will want to monitor, and maybe repeat the scan at a later date to evaluate for changes.

I also noted in the radiologist's report that he noted a small inguinal hernia on the left side. PCP has not commented, nor did uro. I'll just wait on this one, as I have no perception of any sort of symptom, no pain, and I cannot even see/feel where this hernia could be (and, no, it would probably not be "buried" in sub-cutaneous fat. I am sort of a skinny old dude -- about 5'7" and 145 lbs.). I will discuss with my uro at next visit, but with no perceptible defect, I think I can wait a bit to see if it ever develops into anything.

This gettin' old is a real project, isn't it?