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Posted 5/24/2016 1:03 AM (GMT 0)
Captain's Log.....Star Date.....54/120
May 19th PSA=.64
T=◀.6
So I guess lil ol HT is effective.

Tell you what though....I somehow feel disconnected if that makes any sense.

Had a consult the same day to fill out my HDRBT forms. The guy who did the consult was a fellow not Dr Morton, so I didn't have much to say. Just filled out the forms and left.
My Liver ALT is 53 U/L where Less than 40 is the norm. Any resident liver guy out there who can tell me why it's high, and what that means in health terms?
Posted 5/24/2016 1:54 PM (GMT 0)
I've not been on HT, but have some familiarity with what you are talking about.

The medical staff administering HT will continually monitor various functions such as liver enzymes because in some men the HT will throw-off the natural balance. Well, it pretty much gets thrown-off in all men on HT, but it will be thrown-off different amounts in different men. You must have a functioning liver.

In some individual and unique cases, HT has to be stopped if the liver toxicity balance cannot be controlled. Yours is a little high, and will continue to be monitored. I've heard of cases where ALT shoots into the hundreds...at which point HT was immediately stopped. How often are you tested? monthly? You probably had a baseline ALT before starting HT; do you remember the value then?
Posted 5/24/2016 1:57 PM (GMT 0)
I had issues with liver function, but it was due to Zytiga being a part of my HT regimen. They backed off my Zytiga dosage and I was fine. I'm assuming you're not taking Zytiga, but could be some similar reaction from your drugs. I'm not doctor, but I understand it's important to address.
Posted 5/24/2016 2:48 PM (GMT 0)
I believe my ALT has been a little high for a year or so. I seem to remember my GP commenting last year.
When I had my scans in Feb, there was a comment on liver spots, but that they were too small to Dx, but appeared to be non-c.
The typical reasons for elevated ALT don't apply to me since I am not a drinker, and don't do recreational drugs.
Posted 5/24/2016 4:01 PM (GMT 0)

Newton451 said...
The guy who did the consult was a fellow not Dr Morton, so I didn't have much to say. Just filled out the forms and left.



BTW, a "fellow" is going to be a highly capable professional...it's quite different from a PA, a Physician's Assistant that many will see.

A "fellow" has already completed medical school and residency, and then gone on to complete additional oncology training before setting foot in your doctor's office. It could have been a great opportunity for you to get insights into the latest and greatest in oncology which is being taught.

Completing a fellowship is "a mark of distinction representing the pinnacle of integrity, professionalism, and scholarship for those who aspire to pursue careers in Medicine."
Posted 5/24/2016 4:05 PM (GMT 0)
Hi Jack. Yes, I know that. It's just I never met him before, so I have no rapport with him, so really, I wasn't in the mood to start from the beginning and catch up with him.
What I may do is try to schedule another consult a little closer to my HDRBT date.l
Posted 5/29/2016 12:17 PM (GMT 0)
Captains Log....Star Date....60/120

So I guess I'm half way there, although I think this is the easy half.

Even with no T whatsoever looming anywhere remotely associated with my psyche, I don't feel too bad.

Libido at this point is just a lyric in a song that I can't even remember the melody of, but it doesn't phase me much. More time to clean and polish the new boat I guess.

Taking a sleeping assistant these days since sleeping with a nicotine patch on is an interesting experience.

Hot flashes.............yes guys, I agree they are a pain.
Temperature regulation is a daily issue and now that we are ranging in temperatures from 10C to 40C with humidex, things are getting interesting. Sleeping with the AC on and a fan is helpful.

Worst part so far is quitting smoking I think. Dayhum..........I wants one!!!

The gym is kicking my butt hard. It is paying off though I think.

Cheers fellow PCa Alumni...............

Newt out
Posted 5/29/2016 3:18 PM (GMT 0)
I can only guess since I've never smoked, but I'd guess quitting would be the hardest part of this whole process. I actually found having no libido to be sort of peaceful. It was one less thing to worry about...
Posted 5/29/2016 3:36 PM (GMT 0)
Hi Michael. Well, I'm not stressing the libido stuff. Peaceful is a good description.
Posted 6/3/2016 5:13 PM (GMT 0)
Captains Log....Star Date....66/120

Hot Hot Hot.....seems like so much to do but so little time.

Thinking we need to form a PCa Band!!!

Not much to say today.....Have a great weekend everyone!!!
Posted 6/7/2016 9:35 PM (GMT 0)
Captain's Log.....Star Date..... CRAP/120
Hot Flashes are kicking my butt!
It's a real job to walk these days. My hips are tight and stiff and ache.

Is this frickin' normal?
Posted 6/7/2016 9:45 PM (GMT 0)
When I was on hormone therapy I felt like it aged me 15-20 years. But if I'm reading your signature correctly, you've got about a month to go. You can do that...just power through. One foot in front of the other.

You and I are the lucky ones with a temporary sentence. My hat's off to the guys that have to do HT on an ongoing basis.
Posted 6/12/2016 2:59 PM (GMT 0)
Captains Log.....Star Date......75/120

So, as I approach June 21st (Brachy-Day), I have an overwhelming sense of unpreparedness. I can't currently seem to recall what to do the day before, the day after, what to expect in terms of post procedure discomforts, SE's, etc.... or even feel I have done anything towards getting ready yet.

It's getting on to 6 months since my biopsy, and other than an injection....I don't believe I have done anything to combat the beast.

Is this the way it's supposed to play out, or am I being irresponsible in some lack of something on my part?

Typical panic & anxiety or are my concerns warranted?
Posted 6/12/2016 3:13 PM (GMT 0)
Keep in mind that the "injection" both froze the PC in its tracks, plus it sensitized the PC cells to really get whacked by the brachy. There's been an awful lot going on internally--now you're getting ready to deliver the final blow.

But overall, I know what you mean about not having done anything. I even felt that way when I was finished with my treatment. Some people said I was a "warrior" to complete everything, but I didn't feel like that in the slightest. I was just someone that showed up for Lupron shots, someone that showed up for my HDR brachy and someone that showed up everyday for five weeks to have IMRT. I think the Triple Play is just putting one foot in front of the other until you're done.
Posted 6/12/2016 3:31 PM (GMT 0)
Morning Michael. Yes, that's true. I hope that the HDR kicks every single PC cell square in the sac!!

I for one do believe that the docs can only do so much for each individual patient, and that the patient has a LOT to do as well. That's why this forum is so useful. All the research one needs to do to feel they are doing their part sits in here, and if it's one of those occasions where something new has come up, someone always runs in and posts the "HOT OFF THE PRESS" info.

Thanks for the reassurances BTW.
Posted 6/13/2016 2:41 PM (GMT 0)
I agree with Jack that it needs to be monitored.

But, you might make sure that this is part of their plan as it is not necessarily "will monitor" but "might monitor".

My doc doesn't monitor anything but PSA, not even T-levels.

JackH said...
..... will continually monitor various functions such as liver enzymes because in some men the HT will throw-off the natural balance. ....

Posted 6/14/2016 10:08 PM (GMT 0)
Captains Log....Star Date....77/120
The surgical nurse called me today to go over my day before, day of, and following day preparation and recovery plan.
So Tuesday is HDRBT day, as well as CT Scan before I go home for EBRT planning.
So work Monday till noon, then go home and spend the afternoon and evening on the throne.
Tuesday morning...up at 4am to fleet myself, then off to the hospital for a 7am rendevous avec Dr Morton and his crew. He promised that all his team members will have their coffee prior to the procedure so there will be no hands-a-shaking.
Plan is out of the OR by 10:30, then out of recovery before 1pm, then a scan before I head home.
Sounds like a full day!


eyes
Posted 6/19/2016 3:05 PM (GMT 0)
Captains Log.....Star Date.....82/120 (75% complete?????) T-MINUS 2 DAYS!!!!!!!!

So, 2 days till my Prostate HDR Brachy BBQ.

Looks like tomorrow is all jello, Chicken Broth, Water, And Poooooooo till the cows come home.

Last few days, I've been running around like an expectant mother trying to get my subconscious list of stuff done.

HFD guys!!!!!!!!!
Posted 6/21/2016 7:49 PM (GMT 0)
Captains Log....Star Date.....84/120
Well, HDRBRT is complete. Went very well, or so I am told. I slept comfortably through it. Went for my EBRT CT scan and Tattoo party straight after.
Home now EATING EVERYTHING!!!!!!

Got FloMax and the doc said to start tonght.

Oh.....did I mention IT HURTS WHEN I PEE!!!!!!!

LIKE MEGA OUCH
Posted 6/21/2016 8:47 PM (GMT 0)
Newt-

Congrats on finishing Phase 1 of the mission. I'm sure the pee-pain will be gone soon, but you might want to try pyridium. It's available OTC in the US - you may need a scrip there. Be careful - it stains (don't wear white underwear while taking it).

- Allen
Posted 6/21/2016 10:52 PM (GMT 0)
Hi TA.....thanks for the info. I'm heading to the pharmacy in a bit to pickup a script and I'll ckeck it out.
Posted 6/22/2016 11:20 AM (GMT 0)
Captains Log.....Star Date......85/120. (T+1)

Slept pretty good last night. No running to the bathroom at all. The generic FloMax kinda sux. Had a lot of plapitations.
I've come to the conclusion that it must have been a rookie that installed my cath for the proceedure. The majority of urination pain is the tip of my johnson to about an inch or so inwards. I'm thinking it was installed with a grappling hook! (TIC) It was a little better this morning though.
I iced the area most of the day yesterday, but tried to stay as active as possible. Went for 3 walks to the mall and pharmacy and ate everything I could find. My mini pad was a little messy yesterday, but clean as a whistle this morning. If not for the anestethic after effects, I'm pretty sure I could have gone to work afterwards, which is an amazing thing!
Started my day today with 4 fresh baked croissants and a large glass of apple juice. Today's plan is rest, fix the shower head, and go to the marine shop that's fixing my boat gelcoat and see how it's going. I want to put it in the water this weekend.
My first 9 EBRT sessions are booked starting 5th of July. I've requested end of day sessions so that I can work through the treatments and stop in for them on my way home each day. Let's see
how that works out holding in my urine in rush hour traffic. Follow up appointments are booked with Dr Morton every Friday throughout the treatment, which I find very comforting.
I think I heard Dr Morton say after the procedure yesterday that it was 16 catheters inserted, and a total of 50 gy delivered. Seeing that I'm using the MyChart app, I should be able to read the full clinical report sometime today.
Interestingly, while I was reviewing EBRT prep and the HBRBT after care materials with the post op nurse Peggy yesterday (she is extremely good at her job by the way), the looming HT question came up. At that moment, Dr Morton came in. She asked if she should be planning my next Lurpon shot, and Dr Morton said, "No....he only needs the one-time 4 month shot." WOOT!!
Let's hope THAT doesn't change!
That's my update for today.
PS: Going to ask if FloMax is really necessary. I.don't like that drug much.

Newt Out

Read the clinical notes already. HDRBRT was 1500 cGy and EBRT plan is 4600 total cGy with 200 cGy per session.
Posted 6/22/2016 5:58 PM (GMT 0)
It takes a couple of days for your body to get used to Flomax. After that, the lightheadedness, particularly when standing up, should diminish. If not, try Rapaflo. I think you'll be very happy you're taking an alpha blocker after a few days.

I was told to drink the water 20 minutes before radiation. So if you can get there a half hour early, that might be better than holding it in in traffic. Or maybe just sip from a water bottle on your way.

So your HDR boost was 15 Gy (I think Toronto does it in a single fraction) , not 50 Gy as you originally wrote - whew! I was worried for a second. When added to the IMRT, that's equivalent to 118 Gy if it had all been delivered as IMRT in 2 Gy increments -- enough to melt the Starship Enterprise. That's 48% higher than the maximum of about 80 Gy that could have been delivered with IMRT only. You can see what a powerful tool this combo therapy is.

Don't forget to exercise vigorously throughout.

- Allen
Posted 6/22/2016 7:04 PM (GMT 0)
Hi Tall Allen. Correct. The HDRBRT was 15 Gy total dose. The EBRT will be 46 Gy total.
Spoke to Dr Morton today and he said if my stream is fine, then no need to take FloMax. It wasn't lightheadedness that was the issue. Palpitations....like bongo drums, and my kidneys were killing me this morning.
So far, I have to say I am very happy with the immediate recovery. Let's hope that doesn't change in the next few days.
Do you think that my bbq prostate will swell in the next couple of days where FloMax may be a real need?
Posted 6/22/2016 7:34 PM (GMT 0)
Urinary retention (when the prostate swells blocking flow) is a very real possibility with the multimodal therapy. It usually begins with a weak or difficult to start stream, and streams that stop and start.There is some evidence that prophylactic use of alpha-blockers is better than trying to reduce it afterwards. (NSAIDs may help too.)There are about a dozen alpha blockers on the market, and their side effects vary with the individual. I found Flomax didn't work well for me but Rapaflo did. Sometimes urologists get samples from the drug companies - you can ask your doctor if he has some for you to try. They will all reduce your BP to some extent (they were originally developed for that purpose), some more than others. Your heart has to beat more strongly when your BP is low.

- Allen
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